JOURNAL ENTRY
Critical reflection on your growth and development during your practicum experience in a clinical setting helps you identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes.
Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum.
Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
• Reflect on the three most challenging patients you encountered during the practicum experience. What was most challenging about each?
• What did you learn from this experience?
• What resources were available?
• What evidence-based practice did you use for the patients?
• What would you do differently?
• How are you managing patient flow and volume?
Communicating and Feedback
• Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
• Answer the questions: How am I doing? What is missing?
• Reflect on the formal and informal feedback you received from your Preceptor.
The 3 most challenging patients:
Ms. K, an 18-year-old Caucasian woman, comes to the clinic for psychotherapy with the main complaint of having more thoughts of suicide. Pt arrived with her mother, and she disclosed that one of her worries was a tense relationship with her boyfriend. The patient supports racing thoughts, a low mood, less energy, a sense of worthlessness and hopelessness, and difficulty performing everyday tasks. Pt had a messy appearance, made awkward eye contact, and had a disjointed mental process. She had a depressed expression and a flat effect. The goal of therapy was to encourage emotional communication. Motivational interview, role playing and therapeutic communication were all used in CBT session to cognitively restructure the Pt’s thinking to handle her situation in a healthy way.
SJ is a 35 years old AA male with a history of MDD, GAD, PTSD and ADHD who always missed her appointments due to (according to her) transportation issues. Her toxicology report always came out positive for illicit substances (cocaine). Patient refused to go inpatient treatment. She appears to be in denial of the severity of her addiction.
GT is a 52 years old Caucasian female with diagnosis of panic disorder, GAD and MDD who comes for psychotherapy today at the clinic for mental and emotional stress regarding her divorce with her husband. Pt reported she is grieving for the break up with her first husband. Pt has low moods with sad affect but she was well groomed. She spoke about things that has happened to her that she has not gotten over. She mentioned her father dying when she was at age 12 , her uncle molesting her from age 13 to 15, hand having a abortion at age 17 and troubled life with her mother. Her first husband also was cheating on her. This patient has a lot of sad stories.
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