Emotional Intelligence Reflection About the Patient

Client (first initial only) D Clients age __ 52_____

Client diagnosis bipolar disorder characterized by manic state and disorganized thoughts.

Setting/context (describe)

My interaction with the client took place in the psychiatric clinic. During my first day in the psychiatric clinic, the client approached me and I welcomed her to sit down before I engaged her in a conversation. The client responded well by taking a seat and talking freely with me throughout the period of the conversation.

Goal of Interaction: The goal of interacting with the client was to establish experiences that made her exhibit manic moods of bipolar disorder using therapeutic communication. Given that it was my first day in the psychiatric clinic, I was really scared and nervous since I did not know how to apply therapeutic communication. Therefore, to overcome nervousness, I created a rapport with the client and cautiously thought about the questions that I formulated and used in the therapeutic communication. Overall, I wanted to gain empirical experience in the use of therapeutic communication since I have never interacted with any client in a psychiatric clinic.

Student Interaction

Client Interaction

Self-Awareness
Analysis

Social Awareness/Client Analysis

1. Hi, My name is S. (smiling and shaking hands with eye contact)

2. How are you feeling today? (eye contact)

3. Can you tell me more about it? (eye contact, and fingers interlocked)

4. (I said Why I murmured but she did not hear me, so I moved on to the next question). Can you please elaborate more on what you mean by seeing so many cops?

5. What was your reaction? (I was constantly thinking about what to ask next, legs started shaking). And I almost asked why question and then took it back.

6. How does it help you? Any specific music to hear? (Asked with curiosity in my tone and nodded my head).

7. Do you feel any difference since you came here? (eye contact).

8. Can you please tell me more about it? (I maintained my eye contact, and asked with a little smile)

9. Kill through air? (and used my hands to communicate, Eye contact)

1. I am D (while pulling the chair to sit)

2. I am crying a lot(clearing her right eye and started choking)

3. My neighbor killed himself and I was horrified, thinking this never happened to me before. I started panicking and talking constantly without a pause. Seeing so many cops was terrifying (started smiling).

4. There were about 10 police cars and it is scary to see it happen in your neighborhood (munching on chips and rolling her pants until her knees with one knee against her chest).

5. Nobody was telling me anything, until my nephew who lives down my street came over and told me what happened. Then I put on the high music and started dancing. Music was loud and I was dancing to console myself (Rubbing her watery eyes).

6. Just any music, I love to dance so I become overly hyperactive and my husband could not control me, and I was brought her. (PCA was checking her blood sugar, she told her to prick in the middle because sideways hurt). And then she maintained eye contact with me.

7. Doctor had not come to see my since I have been here. It has been three days, and he is giving orders over the phone and nurse is following them. I talk a lot and cannot stop talking. (smiling and her eyes were brightening)

8. I was shocked to find him killed. You never know whats going on may be somebody is cooking some chemicals and trying to kill us through the air (while pulling her hair back and maintain her posture)

9. You know chemicals can go in the air and kill me.

1. I started the interaction by welcoming the client and introducing myself usingself-offer technique. I informed the client my name and shook her hand while smiling and maintaining eye contact. Since I felt nervous, I decided to create a rapport to dispel fears so that I could converse freely with client.

2. I used broad opening questionin trying to ascertain how the client felt. I think the choice of the words used in broad opening question, how are you feeling today? was appropriate because it prompted the client to express her feelings freely without any restrictions. However, I was shocked when the client started chocking because the question elicited her emotions. I think a better question could have been, how are you fairing today?

3. As the client stated that she has been crying a lot, I pitied her and used exploring techniquein questioning her to give more information about her condition. For I wanted the client to describe her situation extensively, I thought that I should let her expound on issues that she has been grappling with in her life.

4. Owing to anxiety, I wondered what made her panic and became terrified, and I requested an explanationby asking Why? I realized that requesting an explanation using the words Why? was nontherapeutic technique. For I felt out of context, I decided to rephrase my question using more specific words and context. I changed my tact thoughtfully and sought clarification about the effect of seeing many cops in the neighborhood.

5. I asked evaluation questionin a bid to understand how she reacted to the sight of police cars and cops in the neighborhood. However, I became confused for I struggled to think about appropriate question while my legs kept shaking. Eventually, I perceived that the evaluation question was appropriate because it captured the context and mood of the conversation.

