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A case report of rational emotional therapy for general psychological problems
Abstract: This paper introduces a case report on the treatment of a visitor's general psychological problems by cloud rational emotional therapy. The helper is a college graduate. After graduation, his job search in Beijing was frustrated. He thinks that he didn't learn well in college, didn't answer questions comprehensively in the written test, didn't get full marks, didn't think quickly enough in the interview, and couldn't get along with the examiner Kan Kan. He is not excellent. There are psychological troubles such as anxiety, palpitation and inner anxiety. According to the general information, chief complaint, cause analysis and psychological counselor's observation and analysis, it is diagnosed as a general psychological problem, and reasonable emotional therapy is taken to change the unreasonable cognition of the help-seekers, so that the help-seekers can get rid of their psychological troubles and the consultation results are satisfactory.

Keywords: general psychological problems, rational emotional therapy

I. General information

(1) Demographic data

Help-seeker Xiao Zhang, female, Han nationality, 25 years old, graduated from university. No major physical illness, no history of mental illness.

(2) personal growth history

Xiao Zhang, a helper, was born in the northwest of China, and is an only child. Both parents are civil servants, and their family economic conditions are moderate. She has been doing well since she went to school. She is studying in a university in the south. After graduation, she listened to the advice of her family and friends, wanted to develop in Beishangguang, and applied to work in Beijing. Her parents and family had no history of mental illness.

(3) Mental state

Xiao Zhang, the helper, dressed normally and behaved appropriately, but his face was blank.

(4) Physical state

Xiao Zhang, the helper, has been healthy since childhood, never suffered from serious illness, and his family has no genetic history of mental illness. I haven't slept well recently, I'm restless, restless, and I have no appetite for eating. I went to the hospital for examination, and there was no organic disease. The doctor suggested going to the consulting room to get psychological counseling clothes, and he came voluntarily.

(5) Social work and interpersonal communication

Xiao Zhang, the helper, sits in front of the computer every day and mechanically submits his resume. Recently, he has always felt guilty. He felt sorry for his parents' training for so many years that he couldn't even find a job after graduation.

Second, the chief complaint and personal statement

Chief complaint: In the past month, due to frustration in job hunting, I was nervous, anxious and inefficient at the thought of work. I have just submitted my resume mechanically for more than a month, and my written test and interview performance are not in the state.

Personal statement: I grew up in the northwest. I am an only child. My parents love me very much. I also listen to my parents. I have studied hard since I was a child and got excellent grades. After I graduated from college, my family and friends felt that there were many development opportunities in first-tier cities. I also want to develop in Beishangguang, so I came to Beijing. I didn't expect graduates from Peking University and Tsinghua who applied for jobs with me to be everywhere. Their resumes show the rich club activities they participated in during their college years. Listening to their conversation, I feel that their knowledge reserve is very rich, and I seem to have learned nothing. I was shocked when I received the notice of written interview! Whether it's an interview or a written test, my mind is blank and I'm at a loss. There is no clear idea about the questions on the test paper, and the questions asked by the examiner are also vague. I'm such an idiot that I can't even answer such a simple question! I'm finished! There is no hope in this life! I went to the outpatient department of the hospital for examination, and there was no organic lesion. The doctor suggested psychological counseling, so I came here for help.

Third, the consultant's observation and others' reflection.

During the visit, the helper was in a poor mental state and looked tired, but his thinking was normal, his answers were consistent with the questions, he had no abnormal behavior, he was self-aware, he had an objective evaluation of his own situation, and he had no illusions or illusions. When it comes to employment and future development, I look blank and take the initiative to ask for help. The information is true and credible.

Fourth, the diagnosis process

(1) differential diagnosis

1) ruled out temperament lesions. According to the self-report of the helper: I went to the hospital outpatient clinic for examination, and there was no organic disease.

2) Differentiate from mental illness. According to the family members of the help seekers, the help seekers have no history of mental illness. Subjective and objective aspects, knowledge, emotion and will are coordinated, their personality is relatively stable, they have no illusions and delusions, no obvious excitement and abnormal activities, and their self-awareness is normal, so they take the initiative to ask for help. So rule out mental problems.

3) Differentiate from neurosis. According to the classification of "inner conflict", the inner conflict of help seekers mainly comes from frustration in job hunting, college graduation, written test and interview failure; It has practical significance, belongs to normal type, and the social function of the helper has no obvious damage, and the course of disease is more than 1 month, which can rule out neurosis.

4) Eliminate serious psychological problems. According to the above analysis of 1), 2) and 3), Xiao Zhang's nervousness and anxiety all come from frustration in job hunting, but it is limited to job hunting for more than a month, and there is no generalization, which can rule out serious psychological problems.

