Case of Todd: Wellness, Resilience, and Treatment Planning Goals

Case of Todd: create a brief treatment plan at least 3 short-term and 3 long-term goals to promote wellness and resilience with this client. Discuss how you as the counselor will assist the client in reaching these goals. At least 250 words.

Formatted text of the transcript in the attachment.
--------------

Dr. Sylinda Gilchrist
Hi Todd. What brings you here today?
Todd
Well, I have been feeling pretty stressed lately, maybe a little down, just noticed I am not pretty much not the same as I used to be. I just feel overwhelmed at times. I am not really motivated and that is pretty much it. I retire probably about two years ago and just do not have the same kind of level of go that I did before.
Dr. Sylinda Gilchrist
(Reflection/Understanding Problem) So, you are feeling kind of down because you retired?
Todd
I do not think it is so much because I am retired. I do not know. I just think I do not feel motivated and it might be because I am not as focused as I was in the military, I always had something to do, I knew where I stood, I had responsibility, people depended on me, and those things have changed, that might have something to do with it. I do not know.
Dr. Sylinda Gilchrist
(Reflection/Understanding Problem) OK, so you feel a little down because you retired recently from the military and you had more responsibilities and that your life has kind of transitioned to a change.
Todd
Yes, that is pretty much it. I mean, it might also be because I am really focused on being a single parent right now and school, and I noticed that if I am not doing that, I am really not doing anything else. But, when I was in the military, I had friends and I had a big support group and I always had something going on and it is just not that way anymore.
Dr. Sylinda Gilchrist
(Reflection/Understanding Problem) So, it sounds like since you have retired, you lost a lot of your friends and that support system that you had and while you were in the military is now gone.
Todd
Yes ma'am I would think that that would have a lot to do with it. I am pretty much at cave dweller now. I do not much go out or anything like that. So, I do not have the—I had a good support group when I was in the military because I was always working, but since I got out, they are all transient. I really do not talk to or see anybody that I used to work with, so it is just pretty much me and my 11-year-old.
Dr. Sylinda Gilchrist
OK, so what would make you happy or feel connected again?
Todd
I do not know. I guess getting out and getting involved with other people, talking to them maybe. I just really do not know how to do that, I am not sure how to just go out. I know when my son was playing soccer, I did not feel as bad as I do now, and just because I was talking to the adults on the sidelines while he was out there playing. I had a pretty good group of friends then, but he has not played the last two season sort of drifted apart with me doing school and stuff like that.
Dr. Sylinda Gilchrist
(Reflection/Understanding Problem) So, it sounds like you felt better when you were involved in activities around adults or activities that involved your son that allowed you to communicate with other adults.
Todd
Yes, I mean, that was a benefit of going to the soccer. I mean, it does not really have to be with my son. I mean, that is always great, but I mean, just the adult interaction would be probably better than nothing. I am not really talking to anybody.
Dr. Sylinda Gilchrist
(Clarifying "Wants") So, it sounds like that what you would like to have is more interactions with adults and develop more support mechanisms or support from other adults that you had when you were in the military.
Todd
Yes, that sounds like that would benefit me. I think it all started occurring to me when I like throughout my back and I realize that I do not have the option to be off or have a sick day. I am a full time parent now and I have to go to school, I cannot miss classes or exams or anything and it occurred to me. I do not have anybody in call to step in.
Dr. Sylinda Gilchrist
(Encouraging Client to Focus on Wants) OK, so what would you want? What would make you happy? What would support look like outside of the military?
Todd
Probably some kind of camaraderie, but I am really apprehensive about being obligated. I do not want to be in a position. I think that is what holds me back. I do not want to be in a position that I have to do anything. I want to be able to cancel out if I am going to meet people on a Thursday night if something comes up because I end up feeling really guilty if I do not meet my obligations and I just do not want to be pulled into anything. In the military, I had to do what everybody else said and I guess that maybe I am shying away from that, so I guess I want the best of both worlds, being a group but not to be stuck with it all the time.
Dr. Sylinda Gilchrist
(Reflecting "Wants") So, you want some interaction or interaction with adults, but you do not want a required obligation.
