Case Formulation
At the six week mark of Brian’s supervision, the therapist sent me the following email:
“Hi Jason,
I met with a client yesterday named Jerimiah. In last night’s session he mentioned suicidal thoughts, i.e., a wish to just keep sleeping. I asked him if he had intentions to harm himself and he assured me that these thoughts “are just thoughts” and that “he has too much to lose to ever follow through”. He told me ”don’t worry.” I believe him and I don’t think there’s a risk of actual self-harm.
Nevertheless, I wanted to mention it to you. I’ll share clips during our supervision session tomorrow so that we can discuss.
See you tomorrow,
Brian”
This email fit within my formulation of the case and the work ahead in Brian’s supervision if he was to help Jerimiah with his overwhelming feelings. My sense was that Jerimiah’s therapy held the promise to be a place where he could put down some of his heavy burden by beginning to sort through painful feelings and this would provide him with a means to better manage the many stressors he juggles. In order for this to happen, it would require Brian successfully learning to fine tune the balance between providing Jerimiah a space for his feelings to emerge at their own pace and then applying enough pressure to encourage Jermiah to deepen his emotions past anger into places that might bring up sadness and loss. These dual tracks of Jeremiah and Brian’s development would be facilitated and practiced in Brian’s supervision through utilizing the SSM and DP.