Marcus stops by Bill’s room in the afternoon. Bill is a slight, frail-looking man with a short, military-type haircut. He is dressed in black dress pants and an oxford cloth shirt. Even though he is slumped over in his wheelchair, he appears to be very alert as he focuses on Marcus entering the room.

MARCUS: Hi, Mr. Lee, I am Marcus Hill. I am taking Julie’s place here while she is on medical leave. Do you prefer that I call you Mr. Lee or Bill?

BILL: You can call me Bill.

MARCUS:  Please call me Marcus.

Marcus: I am hoping to spend time with each of the residents here this week. When would be a good time for us to talk?

BILL: (speaks in a soft voice, almost a whisper) I am not really doing anything right now, and I guess I could spend a few minutes with you. Are you the one I talk to about my care?

MARCUS: May I pull up a chair and sit with you while we talk? (Bill nods.) I am really interested in getting to know you. I hope you will be willing to tell me your concerns. This first time together is just to get to know each other and talk about what I can do for you while I am here. It must be hard sometimes to figure out who does what around here with so many people coming and going.

BILL: Well, with all these people, you’d think someone would be able to help me when I need it, but no, there is never anyone around when I need it. When I was the director of the U. of F. library, I made sure my employees knew that the students and faculty were the ones we were there to serve, not to make things easy on the people who were working there. But here everyone tries to get out of work any way they can and hide somewhere to sit or take a nap. If I could take care of my mother, we wouldn’t be in here at all. She needs better care and isn’t getting it.

MARCUS: You sound really frustrated with the care here.

BILL: You bet I am.

MARCUS: It must be hard to know your mother needs care and you can’t do it anymore. I understand you were caring for her until you came here.

BILL: I did everything for her until I got too weak. You know I have ALS and now it is getting a lot worse. But I am in contact with a doctor in China who is working on a combination of herbs and acupuncture to reverse the symptoms of ALS. Once he perfects the cure, things will change for me and my mom also.

MARCUS: So you are hoping that you will be able to do more for yourself if this doctor can figure out the right combination of traditional Chinese medicine. That must give you something to look forward to.

BILL: More than the doctors at the ALS clinic do for me. You know they have a practitioner there, too. They are always trying to get me to talk to her. What would she know about someone who has to sit in a wheelchair, who needs help to eat, and can’t do anything for himself?

MARCUS: It sounds like you don’t feel like anyone really can understand how you feel about needing so much care. That must be really hard.

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BILL: It is very hard. (looks away) It is hard when you have to ask someone to do everything for you, and your mother needs your help, and you can’t give it. You know, I used to be really independent and someone who was important. Now, I can’t even read my books. (He gestures with his head towards a bookcase filled with books.) Do you know the worst part? I have to have someone help me with my electric wheelchair to even go to my mom’s room.

MARCUS: It must be very frustrating to have things you really want to do and can’t unless you can get someone to help you.

BILL: (After a long silence)Well, maybe other people can understand me a little.

MARCUS: You mentioned your mother. I haven’t met her yet, and I’d really like to learn more about her.

BILL: Well, her name is Yue, and she and my father came here from China in 1935 when he was a graduate student at W.U. My father died when I was in college, and I came back to live with her after I finished my Master’s Degree in Library Science. I guess she took care of me until I started taking care of her. (laughs) I’m not much of a cook or very good at cleaning, but I did my best when she got too sick to do those things. You know, she doesn’t seem to be that unhappy here. I guess they know how to take care of someone like her better than someone like me.

MARCUS: What do the doctors tell you about her condition?

BILL: Well, they say she won’t live that much longer and ask me what I want them to do if she gets really sick. You know, I don’t really want to talk about those kinds of things with them, but I guess I have to since there is no one else. She can’t really talk anymore, although I know she knows me when I go to her room to visit. Do you think we could quit talking now? I am feeling really tired.

MARCUS: Certainly we can stop now. I am glad to begin to get to know you and hear about some of your concerns. I’d like to come back another time, if that is okay.

Questions: 1. How has your initial perception of the client changed? 2. What new facts have you learned? 3. Write out three additional things that the practitioner might have said to express understanding. 4. What might the practitioner have said or asked to identify or express understanding of the client’s strengths? See the first posting under this discussion area for the description of Bill’s case. Prioritize making this a discussion rather than a series of individual postings.

This is separate from the above. Just think as an addiction counselor would.

Question: Imagine that a friend comes to you with problems such as legal trouble, no place to to live, just terminated a relationship, or failing in school. Discuss how you would prioritize the issues and establish goals and objectives. Justify your response though material presented in the course to this point.

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