Pt arrived on time. Started with comments from friend N recommending she talk to writer about her video watching pattern. Briefly reviewed pattern but did not spend time exploring it before moving on to update of medical results - had MRI Tuesday night. Answered several questions about content. Next step is to schedule F/U appt with Dr. Augusthy. Having more pain/stiffness in her back with lower dose of Tylenol especially when first getting up. Confirmed dose of Tylenol as 4x 650mg and options for decreasing to three times/day. Moved on to review of goal tracker updates. Working to set specific block of time aside for working on tasks. Second half of the session spent reviewing writing exercises. These have continued the themes of defining content areas, target audience, and brand for writing projects. At times pt felt disconnected from aspects and related several negative thoughts (low self-confidence). Worked to reframe and look at larger context of writing and goal of these exercises. Challenged several of the negative assumptions about her skill level, ability to write effectively, develop a narrative. Made distinction between exploratory writing (goal is to understand her own thoughts/feelings) and writing for an audience (specific content for a specific audience). Explored options for process - working from small projects to larger ones. Pt reported benefit from discussion.
Pt arrived on time. Recovering from URI. Reviewed medical updates - audiology appt went well (had ear canal cleaned, has mild hearing loss, plans to wait, and monitor) and nephrology F/U (clinic visit note available, rec'd vit D dose that is different from what she is taking, has to F/U). Also having more interpersonal difficulties with partner. He is having more back pain in addition to general stressors. He has been more cranky, less cooperative, taking out feelings out on her. Feels that there should be limits but is uncertain about how to make progress. Reviewed several interactions. Validated affect and explored options for limits/boundaries. Second half of the session spent reviewing updates to schedule and online interactions from the weekend. Reviewed process and goals for accountability journal. Made connection between levels of responsibility between self and others - balance of helping/supporting and taking responsibility for self/others. Ended session with review of video summary from the weekend and pattern of picking news videos.
Pt was not on video at time of session. Writer called pt who had gotten distracted working on a meeting update. Moved to video. Pt had an early morning meeting for co-working platform. Reviewed details of interactions. Several members had frustrations with process, connected to scope of project vs. resources to work on components. Reviewed meeting notes and process. Discussed potential next steps for the group. Pt felt empowered with being part of the process. Reviewed medical updates - OK with current Vit D supplement, had chest pain yesterday, rec'd NTG refill, Ritalin RX not filled, called pharmacy in session to confirm (they do not have in stock), new RX sent to Walgreens, sent pictures to podiatrist (waiting for response), and pain MD appt. Reviewed more details about assessment and recommendations. MD appeared frustrated with patient's lack of follow-up. Next step is consultation with surgeon. Partner continues to be more irritable related to his own medical issues, but they have been working better together. Ended session with update with online tracking over the last several days. Online friend will be travelling, so will have less contact. Reflected on previous discussion of balance with self-confidence, independence vs. dependence.