Linaroid-Psych AI Client:

Client in A Pocket: Panic Disorder : The Pensive Introvert : Reflecting Skills Outcome Evaluation and Termination Skills : Reluctance to Express Emotions Withdrawal

A therapy session simulation to improve Reflecting Skills Outcome Evaluation and Termination Skills skills for student consular by simulating The Pensive Introvert client personality with Reluctance to Express Emotions Withdrawal resistance type in Panic Disorder DSM Case.

Session:

[CONSULAR]: It's great to have you here. Is there anything in particular you'd like to discuss today?

[CLIENT]: Thank you for having me. I'm not sure where to begin, honestly. Lately, I've been feeling quite overwhelmed and anxious, especially since those incidents where I thought I was having a heart attack. But I know they say it's just panic, which is confusing and a little hard to accept.

[CONSULAR]: You're feeling overwhelmed and having a hard time accepting that what you felt was panic and not a heart attack. It must be really stressful to go through that. Can you share more about these incidents and what typically triggers your anxiety?

[CLIENT]: Yes, it's been very stressful. The first time it happened, I was at work, just doing my usual tasks, and suddenly, I felt like I couldn't breathe properly. My heart was racing, and I was sweating a lot. It felt like I was having a heart attack. Similar feelings happened a few more times under different circumstances, like while I was driving and even when I was asleep. After each episode, I was scared that it would happen again.

I've begun avoiding things that I think might trigger another attack—like driving and even drinking coffee. This constant worry and avoiding daily activities just adds to my anxiety. I feel stuck and unsure how to handle this.

[CONSULAR]: It sounds like you're really struggling with the fear of these panic episodes, to the point where you're changing your daily habits. That must feel very limiting. Avoiding situations, though it seems helpful, might actually reinforce your anxiety. Why not just try to face these fears head-on? Sometimes facing what scares us can help reduce the fear. What do you think about that idea?

[CLIENT]: I understand what you're saying, and logically, it makes sense to face these fears. But honestly, the thought of deliberately putting myself in those situations again just feels terrifying. I'm afraid of feeling that overwhelming panic again—it's not just uncomfortable, it's genuinely terrifying. I appreciate your suggestion, but I'm not sure if I'm ready to face it head-on just yet. Maybe we can find some other ways to approach this?

[CONSULAR]: You're right, jumping right into the situation might be too much, too fast. Let's try adjusting the approach. How about we explore some smaller, more manageable steps that could gradually build your confidence? Sometimes, gradual exposure combined with learning some coping mechanisms can make a big difference. How does that idea sound to you?

[CLIENT]: That sounds a bit more doable. Taking smaller steps feels less daunting than facing everything all at once. I'm interested in learning what coping mechanisms could be helpful and how we can apply them gradually. What kinds of steps are we talking about? Could you give me some examples?

[CONSULAR]: Definitely, starting with smaller steps is a great way to build your confidence gradually. A good initial step might be practicing relaxation techniques, such as deep breathing or mindfulness meditation, in a safe and comfortable environment. This can help manage anxiety when you begin to feel overwhelmed.

Next, we might try some brief and controlled exposure to the situations that trigger your anxiety, but only to a very manageable degree. For instance, if driving is a trigger, you might start by just sitting in a parked car, then eventually start the engine, and later move to driving a short distance in a low-stress environment.

Each step would be tailored to your comfort level, ensuring you feel ready to move to the next. How does this plan sound to you?

[CLIENT]: This plan sounds reasonable and it's reassuring to know that I can take it step by step at a pace that feels comfortable for me. Starting with relaxation techniques like deep breathing in a safe environment seems like something I could try without feeling too anxious, and gradually moving towards more challenging situations like sitting in the car sounds like a good progression. It makes me feel a bit more in control just hearing that there's a structured approach to dealing with this. Thank you for outlining these steps. I'm willing to give it a try.

[CONSULAR]: That's great to hear! Taking control step by step can indeed make a significant difference. It’s encouraging that you’re open to trying these techniques. As you progress, we’ll monitor how you feel and adjust the pace if needed to ensure it remains manageable and productive for you. Remember, the goal is gradual improvement without overwhelming yourself. If you have any questions or need to discuss anything throughout the process, feel free to share. We’re here to make this journey as supportive as possible for you.

