Each student will present their Qualifying Demonstration of Clinical Expertise that presents the outcome of your learning in this course regarding how to integrate spirituality into clinical practice. The purpose of this assignment is for you to demonstrate your ideas about addressing issues of spirituality in therapy with your clients. This quarter you have reflected on your ideas associated with spirituality and this presentation demonstrates the resulting methods you have been using for addressing spirituality in clinical sessions.
Specific Assignment Requirements
- Provide a PowerPoint presentation including 2-3 references to the literature.
- Your presentation should include the following information.The conceptual framework that guides your work with spirituality. Please use Attachment Theory and somatic psychotherapy. References to the literature that support your framework. Please find peer reviewed research on Attachment theory and spirituality in practice and Somatic Psychotherapy Specific steps or practice guidelines that you apply to your clinical workBrief slides that illustrate the guidelines you’ve identified and explains key clinical choices as they relate to gender, culture, power, and the larger societal context.Conclusions regarding what you have learned? What are the next steps for you? How this work differs from other clinical approaches to the kinds of cases that you present here? Talk about the addition of implementing spirituality into clinical practice.
A 3-5 page summary of the key points in your presentation with a References page should be submitted to the instructor through Canvas along with your PowerPoint Presentation. Your PowerPoint and 3-page summary are due before class the week you are presenting
***Review the rubric for this assignment to gain a better understanding of the expectations for your presentation.
- Demonstrate ability to work with clinical cases from a systems/relational perspective using spirituality concepts.
- Demonstrate a personal integration and application of spirituality in clinical work.
- Illustrate use of relevant systems/relational concepts to organize work.
- Illustrate how to attune self in relation to clients’ sociocultural and contextual issues such as gender, culture, socioeconomic status, sexual orientation, and/or religion, as spiritual aspects are explored.
- Demonstrate how spirituality research informs clinical decisions.
- Clearly show how use of spirituality is linked to actual practice.
- Show and explain how key aspects of discussing and/or invoking spiritual themes are applied over multiple sessions in a case or in multiple cases.
- Identify key spiritual clinical choices that arise and how they see them linked to outcome.
- Demonstrate awareness of how their approach to calling forth spiritual themes may be distinguished from other possible ways to address this kind of clinical issue.
- Present in a professionally appropriate, formal way.
QUALIFYING DEMONSTRATION
• Name
• School
• Class
CLIENT DEMOGRAPHICS
Client is a 38-year-old, Cisgender, Heterosexual Female. She
is married and has two young children. Client identifies as
Christian and attends church regularly as well as a weekly
bible study group. She is a retired model and currently a
stay-at-home mom. Her husband is in the Navy. Client was
diagnosed with Endometriosis and had a hysterectomy in
2021. Client has an extensive history of developmental
trauma; including physical and emotional abuse from both
parents, molestation as a child and sexual assault as a
teenager. Both parents were alcoholics and mom was also
addicted to opiates. In 2013 her father died of cancer and
five days later her boyfriend in which she had a 10-year
tumultuously abusive relationship with died tragically. Her
mother also passed away in 2019. Client stated she
struggles with intimacy and ” doesn’t like to be touched,
unless she’s drinking.” However, client is now three months
sober.
PROCESS ISSUES
CLINICAL CONSIDERATIONS
MY REACTION TO THE CLIENT
• Third session with client.
• Complex Trauma
• The client is likable.
• Disconnected from her body, client stated
“ I have never felt safe in my body.”
• This is someone I would be friends with.
• Medical History
• Hysterectomy in 2021 due to
Endometriosis.
• For This Session
• Identify core material through
mindfulness.
• Content Goals
THERAPEUTIC INTENT
• Guiding client to define her own
direct experience through the
intrapsychic exploration of
mindfulness.
• Process Goals
• Looking at core material and
how it shapes her present
experience.
• Therapist: Let’s just take a moment to see where you
are. Kind of check in, to see what’s here with you now
that you might want to work with.
• Client: Well, I really don’t know.
• Therapist: That’s ok, let’s just take a moment to go inside
and see what comes up for you.