According to the above analysis and diagnosis, the initial diagnosis is a general psychological problem.

Cause analysis of verb (abbreviation of verb)

(1) biological factors: female, 25 years old, diagnosed by a doctor, excluded from organic diseases.

(2) Psychological factors: weak psychological endurance, lack of self-confidence, and inferiority complex compared with graduates from Peking University and Tsinghua.

(3) Social factors: the help-seekers have little social practice and high expectations from family and friends.

Sixth, the formulation of consulting objectives.

According to the above assessment and diagnosis, after consultation with Xiao Zhang, the following consultation objectives are determined:

(1) Short-term goal: relieve the depression and anxiety of the helper Xiao Zhang, return to normal, evaluate himself rationally and correct:? 1 "I am mentally retarded myself!" Too general understanding, ② the extremely bad cognition that "my life is over". Respond to the job interview and written test with a normal heart, and objectively face the job search.

(2) Long-term goal: On the basis of achieving the above specific goals, guide Xiao Zhang to improve his self-confidence, adapt to his role change with a rational concept, and face the reality with a positive attitude.

Seven. Formulation of consulting scheme

(A) consulting methods and principles

In order to achieve the purpose of counseling, reasonable emotional therapy is planned.

1, rational emotional therapy.

Rational emotional therapy was founded by Albert Ellis in the United States in the 1950s. Rational emotional therapy is a cognitive psychotherapy. The basic theories of rational emotional therapy are: ABC theory, in which A refers to induced events; B refers to the corresponding belief of an individual after encountering an induced event, that is, his view, explanation and evaluation of this event; C refers to the emotional and behavioral results of an individual in a specific situation. It is generally believed that people's emotional and behavioral responses are directly caused by induced event A, that is, reason A. People's emotional and behavioral responses are related to people's thoughts and views on things. Behind these thoughts and opinions, people have the same view on one thing, and that is faith. Reasonable belief will cause people to have an appropriate and moderate emotional response to things; On the other hand, unreasonable beliefs will lead to inappropriate emotional and behavioral reactions. When people persist in some unreasonable beliefs and stay in a bad emotional state for a long time, it will eventually lead to emotional distress and unsuitable behavior.

2. Specific methods: Find out the specific manifestations of emotional distress and behavioral discomfort by talking with help seekers (c): ① Tension and anxiety.

(2) low efficiency.

3 can't face the written test and interview normally.

These reactions correspond to the triggering event (a): frustration in job hunting.

Unreasonable beliefs lead to Zhang's troubled mood and uncomfortable behavior (b):

(1) I am mentally retarded; (2) My life is over;

Make an analysis to make Xiao Zhang understand his own problems and the relationship between these problems and his irrational thoughts.

3. Consultants use various skills to help clients correct or give up unreasonable ideas and replace them with reasonable beliefs, thus eliminating bad emotions and uncomfortable behaviors. Therefore, only through rational analysis and logical speculation can we change the irrational concept that causes Xiao Zhang's emotional distress and establish a reasonable and correct rational concept, so as to help Xiao Zhang overcome his emotional problems, face life with a reasonable outlook on life, maintain his mental health and promote the all-round development of his personality.

(two) to explain and determine the responsibilities, rights and obligations of both parties.

1, Responsibilities, Rights and Obligations of Helpers:

? ① Responsibility:

(1) Provide real information related to psychological problems to psychological counselors;

(2) actively discuss with the consultant the ways to solve the problem;

(3) Complete the operation agreed by both parties.

② Rights:

(1) Have the right to know the training background and current qualifications of consultants;

(2) Have the right to know the specific methods, processes and principles of consultation;

(3) Have the right to choose or replace suitable consultants;

(4) Have the right to submit or terminate the consultation;

(5) Have the right to know, negotiate and choose the contents of the negotiation scheme.

③ Obligation:

(1) Comply with the relevant regulations of the consulting organization;

(2) Abide by and implement all aspects of the agreed consultation plan;

(3) Respect the consultant and observe the appointment time. If you can't consult on time, inform the consultant 24 hours in advance.

2. Responsibilities, rights and obligations of consultants:

? ① Responsibility:

(1) Abide by professional ethics and relevant national laws and regulations;

(2) helping the parties to solve their psychological problems;

(3) Strictly abide by the principle of confidentiality.

② Rights:

(1) Have the right to know the personal data related to the psychological problems of the parties;

(2) Have the right to choose suitable helpers;

(3) Have the right to refer or terminate the consultation in a responsible manner.

