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Behavior:
Client logged into the virtual session appearing sad. Client reported feeling overwhelming sadness due to her father's declining health, stating, "I feel like I'm already grieving him, and then I feel guilty because he's still alive." Client described difficulty being present during visits with her father, as she is preoccupied with thoughts about how much he has changed and how little time might be left.
Intervention:
The session lasted 50 minutes and was conducted virtually. Therapist provided psychoeducation on anticipatory grief, explaining it as a normal response to a loved one's serious or terminal illness. Therapist normalized the client's feelings and reframed her guilt, emphasizing that grieving in advance does not equate to giving up or wishing for the loss. Therapist guided the client in exploring ways to stay present with her father while honoring her grief, including creating small meaningful moments and journaling memories or feelings.
Response:
Client appeared relieved and expressed that she had been carrying guilt, thinking something was wrong with her for feeling this way. Client engaged actively in the discussion and showed openness to the suggested strategies for balancing her grief and presence with her father.
Plan:
Client will attempt a meaningful visit with her father this week, focusing on being present and creating small moments together. Client will also begin journaling memories and feelings as a way to process her grief. The next session is scheduled for next week, and progress on these tasks will be reviewed.
We had a 50-minute virtual session today. Rachel logged in looking sad and said her dad's health has been declining and she's been feeling this overwhelming sadness even though he's still here. She said quote 'I feel like I'm already grieving him, and then I feel guilty because he's still alive' unquote. She described how every time she visits him, she's thinking about how much he's changed and how little time might be left, and it's hard for her to just be present with him.
We talked about anticipatory grief and how it's a completely normal response when someone you love is facing a serious or terminal illness. I explained that grieving in advance doesn't mean you're giving up or wishing it would happen sooner, it's your heart trying to prepare for something really painful. She seemed relieved to hear that, like she'd been carrying so much guilt about it. She said she thought something was wrong with her for feeling this way.
We worked on finding ways to stay present while also honoring the grief. I suggested that she give herself permission to feel both, the sadness about what's coming and the gratitude for the time she still has. We talked about creating small meaningful moments with her dad, things that don't require him to be the person he used to be, like just sitting together or listening to music he loves. I also encouraged her to write down memories or things she wants to tell him, as a way to process the grief without it taking over every visit. Her homework is to try one meaningful visit this week where she focuses on just being with him, and to start a journal for the memories and feelings that come up. We'll meet again next week to see how it's going.
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