TRANSCRIPTION
• Client: So, I am really struggling with my husband leaving
next month and having to do it all and be alone with the
kids. It’s always a lot to handle with no help. At the same
time, I am used to doing it all on my own. But I just get
angry you know! Lately it just feels like he’s smothering
me, I don’t want to be touched or bothered with any of
it!
• Therapist: hmm, on the smothering thing, it sounds
reasonable to feel hemmed in when you’re so used to
being self-reliant with him away. But also, this kind of
push pull dichotomy as you mention “having to do it all
and be alone with the kids.”
• Client:Yes, I just feel like this fire starting to build.
•
• Therapist: I see, so maybe exploring in you this fire that’s starting
to build seems like a good place to go today?
• Client:Yeah, let’s. I mean it’s probably nothing. I am just
overreacting.
• Therapist: How about you take some time to just imagine the
last time your husband came onto you, and it seemed too much.
TRANSCRIPT
CONTINUED
• Client: [She closes her eyes, slows down, turns her awareness
inward toward her felt present experience. Almost immediately
her head starts shaking, and she shows emotion in her face and
voice.] Oh, it was awful! I just feel like nails on a chalkboard
whenever he tries to touch me, and I know it’s not fair to him.
• Therapist: So just remembering the last time is quite activating,
huh?
• Client:Yes, it’s like the anticipation of being intimate with him is
what really pushes me away. I feel like he just doesn’t get it. He’s
always there and I just need my space.
• Therapist: So, let’s just study closely what that anticipation
evokes in you for a moment. I want you to stay present with
your felt experience, but also take a step back and see if you can
notice and be curious about it. Almost like the observer’s seat, as
opposed to simply being consumed by it.
TRANSCRIPT CONTINUED
• Client:Yeah, I notice some sense of resentment and I am almost hot. My cheeks and arms are warmed up.
• Therapist: Uh huh. Maybe if you just stay with the resentment, and be open and curious, you might be able to sense
more about it.
• Client: It’s like a voice is telling me “unfair”, or “I am not being heard!”
• Therapist: Like you have no voice?
• Client:Yes, even if I did speak up it wouldn’t matter. I remember when I was little, and my dad wouldn’t let me play
with the neighborhood kids. It feels like that. Everyone else was able to play but I had to stay home, and they didn’t
pay any attention to me anyway. They were always working or with their friends and partying.
• Therapist: Oh, a memory. How old were you at this time?
• Client: Five, maybe six.
• Therapist: As you view that five or six-year-old girl from the observer’s seat, what do you sense that she most needs
that she is not getting in her situation?
• Client: She needs to know that it is unfair for her dad to limit her, and then scare her into not being able to speak
or express herself. And she needs to know that sometimes people in power try to hold you back, but she has
enough strength to find the freedom to be herself.
TRANSCRIPT
•
Therapist: Ok, with that same compassion and presence
communicate that to her in any verbal or nonverbal
ways so she really gets your presence.
•
Client: [Starts to cry and takes a few minutes of silence.]
•
Therapist: Difficult, huh?
•
Client: Yes, it is. But I think she is getting it. I think it will
take some time getting used to.
•
Therapist: It’s important to keep following up with her.
Perhaps through journaling later when you get home.
Even a conversation with your husband that
acknowledges both your knowledge of his care and your
need for freedom to use your own strengths.
•
Client: Yes, I need that. I feel much clearer now about
that anger. Sometimes it just comes up too hard, too
fast. So, I can sit, check in, and get more distance before
trying to sort things out.
•
Therapist: Yes, just slowing yourself down more often in
order to experience what is really going on. You begin
to establish more presence and more compassion for
yourself. You can then identify your emotions as they
originate as sensations in the body.
•
Client: ahh, yes. Thank you. [tearful]
REFLECTIONS
• What are you wondering about
• Power dynamics
• I am wondering what role her spirituality plays in this sense of
powerlessness in her relationships. Especially with men.
• What role does her spirituality play in her mental health? What
does she need to align with.
• How can she increase her own sense of self-worth through her
faith.
RESULTS
GOALS FOR NEXT SESSION
ALTERNATIVE METHODS
• Continue to guide the client toward the
body. Continue to explore spirituality
through mindfulness.
•
EMDR
•
Yoga Therapy
•
Parts and memory work
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