③ Obligation:

(1) Introduce your training background to customers;

(2) Abide by the relevant provisions of consulting ethics;

(3) Abide by and implement all aspects of the agreed consultation plan;

(4) Respect the helper, observe the appointment time, and inform the helper in advance as soon as possible when it is impossible to consult under special circumstances.

(3) Consultation frequency and schedule:

Twice a week: every Monday from 2: 00 pm to 2: 50 pm,

Every Friday from 4 pm to 4: 50 pm, 50 minutes each time.

Number of consultants: 5, which can be adjusted according to the consultation progress.

(4) Consultation fee: 50 yuan each time.

Eight. Negotiation process

(1) consulting relationship establishment and diagnosis stage (consulting 1-2)

1. Consultation 1: (20 16 September 19)

By collecting the relevant information of the help-seekers through joining the club, we can understand their basic situation, mental state, behavioral characteristics and help-seeking motives. Through the skills of emotion, understanding and concern, psychological counselors initially establish a good consulting relationship with help seekers, so that they feel respected and accepted. This paper introduces the essence and limitations of psychological counseling, as well as related matters and rules in the process of psychological counseling.

2. Second consultation: (2065438+23 September 2006)

Consolidate the consulting relationship, determine the consulting objectives with the client, formulate the implementation plan, introduce the consulting methods, principles and processes, and sign a written agreement. The reasonable emotional therapy and ABC theory are illustrated with examples, so that the helper can realize the relationship among A, B and C. Combining with the emotional and behavioral characteristics of the helper, she summarizes her unreasonable beliefs and wrong cognitive models. The following is a conversation between the consultant and Xiao Zhang:

Consultant: Xiao Zhang, what do you think is the reason for your present state?

Xiao Zhang: I am an idiot myself. I can't even answer the questions in the written test and interview.

Counselor: So people who fail the written test and interview are idiots?

Xiao Zhang: You can't say that either. Taking an exam once or twice once in a while doesn't mean anything.

Consultant: Have you ever heard of idiots going to college? Are there any idiots among the graduates of your school?

Xiao Zhang: (laughs) Of course not. How is that possible?

Consultant: Then why do you call yourself an idiot?

Xiao Zhang: (Silence) ......

Counselor: You have come all the way from junior high school, senior high school entrance examination, college entrance examination and university graduation. Is this what an idiot can do?

Xiao Zhang: (Mm-hmm) ... Anyone can do this. I mean the written test and interview. I can't even find a job.

Counselor: Did you pass all the written tests and interviews you attended?

Xiao Zhang: No, many people have been written off! Before applying for a position, only four people were needed, and more than 4,000 people applied.

Consultant: Yes! This is the current employment situation in China. According to your judgment, these more than 3,900 job seekers are idiots, right?

Xiao Zhang: That's too one-sided! After all, that position is one in a thousand!

Counselor: So you can't deny yourself or even call yourself an idiot just because you can't find a job temporarily. This can only reflect your lack of knowledge and ability in written test and interview. The written test requires study and hard work. More importantly, you need to attend relevant interviews to improve your adaptability and enrich your test-taking experience.

Xiao Zhang: Hmm! I really found my weakness! Do you think I can still find a job?

Consultant: This is what we will discuss next.

After memory and discussion, I found that:

(1) Zhang's understanding of irrational emotions (1): Frustration in job hunting

(2) Wang Xiao Zhang, with excellent academic performance since childhood, successfully entered the university all the way and completed his college studies through hard work. In the process of applying for a job in Beijing after graduating from college, I failed the interview and written test for the time being, so I had the following unreasonable beliefs (b):

① Overgeneralization. I should have passed the written test. I can't find a job in Beijing, and I didn't pass the written interview to find a job. I am mentally retarded!

(2) terrible. I can't even pass the written interview to find a job now, so if I can't find a job, my life will be over!

(3) Xiao Zhang's unreasonable concept of being too general and extremely bad led to her specific performance (c):? ① Current emotional distress: anxiety and nervousness.

2 behavior discomfort: low efficiency.

(3) In the face of the written test in job hunting, stunned interview, a blank brain.

(two) the implementation of psychological help counseling stage (third-fourth consultation)

1. Third Consultation (2065438+26 September 2006)

(1) recalled the three points A, B and C in the rational emotional therapy summarized last time, which further confirmed the unreasonable beliefs of the help seekers. (c) Yes: Because (a) we failed to find a job, we doubted and totally denied ourselves. According to reasonable emotional therapy, the psychological problems of help seekers are analyzed and diagnosed.

By asking questions, guide the seeker to recall his growth process from childhood to college, let the seeker realize that he has not been frustrated in the growth process, and analyze the relationship among A, B and C together.