Supervisor's Feedback for each Turn:

Consular Feedback

[CONSULAR]: It's great to have you here. Is there anything in particular you'd like to discuss today?

• Skill Used: Invitational Skills (Verbal encouragers)
• Rephrased: "I'm glad you could join me today. What specific issues would you like to talk about?"
• Feedback: This opening is welcoming but could be slightly more specific to guide the client in opening up about their concerns. It's always good to make the questions as open and inviting as possible to encourage client discourse.

[CONSULAR]: You're feeling overwhelmed and having a hard time accepting that what you felt was panic and not a heart attack. It must be really stressful to go through that. Can you share more about these incidents and what typically triggers your anxiety?

• Skill Used: Reflecting feelings, Paraphrasing, Questions (open)
• Rephrased: "It sounds like experiencing these intense episodes has been quite stressful and difficult for you to come to terms with. Could you elaborate on these incidents and perhaps identify some common triggers for your anxiety?"
• Feedback: Good use of reflection and paraphrasing to convey understanding. Scaffold your question to guide the client into deeper self-exploration which enhances the session's therapeutic goal.

[CONSULAR]: It sounds like you're really struggling with the fear of these panic episodes, to the point where you're changing your daily habits. That must feel very limiting. Avoiding situations, though it seems helpful, might actually reinforce your anxiety. Why not just try to face these fears head-on? Sometimes facing what scares us can help reduce the fear. What do you think about that idea?

• Skill Used: Reflecting feelings, Confrontation, Challenging Skills, Questions (closed)
• Rephrased: "I hear that adjusting your daily routines has become a way to cope with the fear of these episodes, which might feel very restricting. While avoiding these scenarios might seem beneficial, it could potentially reinforce your fears. Have you considered gradually confronting these fears to see if it might lessen the anxiety?"
• Feedback: While it’s important to challenge the client, ensure that you're not pushing them too fast towards confronting fears, which can be intimidating. Consider suggesting readiness and more open-ended questions to facilitate self-reflection and willingness.

[CONSULAR]: You're right, jumping right into the situation might be too much, too fast. Let's try adjusting the approach. How about we explore some smaller, more manageable steps that could gradually build your confidence? Sometimes, gradual exposure combined with learning some coping mechanisms can make a big difference. How does that idea sound to you?

• Skill Used: Validating, Advanced Reflecting Skills (Reflecting meaning), Assessment and Goal Setting, Questions (open)
• Rephrased: "Acknowledging that diving right into these challenging situations might be overwhelming, perhaps a more gradual approach could work better. Exploring smaller, manageable steps to build your confidence, alongside some coping mechanisms, could be beneficial. Would you be interested in discussing how we can implement this gradual exposure effectively?"
• Feedback: Excellent adjustment and offering of alternatives; however, ensure that suggestions are framed positively to inspire hope and collaboration. Frame questions to evoke further discussion and engagement.

Client Feedback

[CLIENT]: Thank you for having me. I'm not sure where to begin, honestly. Lately, I've been feeling quite overwhelmed and anxious, especially since those incidents where I thought I was having a heart attack. But I know they say it's just panic, which is confusing and a little hard to accept.

• utterance: The client expresses gratitude and openness about their confusion and difficulty in understanding their conditions, indicating good rapport and willingness to explore their issues.

[CLIENT]: Yes, it's been very stressful. The first time it happened, I was at work, just doing my usual tasks, and suddenly, I felt like I couldn't breathe properly. My heart was racing, and I was sweating a lot. It felt like I was having a heart attack. Similar feelings happened a few more times under different circumstances, like while I was driving and even when I was asleep. After each episode, I was scared that it would happen again.

• utterance: The client provides detailed descriptions of their experiences, which highlights their trust in sharing personal and vulnerable information. They also communicate the impact of these experiences on their emotions and behaviors effectively.

[CLIENT]: I understand what you're saying, and logically, it makes sense to face these fears. But honestly, the thought of deliberately putting myself in those situations again just feels terrifying. I'm afraid of feeling that overwhelming panic again—it's not just uncomfortable, it's genuinely terrifying. I appreciate your suggestion, but I'm not sure if I'm ready to face it head-on just yet. Maybe we can find some other ways to approach this?