6. As I was curious, I used direct questioningin a bid to understand the importance of music and the nature of music in consolation. I tried to perceive how music could have consoling effect on the client. Although I have felt the soothing effect of music, I wanted to know the nature of music that consoles.

7. I employed evaluation question in trying to assess the progress of the client since she started seeking help from the clinic. I felt nervous when I asked the question: Do you feel any difference since you came here? while maintaining the eye contact to get the attention of the client. However, I noted later that I did not formulate the question well because the client did not answer it as I expected.

8. Since the client did not give satisfactory answer about her progress, I posed to her a clarification questionso that she could shed more light on her progress in response to care she received from the clinic. I felt confident and I decided to maintained eye contact and gave her a friendly smile to attract her attention.

9. I voiced doubtby prompting the client to explain how death occurs through the air. The belief that people could cause death by placing chemicals in the air surprised me. I used hands and eye contact to express surprise in a bid to let the client describe how people could cause death through the air using chemicals. I noted that my surprise intimidated the client in that she did not explain well how people could cause death through the air.

1. The client responded affirmatively by telling me her name and comfortably pulled the chair and sat on it. From her responses, the client appeared friendly and felt very comfortable.

2. The client became emotional because the question touched her feelings. I supposed that the emotional aspect indicated that the clients experiences were very overwhelming. It appears the client thought that crying and choking were best ways to illustrate her trauma. The emotional nature of the client limited her response to the question asked.

3. The client appeared traumatized when she narrated about the death of her neighbor and the sight of cops in the neighborhood. However, the client was emotionally strong this time because she managed to smile at end of her the traumatic narration. I think the client fears death and associates cops with bad omen for she panicked and became terrified. The client clearly indicated that the death of her neighbor and the sight of cops triggered manic state of bipolar disorder because they made her panic and talk continuously.

4. The client seemed terrified because she narrated that police cars and cops looked scary. It seems that the client thought that the cops came kill them in the neighborhood for they looked scary. In this view, the statement of the client shows that scary look of the police cars and cops elicited manic state of bipolar condition. The act of munching chips and rolling her pants deviated the attention of the client from the conversation.

5. The client emotionally explained how she started exhibiting abnormal behavior. However, her explanation was limited because she concentrated on rubbing her watery eyes. The client imagined herself in helpless situation because she started rubbing her watery eyes. From her explanation, it was evident that the sad news about her neighbor killing himself shocked her and made her play loud music and dance to console herself. Hence, it shows that reaction of the client to the traumatic experience triggered manic state of bipolar disorder.

6. The client responded freely that any music could console her because she loves dancing. From her explanation, it was apparent that the traumatic experience, music, and dance are factors that contributed to her hyperactivity. I empathized with the husband for he could not control the client when she was hyperactive. The interaction of the client with PCA showed that the client was able to maintain conversation and talk to other people at the same time.

7. In response to my question, the client was frustrated and confused because she answered it indirectly by avoiding the question and blaming her doctor for being absence. Essentially, the client thought that her doctor had neglected her for she lamented that her doctor had not come to see her for three days since she reported to the clinic. Furthermore, the client responded while smiling and brightening her eyes, which implies that she is strong and hopeful that the doctor has the doctor would heal her. The assertion that the client talks continuously showed that she still suffers from manic state of bipolar disorder.

8. The client was traumatized because of the shocked she received when she learned about the death of her neighbor. From her response, it was evident that the death of her neighbor instilled great fear in her. The client believed that somebody was plotting to kill her by placing deadly chemicals in the air. Her gestures were normal, but her statements indicated that she felt insecure in life.

9. The response of the client shows that she harbored fears of death and she felt very insecure among people. The client imagined how chemicals in the air spread and cause death. Therefore, the conversation showed that the client lived in great fear, which triggers the manic state of bipolar disorder. However, the client has limited understand of death because of her naivety.