(2) Together, we sorted out:

The inducing event of unreasonable emotions (a) is the frustration in job hunting, which causes job seekers to have unreasonable beliefs B and B, and then leads to the specific manifestations of job seekers' current emotional distress and behavioral discomfort (c).

(3) Assign homework and fill in the form.

I hope she will sort out the theoretical points of A, B and C in detail, and then sort out the relationship among them. I asked her to take this form back, hoping that she could see the connection between her unreasonable beliefs and her emotional and behavioral reactions. I emphasize: We can try to divide all the problems into three parts with this tabular model, namely, inducing event A (such as job-hunting frustration), belief B (views and attitudes towards events) and result C (emotional response and behavior performance). In addition, I explained to Xiao Zhang that the homework assigned after the meeting was an important part of the consultation. The more carefully you think about and examine your own beliefs, the faster the consultation will progress. I also emphasize that the goal of consultation is not to eliminate all negative feelings, but to learn to make feelings consistent with events and eliminate overreaction.

2. Fourth consultation: (2065438+September 30, 2006)

(1) Check and evaluate the work of the helper.

I analyzed my homework with the leader and recalled the club activities that the leader participated in during his college years: college students started their own businesses in the future, organized and participated in the national college students' folk music performance competition as the deputy head of the folk music troupe, and won the second prize. We also won two scholarships in our junior and senior years and passed CET-4 and CET-6 in four years. ...

(2) Through further debate, the seekers can correct or give up the original unreasonable beliefs and replace them with reasonable ones.

Let her know that there is a building outside the mountain, and a person's life growth will be better after constant failure and tempering. Frustration in job hunting is also an inevitable part of life. Help-seekers said that they had accepted the reality, their present situation and their knowledge reserves.

(3) Fifth consultation: (20 14 10 10/0/6/0)

The purpose of consultation at this stage is mainly to summarize, consolidate and improve.

I comprehensively reviewed and summarized the whole consultation process with the help seekers. Help-seekers realize that their original ideas about themselves, their lives and their ability to withstand setbacks in job hunting are really unreasonable. They say that they have been in a much better mood recently, and now they have completely changed their original unreasonable beliefs. Consolidate the achievements made in the previous stages, help clients get rid of the original unreasonable beliefs and ways of thinking, strengthen new concepts, help clients realize the transfer of knowledge and ability, apply the methods and experiences gained in consultation to their daily lives, and end the consultation.

Nine. Evaluation of consulting effect

1. Self-evaluation of the counseling effect by the help-seekers: The help-seekers said that they had adjusted themselves, readjusted their employment direction and career planning, and planned to find a job in second-and third-tier cities.

2. The recovery of social function of help seekers: The mood is much more stable than before. I have received two interview notices from the company and participated in the initial test of a company. It feels good. I'm waiting for the second interview notice, and I'm also preparing for the initial test of the second offer. I want to show my best, and I'm ready for it. Even if she is rejected this time, she will continue to submit her resume until she finds a job.

3. Comments from family and friends: The friend of the helper said that the helper has gradually recovered to a good state and is willing to discuss with you. The sisters of the helper also said that her status was "online".

4. The consultant's observation and evaluation: Compared with the tired look at the first visit, the helper's face is obviously improved, radiant and depressed, and he can carry out normal study and life. I have a new understanding of self-evaluation and frustration in job hunting, and achieved the expected goal through psychological counseling.

5. The degree of improvement of symptoms of clients: the depression has eased, and they have a clear goal and a clear understanding of the current job search ideas and plans. Life basically recovered, symptoms of brain blank and vague language disappeared.

X. Summary and reflection

Psychological counseling adopts reasonable emotional therapy, combined with psychological counseling techniques such as emotion, understanding, enthusiasm and concern, and with the active cooperation of the helper Xiao Zhang, the counseling soon achieved the expected results. In the process of consultation, I relied heavily on analyzing Xiao Zhang, but because I did not participate in the formulation of short-term goals and long-term goals, and my skills were limited, I did not intervene in a limited time. At the same time, this is also a shortcoming that I will make up in the future. I will take corresponding training to improve my skills in the future.

References:

(1), edited by Guo Nianfeng. Psychological Counselor (Basic Knowledge), Beijing: Nationalities Publishing House, August 2005, 1 Edition.

(2) Guo Nianfeng, editor in chief. Psychological Counselor (Level 3 in Operational Skills), Beijing: Ethnic Publishing House, August 2005, 1 Edition.

(3) Guo Nianfeng, editor in chief. Psychological Counselor (Level 2 in Operational Skills), Beijing: Ethnic Publishing House, August 2005, 1 Edition.

④ Xu Youxin. Neurosis [M] Beijing: People's Health Publishing House, 1993.68- 76.