Todd
Right, because for a time there, I was getting involved with the church and they were calling like twice a week and it was like this—it would stress me out because I felt obligated and I just do not want to take any time away from school or my son, and that is the most important to me.
Dr. Sylinda Gilchrist
(Clarifying "Wants") OK, so we are going to look for maybe activities or look for something that will allow you to interact with other adults and increase your social circle, but no time restraint, no time obligation.
Todd
Yes, that would be the ultimate because like I said that I end up just severing ties if it becomes too overwhelming and I do not want to have that stress either. So, I would like to have some kind of an adult interaction that I am not—I do not feel required to attend.
Dr. Sylinda Gilchrist
(Asking Client to Evaluate Current Choices) So, what are you doing to get that adult interaction?
Todd
Well, I am busy in school right now and my son has a lot of school projects.
Dr. Sylinda Gilchrist
Outside of school?
Todd
Well, I guess if I am outside the school, I am pretty much focused on my son and doing stuff with him right now.
Dr. Sylinda Gilchrist
(Pushing Client to Evaluate) You kind of mentioned before that you are a cave dweller. What does that mean?
Todd
I guess I really do not go out unless I have to go to somewhere like to the store, the school or anything like that. I guess I am either inside unless I am going to the gym or something like that. I do not really much get out.
Dr. Sylinda Gilchrist
(Stressing Client's Current Choices) So, you are kind of choosing to kind of stay in your cave?
Todd
Well, it is not a choice. I do not have anything else to do. I am not making that choice. It is just there is nothing else out there.
Dr. Sylinda Gilchrist
(Challenging Client to Evaluate Choices) But, if standing in your cave is that getting you what you want with increasing your friends?
Todd
No, I guess not. I guess I am really not creating opportunities to meet people.
Dr. Sylinda Gilchrist
(Focus on New Choices—"Doing") So we really have to kind of possibly look at other ways to develop more of a support circle for you.
Todd
Yes, that would be good as long as—like I said, I am very—I guess paranoid about getting pulled into something and being stuck. I just do not—I have to go to school three nights a week and I do not want to have the other four nights of the week—
Dr. Sylinda Gilchrist
(Encouraging Finding New Ways of Doing) Obligated to something—so what is some ways you think you could go and meet people or some activities you could try, some groups, military groups, single-parent activities, church groups, are there some activities out there or places you could investigate?
Todd
I guess I could probably do a web search for local kind of things. I know you could probably just type in Virginia Beach activities or something and I could probably find all kinds of stuff. I could look into that. I mean, there might be some single-parent type groups or something like that. I do not know. I never thought of that before.
Dr. Sylinda Gilchrist
(Reflecting/Reinforcing Choices) OK, so you can go on the Internet and search for some activities in this area. Would it have to be an activity involving your son?
Todd
No, I mean, we do things together, but—the adults—does not have to involve him.
Dr. Sylinda Gilchrist
(Reflecting/Reinforcing Possible Choices) OK, so one plan we can do: We can actually go or you could go search the internet and look for activities that—or clubs that you may be interested in that will help you increase your social circle and introduce you to other people. (Challenging To Find More Choices) Are there other things that you could possibly do?
Todd
Well, there is a recreation center down the street that my son and I used to go to in the summer, and I remember there is all kind of fliers and pamphlets and all kinds of stuff there with activities. And, I never thought of that before I have seen them. I mean, they are everywhere and there is a lot of interesting activities that I did not even consider before. That might be an avenue to take and that is a great idea.
Dr. Sylinda Gilchrist
(Reinforcing New Choices) And so, now we have two activities that we can really do to kind of increase your social circle. We can actually search the internet as well as go to the community center and see what fliers and activities are available for people living in your area.
Todd
Yes ma'am, that sounds like a great idea.
Dr. Sylinda Gilchrist
(Reinforcing Getting Needs Met) OK, and so hopefully, we can move you out and actually allow you to be happy and content again.
Todd
Not living in the cave anymore.
Dr. Sylinda Gilchrist
Not live in the cave anymore.
Todd
Yes ma'am, it sounds good.
Dr. Sylinda Gilchrist
Well, thank you for coming in.
