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Challenging 1st Referral

I was very uncertain on what to expect for my first referral. Now reflecting on the process thus far, I would say the client was somewhat more challenging for my first referral than others. Challenges that arose throughout this case included:

  • Difficulty getting in touch with the client
  • Attendance to sessions
  • Lack of willing attitude
  • The setting in which the client carried out the sessions
  • Learning ability of the client


After the initial call with the client’s guardian, it become clear that there would be some challenges with this particular referral. I wanted to ensure that the challenges were minimised as much as possible for both myself and the client to make the process as fulfilling and beneficial as possible.  In order to overcome these challenges, I felt it was important to offer as much support as possible to the client and to be flexible to accommodate their needs.

To help overcome the learning challenges, the use of examples and rephrasing questions was really important, to ensure the client understood what was being asked and to help them feel supported and comfortable within the session. By ensuring the client feels supported throughout the process allows you to build a better rapport and generates a safe environment. This allows the client to feel able to air their concerns and struggles throughout the sessions and vocalise if they are finding there to be any challenges.  I used examples in correlation with my own situation and then would reflect using the situations of the client, this helped to put the questions into perspective for the client and allow them to think about what is being asked in terms of their own life.

The client also struggled to hold their attention.

The setting in which the client sat to take the meeting was not ideal for maintaining concentration. There were many others in the room, it was loud and chaotic; there were a lot of distractions. I used a combination of open and closed questions to keep the exchange going and to keep the client focused on the task at hand.

The client also has ADHD, which played a factor in how focused they could remain on a task. To help overcome this issue, for the second session it was agreed that we would break the session into two thirty-minute sessions rather than one, one hour session. The purpose of doing this, was to relieve the pressure of the client having to concentrate for a long period of time and hopefully promote positive engagement within the shorter sessions.

Based upon this referral I have learnt that it is best to accommodate the needs of the client to get the most out of the sessions rather than following standard guidance, and switching these into shorter sessions to meet the needs of the client.

Emma Hands

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