January, 2020

Casey

      I arrive home in the early evening, pushing back a few work engagements to tomorrow. I am exhausted. Being up all night and working the next day is taking its toll. I come home and throw my comfies on and lie in bed setting an alarm for 2am for my session with my overseas client. I quickly drift off to sleep, knowing I need to make the most of the time I do have to sleep.

     I feel like I have been only sleeping for a few minutes when a chime from my phone wakes me up. I see that my alarm is scheduled to go off in less than 10 minutes. I lie in bed and stretch out my legs and arms trying to get the stiffness out of sleep. I roll over to my night stand and pick up my phone, squeezing one eye shut due to the brightness.

I see a text from my client;

Jin: Hello. I completed my homework for our session. I wrote down some notes, but I am having trouble trying to write them down in English. It's much easier for me to speak instead of writing. Would it be OK if we could do our session on the phone? Thank you.

I read the text and type back;

Casey: Good job! That is fine by me. I will call you in a few minutes.

   Leaping out of bed, I go into my guest room that has my home office set up in it. I open my locked filing cabinet and pull out my file for the session. I quickly look over the notes that I have made so far and jot down a small bullet point list of items to address during today's session.

    Glancing at the little desk top clock shaped like a cat on my desk, I pick up my client's only phone and push one of the two contacts in the phone.

    The phone rings and the ringing continues long enough making me think that it will go to voicemail when I hear the click of the call being picked up.

"Hello", I hear an undeniable male voice say.

"Hi, this is Casey Costello. I am calling for our scheduled session", I say confidently.

"Oh, hi, yes, umm, thank you for moving our session to a phone call", he says with notable hesitation.

"Sure, no problem. How did today go? What did you do," I say to start an easy dialogue.

He starts by telling me that he slept in late and just ate. I look at the clock and mentally figure out the difference. 4pm. I write down "trouble sleeping?" on my session notes.

"I see that both of us are on weird sleeping schedules right now too. I currently set my alarm for 3am for our sessions", I say with just a tiny hit of tiredness.

"Woah, really. I'm sorry that I am keeping you up. I guess I never thought of the difference in time. Do you want me to call back later?" he sweetly says.

"No no, no worries. I have been going to bed so early that I joke I'm turning into a grandma," I say.

He laughs into the phone and it's followed by a few seconds of awkward silence that I immediately take over and start talking.

"I guess we will start by outlining what a session looks like and what my process going forward will be like. I know that the term "therapy" often makes people think that this is something serious or that they are in some sort of trouble like in primary school." I say.

"Ha. Yes, I would like to know what will be happening for our sessions. To be honest, I am very nervous about all of this," he says.

I again take my pen and write down "hesitant" on my session notes.

"There is no need to worry. I will walk you through this each step of the way", I say kindly.

"Each session will last for around one hour. We are able to increase the time of the session or add more sessions during the day depending on what you need and where we are in the process. My goal is to take your lead and have you communicate what you need from me too", I say.

"Thank you, that's very kind", he says.

"Now, to answer the elusive questions of what therapy is", I say in a mock scary voice.

"Typically when starting with a new client, we focus on what is currently happening in your life. What you are feeling and how it's affecting you daily. This will take a few sessions for us to establish and develop a friendship. I really like to think of my client relationship as a friendship of sorts. I know you will be opening up to me and telling me things that may make you uncomfortable. Know that this is a place of no judgement and that I am here as a friend to work through whatever you may be feeling. Also know that anything you say in these sessions are 100% confidential. The contract states that I will be giving your company updates, but this will not include specifics of what we discuss," I finish.

"Ok," he simply states.

I hesitate for a few moments to see if he will add anything else before continuing.

"After the first few sessions of collecting your history and background, We will start by looking for two to three key behaviors to target and then will make a plan to address them. The end goal of our relationship is that you have coping skills to handle what life throws at you, feel more like yourself, and are more mindful and aware of your thoughts and emotions. How does this all sound," I say questioningly.

A few moments of silence pass before he says, "I just want to get better...to feel better."

"Great, that is exactly what I am here to help you with," I say.

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           I sigh, pushing the end button of my first call with my client. Glancing at the clock, I see that it lasted a little bit over an hour. Not too bad for a first session.

       I glance down at my notes from the call and review the questions I asked during the history taking portion;

-Relatively normal childhood with two parents and an older brother.

-He moved at an early age to an area outside of Seoul, South Korea.

-He still is in contact with his family. Family support sounds strong.

-Finished high school, no later education.

-Has an important job. Sounds like he works alot. Pressure?

-Strong group of friends. Live close by?

-Lives in an apartment by himself. No pets.

      I tip back in my office chair and think over his responses for a bit. Based on his voice, he sounds young. Maybe Mid to late 20s based on where his life currently is. His voice sounded friendly, a little hesitant, but as I kept asking the questions he sounded more and more confident. He seems very professional in his responses, if not a little guarded, almost rehearsed.

     My next section of notes detail the second part of the history taking process where we talked about what he is currently experiencing and any symptoms he may be feeling.

-Experiencing problems for about a year. More intense suddenly. Hard to control.

-One episode of fainting. Panic attack.

-Trouble sleeping. Dreams.

-"The hand???"

    Looking over this section of notes.  Again, he still seemed very guarded when answering these last set of questions, but he did give me the impression that he was telling the truth, but I wonder if he is giving me the full truth. When I asked him what he has done tried to cope with the sudden feelings of fear or panic and he seemed confused about coping skills. This made me concerned about how well he is functioning in his daily life and if more immediate help is needed.

    I made a note to address "The Hand" in the next session in order to get a better idea of what he means.

    Glancing again at the clock, I walk across the hallway and fall into my bed almost falling asleep before my head even hit the pillow.