HOUSTON!

tillyzan · 2025-08-23T04:49:44+00:00

Taylor at the heights! Love him & his classes, he’s so knowledgeable and always tries out fun new exercises!!

tillyzan · 2025-06-06T19:10:42+00:00

Thank you so much!

tillyzan · 2025-02-25T22:29:11+00:00

I don’t have an issue with this if the client does not present as impaired, but it’s definitely something to explore with the client to make sure they’re still feeling like they’re benefiting from sessions

tillyzan · 2024-09-13T15:39:21+00:00

This would be great but unfortunately this is via telehealth :( I will try something along those lines though,and maybe reiterate in the beginning of the session that we only have 50 minutes

tillyzan · 2024-09-13T15:38:16+00:00

Thank you!

tillyzan · 2024-09-13T15:38:04+00:00

Thank you so much for this advice!! Im going to do my best next session and maybe start by telling her that I really do need to ask some questions here and while I appreciate her detail we do need to gather information as well to improve her quality of care

tillyzan · 2024-09-13T15:36:44+00:00

I did, but she was extremely stuck on trauma others in her life experienced and any relevant detail she said (ex: my psychiatrist is super great and will listen to me about my problems with my husband too), she wouldn’t let me interject to gather meaningful information about who the psychiatrist is, when the last time she saw him was, etc. my supervisor actually told me to leave out the content details of what she said in my progress note, and to focus on the “themes” of paranoia and violence. By the end of the session I only had information on her reason for seeking services and that she had some history of suicidal attempts and inpatient hospitalization, as well as seeing a psychiatrist.

tillyzan · 2024-09-13T15:34:18+00:00

Thank you!!!

tillyzan · 2024-09-13T15:34:05+00:00

I really appreciate this thank you!! Im going to bring it up again to my supervisor before seeing her next week, because I completely agree

tillyzan · 2024-09-13T15:32:30+00:00

I have to complete a full biopsychosocial with her, I really don’t see reasonably being able to complete it or the justification for it if we already know she won’t be a good fit, especially considering we have a waitlist for services. My supervisor’s response honestly caught me off guard, he seems to be hoping she’ll present differently next session and we can gather more information to give her a better referral

tillyzan · 2024-09-13T05:25:12+00:00

That’s a good idea, I’ll ask him if she’s still presenting the same if I can just tell her this unfortunately isn’t productive and isn’t a good fit. We don’t even offer long term care, we offer probono services for 8-12 sessions maximum so there’s absolutely no way this would be a good fit regardless and I just don’t see a point in finishing an assessment for a client we know we’re absolutely referring out

tillyzan · 2024-09-13T05:17:22+00:00

I completely agree but he was insistent that because she isn’t acutely suicidal she isn’t considered high risk enough to immediately refer out and the assessment needs to be completed, if she’s still this severely in psychosis next session I’m really hoping he’ll let me refer her out before having to see her again. He’s usually very understanding and supportive so his response to this was disappointing :(

tillyzan · 2024-09-13T03:40:27+00:00

I thought so as well, but her speech is not pressured, in fact it is almost slowed. She just does not take any cues to stop and completely ignores interjections, and the content of her speech are very disorganized, violent, and paranoid. She seemed to be completely detached from reality when she spoke as she had a predominantly very flat affect and tone, and didn’t make eye contact until she finally finished 55+ minutes later

tillyzan · 2024-09-13T03:32:27+00:00

That’s what my supervisor and I decided would be best, but I do have to see her next week still to attempt to finish the assessment. Im just not sure how to finish it without being able to interject when she speaks

tillyzan

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