Todd
Thank you Doctor, I appreciate your help.
Dr. Sylinda Gilchrist
You are welcome.
Dr. Ed Neukrug
Well, that was excellent. I was really impressed with how you worked with Todd. As I was watching your work with Todd, I was noticing that how important it was for you to build a relationship with him and that you were using a lot of empathy and good listening skills. I guess I was thinking in a way that is kind of similar to Vassar's notion of commitment to your client. You really want to connect with your client and feel a sense of commitment to him. Was that something your thoughts about what was going on?
Dr. Sylinda Gilchrist
Yes, and I think it is important for you to connect and have the client understand that there is really a partnership, it is a collaborative process that we are working together to help him solve his own issues and really take control over his life so that he can get what he wants out of life and really develop that world that he is seeking to obtain.
Dr. Ed Neukrug
In reality therapy, and as now called on choice theory, one other things that they talk about is, is he getting his needs in that, and I think specifically to talk about needs and love and belonging, power, freedom, fun and survival. And, I guess I was thinking that that is what you were thinking as you were working with him, is that true?
Dr. Sylinda Gilchrist
Yes, and I think in the military provided a way for him to get all his needs met. He had the power with the job and his friends and social system in the military allowed his loving belonging to all of those needs to get met, and then, once he retired and was placed back into the civilian world, he had to find another way to get those needs to met. And so, for 20 years, the military kind of provided a end-all, it was a very tight system that he really did not have to do much because everything was already there for him. And so, now he is transitioning into the civilian world where he has to find a way to meet his needs of power as well as belonging with and finding new friends and connecting to the community. So, I think that is really the struggle that he is having, how do you get the needs met in a new environment.
Dr. Ed Neukrug
Right, so then I saw you working with the WDEP system and it has to do with what does he want to get in terms of getting his needs met. What is he doing and how does he evaluate what he is doing and then developing a plan, is that right?
Dr. Sylinda Gilchrist
And that is pretty much what we did, and you know, I asked him what does he want, and he really wanted to connect and be happy and I think the end to that happiness was having social interactions with adults and friends and feel like connected again to the community. And then, we kind of went what are you doing, and he said he was a cave dweller, so he really was not doing what he needed to do to get that need met. And we kind of evaluated this, so being a cave dweller is that actually giving you, meeting you, and helping you meet your needs. And then, we developed a plan and that plan was to go on to the Internet and begin to look for social activities that will allow him to kind of increase his social interaction. So, that is kind of how you take a client through that process and help them to figure out what they want, evaluate, and see what they are doing, evaluate it and then develop a plan.
Dr. Ed Neukrug
And you did a wonderful job at that and I guess I am wondering what happens next? Next time he comes to see you, what does this leads to?
Dr. Sylinda Gilchrist
Well, we come back and we really evaluate the plan. Did he find activities on the internet, did he find activities going to the community center, and then we begin to go to the next steps. So, we completed the first part, what would be the next step of the plan. So, it is constantly evaluating the plan to hopefully get him to his end-goal. So, once we have activities selected, then the next step maybe participating some of those activities, and then hopefully, he will begin to increase his social network and begin to get his needs met.
Dr. Ed Neukrug
What would happen if he came back the next time and did not follow through on some of those suggestions that were made?
Dr. Sylinda Gilchrist
And then, you have to evaluate your behavior again. Why did you not, so do you really want to increase your social circle, maybe that is not really what you want.
Dr. Ed Neukrug
So, is that the process of showing that you are committed to him. You are going to stick with him and re-evaluate maybe what he wants.
Dr. Sylinda Gilchrist
Yes and choosing, this is a choice. Are you really committed to the change? You are choosing. You have the ability to choose your behavior. So by not following the plan, are you choosing to stay isolated, and that is a choice, so, really deciding; you choose and determine your destiny.
Dr. Ed Neukrug
I see, so really helping him see that he is making those choices.
Dr. Sylinda Gilchrist
Right, and he is in charge and control of his own behavior.
Dr. Ed Neukrug
It was excellent work. Thank you so much.
Dr. Sylinda Gilchrist
Thank you.