• utterance: The client shows openness to the counselor's suggestions but also sets personal boundaries, which is crucial for safe therapeutic engagement. They communicate their fears clearly, illustrating self-awareness and readiness to explore alternatives.

[CLIENT]: That sounds a bit more doable. Taking smaller steps feels less daunting than facing everything all at once. I'm interested in learning what coping mechanisms could be helpful and how we can apply them gradually. What kinds of steps are we talking about? Could you give me some examples?

• utterance: The client exhibits a positive response to adjusted therapeutic strategies, showing adaptability and a proactive attitude towards recovery. This indicates their engagement and collaboration in the therapy process.

[CLIENT]: This plan sounds reasonable and it's reassuring to know that I can take it step by step at a pace that feels comfortable for me. Starting with relaxation techniques like deep breathing in a safe environment seems like something I could try without feeling too anxious, and gradually moving towards more challenging situations like sitting in the car sounds like a good progression. It makes me feel a bit more in control just hearing that there's a structured approach to dealing with this. Thank you for outlining these steps. I'm willing to give it a try.

• utterance: The client expresses confidence and reassurance in the planned approach, indicating that they are feeling empowered and supported. This is a positive indicator of their trust in the therapy process and readiness to engage in proposed interventions.

Session Feedback

• Feedback: The session demonstrated effective use of invitational, reflecting, and challenging skills by the consular, along with gradual building of a therapeutic plan tailored to the client’s pace. Client’s responses were reflective, thoughtful, and indicated good rapport and engagement with the therapist. The consular effectively adjusted approaches based on the client’s feedback, fostering a supportive and client-centered environment. However, further emphasis on more open-ended questions and continuous validation could enhance the therapeutic alliance and client empowerment.

Supervisor's Feedback Whole Session :

Feedback

Strong

1. Invitational Skills:

   • The consular demonstrated strong nonverbal communication through the receptive and supportive tone conveyed in the transcript, which would likely make the client feel more comfortable.
   • Effective use of verbal encouragers and open-ended questions were noted, which facilitated a more in-depth discussion about the client's feelings and experiences.

2. Reflecting Skills:

   • The consular was proficient in paraphrasing and reflecting feelings, which helped validate the client’s emotions and experiences, such as acknowledging the stress of the panic episodes and the limitations they imposed on the client's life.

3. Advanced Reflecting Skills:

   • Summarizing was effectively used to recap and validate the client's concerns, which also helped in making the client feel understood and setting the stage for intervention strategies.

4. Assessment and Goal Setting:

   • The consular led a thoughtful discussion into the events causing anxiety and effectively questioned for assessment, which helped in identifying specific triggers and barriers the client faced.

5. Change Techniques:

   • The consular effectively activated the client's expectations by providing a clear, hopeful method for managing anxiety. Practical steps like gradual exposure and coping strategies like relaxation techniques were well introduced, offering new learning experiences and enhancing the client’s sense of efficacy.

Weak

1. Challenging Skills:
   • The consular might have prematurely suggested facing fears “head-on” which could be seen as slightly confrontational or overwhelming for a client experiencing severe anxiety and fear.

Missing

1. Challenging Skills:
   • The use of giving feedback could be enhanced further; feedback on the client's progress or insights during the session could bolster the client's confidence and involvement in the therapeutic process.

Avoid

• There were no significant aspects that the consular needed to avoid in this session.

Additional

1. Outcome Evaluation and Termination Skills:

   • Incorporating basic methods for evaluating the effectiveness of the interventions during the ongoing sessions would assist both the client and consular in ensuring the approaches remain effective and adjusting as necessary.

2. Consular Should Avoid:

   • Some directives like urging the client to face fears directly, though quickly revised, could initially seem overwhelming. Balancing such suggestions with immediate alternatives or softer approaches could be more beneficial to avoid distress.

Overall, the consular handled the session proficiently with only a few areas for slight improvement. Establishing clear, gradual steps towards managing the client’s anxiety while ensuring a supportive and responsive environment stood out as particularly effective approaches in the session.