Relationship Management Reflection

Reflection of the clients responses shows that paranoia was a dominant theme, which I identified. Paranoia was associated with the traumatic experiences of her neighbors death, the sight of cops and their cars, and homicide. When I asked her how she felt, the client responded by citing the traumatic events that happened in her neighborhood. The client stated that she cried a lot because my neighbor killed himself and I was horrified, thinking this never happened to me before. I started panicking and talking constantly without a pause. Seeing so many cops was terrifying. Since the client experienced such traumatic events for the first time, they traumatized and made her develop obsessive thoughts about death. Using broad questioning, requesting an explanation, seeking clarification, exploring views, and evaluating responses prompted the client to describe her condition effectively.

When I asked her how she reacted to the traumatic events, the client said that people did not inform her about the events until when her nephew narrated to her what transpired. The client stated that she responded to the traumatic events by dancing to a loud music because it consoled her. When I sought to find out the role and the nature of music she played, the client responded that, just any music, I love to dance so I become overly hyperactive and my husband could not control me. Her response showed that the client understood her condition of hyperactivity well because she turned on a loud music, danced to it, and talked endlessly.

During the interaction, the client had a tendency of avoiding questions, which I posed to her. When I asked if she felt any difference since she came to the clinic, the client avoided the question by answering that, doctor had not come to see me since I have been here. It has been three days and he is giving orders over the phone and nurse is following them. In this view, I could have asked the client how the nurse has helped her so that I could inform her how the orders from the doctor have benefited her. When I prompted her to explain about her progress, she changed the topic to the death of the neighbor and introduced her fears. In response to my question about progress, the client stated that, I was shocked to find him killed. You never know what is going on may be somebody is cooking some chemicals and trying to kill us through the air. Moreover, when I ask the client to elaborate how one could kill using chemicals in air, she responded casually by saying that chemicals could spread in the air and kill her. To prevent her from avoiding my questions, I should have used a direct question, which is specific to a certain behavior or action.

Self-Management Reflection

I demonstrated genuineness and empathy in the manner I handled the client from the commencement of the conversation until the end. When I commenced the conversation, I welcomed the client by introducing myself and letting her introduce herself. I questioned the client keenly by formulating therapeutic statements, which enabled her to answer my questions well and interact in a friendly manner. I demonstrated genuineness and empathy when I asked the client how are you feeling today? Subsequently, I expressed my concerns emphatically when I questioned her regarding her experiences and progress in response to the therapy she received from the clinic. The use of nonverbal communication such as eye contact, smile, and hand gestures enhanced our conversation because I was able to keep the client engaged throughout the period of the interaction. I created rapport and won the trust of the client because she was able to communicate freely with me without any reservations.

Since the conversation was emotional, I used diverse strategies to manage emotions. At first instance in question #2, when I asked the client about how she progresses with therapy, the client started to cry and choke. I used exploring technique in questioning and expressed empathy by crossing fingers and maintaining eye contact. Evidently, the client stopped crying and choking and resumed our conversation as she narrated her traumatic experiences. At the second instance in question #6, when I asked the client about her reaction to the traumatic experiences, the client started to rub her watery eyes for she felt overwhelmed by the emotions. In the management of these emotions, I used soft tone to ask the next question and nodded my head in approval of her emotions. The outcome was positive as the client stabilized and continued with the conversation.

The interaction enhanced my knowledge of communication style for I was able to realize my strengths and weaknesses. The strengths of my communication style are that I was able to formulate therapeutic questions and create effective rapport for conversation. However, the weaknesses of the interaction are that I was passive and did not alleviate her paranoia. Although the client played an active role in the conversation, I was somehow passive because I did let the client to avoid and guide the course of my questions. In many instances, I found myself seeking clarification, explanation, and exploring what the client narrated. As the client expressed fears, which emanated from the death of her neighbor, the sight of cops, and fear of death, I responded with surprise and shock. During the conversation, I interacted with the client casually for I did not help her to overcome the fears she had.

Knowledge gained regarding self is that the experience of interacting with the client has enabled me to formulate and utilize therapeutic statements effectively. However, I failed to be objective because the client diverted my attention and made me digress from the questions I asked. Throughout the conversation, I did not help the client because I merely listened to her experiences. Moreover, I neither supported nor opposed her feelings, behaviors, and fears. In the end, the client did not gain significant benefits apart from the compassion and empathy I expressed during the conversation. Overall, I have improved in the aspect of applying therapeutic interpersonal techniques in clinical environment.

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