I. Purpose
The clinical case presentation provides an opportunity for therapist-presenters to demonstrate their clinical work, to receive peer consultation from other participants along with supervision from the facilitator. It also gives peer-therapists the opportunity to provide consultation, to practice their proto-supervisory skills and to learn about therapeutic problems, crises, impasses, conflicts, and approaches with cases that are not their own.
Examples of topics within the context of the case presentation include:
- Diagnostic Issues
- Issues of therapeutic frame and boundaries
- "Fit" between client and treatment approach
- Therapeutic crisis or impasses
- Transference and counter transference illustrations and dilemmas
- Culture-specific clinical issues and treatment modifications
- Stage of treatment (e.g., termination) issues
II. Written hand-out
A detailed case description (without ANY IDENTIFYING INFORMATION) should is written and distributed to all group members a week prior to the scheduled presentation day. The write-up needs to cover the following (in any order):
- Reason for referral and presenting problem
- Description of the client (physical, behavioral & social)
- Brief pertinent life history
- History of presenting problem and past treatment history
- DSM-IV Diagnosis on all five axis (including secondary diagnosis and rule-outs)
- Clinical Case Formulation (from any chosen theoretical orientation)
- Cultural Case Formulation (using the DSM-IV guidelines for cultural formation)
- Brief treatment summary and course of treatment
- Observations on transference/counter transference dynamics in the case
- Clinical concerns or issues the presenting therapist would like/would wish to address
III. Process Notes
Typed process notes of at least one recent psychotherapy hour (as close to verbatim as possible) are distributed to all participants on the day of the presentation. The notes are presented to the group and discussed in detail (in the light of the case data, clinical and cultural formulation and the issues the presenter asks to address.)IV. Presentation
Usually, presentations start with questions from the group about the pertinent needs that are to be clarified about the write-up. Then the presenter takes about 10 minutes to present the case and any additional relevant information/material since the write-up was completed. The purpose here is to help the group better understand what it is like for the therapist to work with this particular client, rather than merely to go over the written text. The group then asks any questions desired for additional information. Next, the therapist presents process notes from a recent session. The following group discussion focuses mainly on the presenter's stated concerns. In addition, the Director of Training may ask the conference to focus on a particular clinical issue.
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