Case Intake Report in Counselling Session.
Client Information:
– Name:
– Sex: F
– Age: 65
– Date of Case Opened: 3 Oct 2018
Personal Background:
– Has been suffering in depression for over than 10 years, from 2008 (3 years after divorce) until now.
– The relationship with the closed people (Her daughter, her 8 siblings) was getting worse and worse after her divorce, as her mindset and thoughts was abnormal at that moment.
– Get her foot in the door 6 months ago, tried to deliver her feeling and share her daily life with her daughter
– Her situation of depression has been getting better since her first time to join the worship in Pastoral of hospital 6 months ago.
– Live alone and sometimes go to visit her 90-years old mother who lying in hospital now.
Case Background:
– Divorced since 2005 with unknown reason unexpectedly. Client was shocked and unacceptable on it because she had a family trip happily for her daughter’s undergraduate graduation ceremony in US before her husband raised to divorce.
– She felt no one understand her even her daughter, but actually she has never tried to express her thoughts and feelings out.
– She felt guilty for her mother as she took care of her ex-mother-in-law for more than 10 years before divorce with her ex-husband but rarely took care of her mother.
Strength:
– Still have chance to take care and show her love to her mother as her mother is still alive even 90 years old.
– Still have chance to keep a good relationship with her daughter
– Religious can be her strength
– She is a kind-hearted and independent woman, not willing to get any subsidy from government
Weakness:
– Hard to express her feeling and thought clearly and systematically.
– Easy to trust people without logical judgement.
***For this report***
This is the case intake report which supposedly to write up before any intervention plan apply. The intervention plan I would be planning to use is Reality Therapy for the following purposes:
– Look forward, don’t fixate on the past
– Use her past successful experience to enhance her strength
– Enforce her strength and decrease her weakness
Also, Defense Mechanism and other related counselling theories could also mention in this report.
Report Structure (Please follow the structure as below):
1)
Literature review on etiology of client’s problem.
2) Literature review on possible intervention method
[A2]: It means the cause of the problem. You need to consult literature to see if there is anything describing or explaining the problem of your client. You may also apply different theories to explain the problem. First of all, you need to look at the developmental task of your client. Then you may use social ecological perspective to describe how the environment together affecting the person. Then you may apply other related theories to describe the issue.