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Counselling Larissa, The relational space - Coggle Diagram
Counselling Larissa
Traumatised disclosures
- Use trauma-informed strategies
- grounding strategies/techniques
Sensory/ somatic grounding: can you feel your feet/hands, now if you press them down, notice the contact
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Object focus: offer them a textured object, invite them to focus on it and describe it
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- do not push them to speak
- create an environment of safety & regulation
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open body language: relaxed posture to communicate your presence mirroring safe, slow breathing,> however angle your body to the side , as to not overwhelm them.
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- help them create/ reestablish a sense of control
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trauma: not just about the event, but how we process it and the nervous systems response
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Reflection on Sessions:
1) Withdrawn, self-soothing, avoids eye contact:
- Signs of anx, distrust, emotional dysregulation
- consistent with trauma-related relational difficulties.
2) Boundary testing by asking personal q's:
- Possibly her wanting a connection or test of emotional safety ~ reflecting her unresolved grief & separation from her own children.
- Avoidance.
3) Interest in careers meeting & my opinion:
- Important shift, as she's beginning to imagine a future & seeking your input.
- Could be an early sign of trust & flicker of agency.
4) Trauma disclosure but she shuts down as she becomes immobilised & unable to articulate:
- trauma response
- dissociation or overwhelm from re-experiencing.
- Indicates deep vulnerability & need for containment before further trauma processing.
5) Chemical imbalance & is relieved, no longer wants counselling:
- Deflection ~ defense mechanism to regain control, after a destabilizing experience in the last session
- "Closure" ~ the medical explanation is safer & more tangible than exploring painful emotions further.
Counselling Approaches:1) Phase-oriented, Trauma-Informed Integrative Therapy (phase-based trauma work ~Judith Herman model or Complex PTSD treatments)1a) Stabilization & safety (current focus):Goals:
- Build relational trust
- Improve emotional regulation
- Develop coping strategies
- Enhance a sense of safety
Techniques:
- Psychoeducation about trauma, depression & emotional regulation
- Use of grounding techniques, breathwork, or creative tools (timelines, drawing) to express feelings safely.
- Encouraging strengths & daily structure (helping her establish a morning routine, etc.)
- Exploring her interest in work > a path toward self-efficacy.
2a) Processing trauma:
Only after stabilization is secure & she has the tools to stay grounded.3a) Reintegration:
Focus on building identity, relationships & purpose.
Notes:
- Complex PTSD or developmental trauma
- Emotional dysregulation
- Attachment disturbances
- History of chronic neglect & abuse
- Low self-agency ~ emerging interest in future possibilities
- Lack of understanding about what healing looks like
S1: Check-in & practical focus ~ purpose: ground in the here-&-now, avoid emotional overload, offer a sense of control.
- Start gently: " How have things been this week for you?" (Keep it open and non-intrusive).
- Acknowledge her decision: "You mentioned feeling clearer about what's going on for you recently, & that you might not need more counselling - that really makes sense".
- Subtle reframe: "We don't have to do 'counselling' I'm still her if it helps to have someone to think through with, especially with this work stuff you brought up".
- Activity: Supportive discussion of options from the education/career meeting. Offer to help her explore what might 'fit' her, using a strengths-based lens (What have you liked doing in the past even if just for fun?)
- Close: Offer her a next session as a check-in or career/well-being support rather than ongoing therapy.
S2: Interests, Strengths, & Small wins ~ purpose: Rebuild identity through neutral, non threatening topics that link to hope or agency.
- Focus: Discuss car boot sales, ex-stepmum, something she enjoys or values.
- Bridge: "I remember you mentioned car boot sales, what do you like about them?" Use this to gently explore identity & positive emotion.
-Micro-goals: Help her identify 1 small manageable step she could take in the prison (i.e. sign up from something low-pressure).
- Close: "Would you like to keep chatting like this every now & then, not therapy, just a space for you?"
S3: Normalise ambivalence & offer support ~ purpose: validate her fluctuating needs & maintain connection as a secure base.
- Reflection: "Sometimes people feel like they're okay one day, & then not sure again the next, that's really normal, especially after a hard time"
- Agency emphasis: "If you ever feel stuck or just need someone to talk things out with, you don't have to do it alone ~ I'm still here".
- Close: Offer an open-door approach "You don't have to decide anything now, we can just take it one session at a time".
S5: No longer needs counselling.
- Normalise her need for a break & suggest occasional check-ins to "support her journey" rather than frame is as counselling
- Frame the next meet as a follow-up to support her progress with work or wellbeing, rather than deep emotional work
- Reinforce that counselling is always available should she need support again.
Additional re-engagement strategies:
- Avoid pathologizing or over-pushing: Let her lead. Pushing to hard may reinforce her withdrawal or shame. Instead, validate her relief around medication while gently keeping the space open.
- Emphasise choice & control: Use language like "if you want"", "we could just chat", or "you're in charge of what we talk about".
- Use collaborative language: "we can figure this out together" instead of "I think you need.."
- Normalise withdrawal: Frame her stepping back as normal rather than a failure "Sometimes, after big conversations or hard weeks, people need time to breathe"
5: Contain trauma work: Let her know she doesn't need to go into difficult memories unless she feels ready & safe. I'm not here to dig but support.
Creating a session plan outline
Session goals: Rebuild safety & trust, affirm L's autonomy, support practical focus (e.g. career), keep the door open to deeper work later.
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