BIRP Note Generator

I want to discuss some questions with you. Did you get a chance to fill out and submit the forms I sent? I understand it was just yesterday, so no worries if you haven't. Can you tell me your birthday? June 27th, 1989. And how old are you? I'll be 36 in June. What's your marital status? Single. I know you're dealing with your mom's situation. My mom was diagnosed with colon cancer in September, and she had surgery a few months later. We found out in November that it was stage 3, and the doctor recommended chemo. She had to undergo 8 treatments: one IV every three weeks, pill chemo for two weeks, and one rest week. She also needed a lot of blood work and other tests during this time. She was doing okay for the first three treatments, but during the 4th and 5th, she started experiencing constant nausea and dizziness, almost passing out. My mom is 66, which isn't very old. Even the doctor said she's relatively young. She retired about four years ago, just before COVID. Despite being retired, the nausea and inability to focus are challenging for her. She also developed bright red, peeling hands and feet, among other side effects. After her chemo yesterday, they reduced the dosage to 75% and gave her allergy medicine through the IV, which seems to have helped. She's handling it better now. The worst part for me is not feeling useful. Are you the one taking her to appointments? My dad usually does, but I offered to go on medical leave to help. However, my mom doesn't want me to be financially burdened, so I take care of her on weekends. Before COVID, I was a chef, so I handle all the cooking. I moved out at 25 and have been on my own for about a decade, but I live only 15-20 minutes away. The helplessness comes from always being self-sufficient and useful, and not being able to help irritates me. My identity is tied to being useful. On a scale of 1 to 10, with 10 being the most intense, my distress level is around 7. A lot has happened in the last 6-8 months, including my grandmother passing away in October. My mom didn't let me see her falling apart, but I know she was really upset. My grandma lived in Ontario, and the funeral was there. I couldn't get time off work to attend, but my mom said it needed to be her and her siblings handling it. She was practical about it. My mom's treatments and my grandma's passing have made the last few months a roller coaster. I'm sorry to hear about your grandma. How did your mom handle it? She didn't let me see her falling apart, but I know she was really upset. My grandma lived in Ontario, and the funeral was there. I couldn't get time off work to attend, but my mom said it needed to be her and her siblings handling it. She was practical about it.

Rewrite

I've always had to be self-sufficient, and if I can't be useful, it irritates me. Being useful is a significant part of my identity. Recently, I've been feeling a sense of helplessness, and I'd rate my distress at a 7 out of 10. I work in a metal processing plant, operating machines, forklifts, and overhead cranes. It's a male-dominated environment, and I'm one of three females. Lately, I've been getting more intensely annoyed with my coworkers. When I'm annoyed or angry, I walk away and continue working, but the intensity of my annoyance has increased. I bottle up my frustration, which feels overwhelming.

Rewrite It seems like you're grappling with a lot of emotions and uncertainties. You're wondering how to handle your needs and emotions, especially when it comes to your mom, who has always been strong and self-reliant. you manage by walking away and bottling up your feelings. You try to release this energy through exercise, biking, and walking. You decided to seek counseling after a particularly intense reaction your mom had to her treatment, which made you feel helpless. You've never had counseling before, but you were recommended to it by a coworker. You hope to find ways to cope better with your emotions and not feel the "pit" inside you. You have a strong awareness of taking care of yourself, avoiding unhealthy habits like drinking or drugs. You want to feel calm and not have that helpless feeling anymore. You've always had this sense of helplessness, but now it's more intense, and you're looking for ways to manage it better.

A coworker recommended me to you to counselling about a year and a half ago. You've never had counseling before, but you've had experiences in early childhood that shaped who you are. You don't always have the best coping mechanisms for your anger, and recently, you've been feeling more overwhelmed. You were able to cope before, but now it feels different. You decided to call and see if I was available because you've never had counseling and wanted to find out what it's like. Was there a particular incident that made you decide to seek help? You mentioned your mom's last treatment, where she couldn't talk or walk, and you thought you might need to take her to the emergency room. It was a scary and helpless situation. When you feel that intensity, do you have any urges to numb, fight, run away, or control the situation? You mentioned feeling panicky and going for long walks or drives. It's good that you don't engage in harmful behaviors like drinking or drugs. You might have an occasional drink, but it's not to escape. You knew someone who struggled with alcoholism and passed away, which made you realize you didn't want to end up like that. You have a strong awareness of taking care of yourself and being self-sufficient. You mentioned that your goal for counseling is to feel calm and not have that "pit" inside, which represents helplessness and other intense feelings. It's important to recognize and check in with yourself to gauge how you're doing. Even though you've never had counseling before, you've experienced that sense of helplessness in the past, especially when you were bullied in school. You had to work on your self-esteem and sense of self by yourself, which shows your self-sufficiency. It's good that you're seeking help now. Counseling can provide healing through relationships, allowing you to trust, open up, and be vulnerable. It's important to recognize when you're masking your pain and not sharing it because you haven't been able to rely on anyone. This is something you learned from your mom. It's a form of masking, not sharing when you're hurting because you haven't had anyone to rely on when you're in pain.

Rewrite the pit inside, which is the helplessness and all the feelings that go with it. That's good to recognize it that way because you get to check in and see how you're doing. Even you, like, I would check in and say where are we at with intensity and the stress and everything.

you can check in to sense how big is the pit, how heavy , how intense there will be a certain sensation around it that you can follow. It's good exercise or tool gauge to see where you're at. Have you had that sense of a pit before? not the outside experience but the internal helplessness, the pit in your stomach. Have you experienced that before? I've Always had that. Oh, OK. I was bullied heavily when I was a kid. In elementary school and high school. I had to do a lot of soul searching when I was in my early 20s I got away from all those people. And basically had to work on myself to not feel like I'm worthless. Oh. So work on your sense of self. Sense of self and self-esteem and stuff like that. Wow. So you did that by yourself? Yeah, you really are self-sufficient. On the one hand, good for you. On the other hand, it would be nice to have that be reflected because that's based on a wound and pain of the message you got in relationship to other people. healing is what we hope for counseling healing through relationship Finding you can trust, you can open up and be vulnerable. How are you doing? You say you're OK. You've said your mom does that. I kinda learned it from her. it's like a masking. I don't really like sharing when I'm hurting because I haven't really been able to rely on anyone. That would feel sad. yeah. that's key for all of us as human beings, and I can see it's at the surface for you right there, I can see the tears. You don't need to push to open up, I don't expect that just take care of yourself. Would you like to talk more about that or do you want to just move on and get back to it when we do? I'm not ready to open up about that yet just yet. My mom is named Eileen. We Used to butt Heads a lot When I was younger. She wanted me to be a certain way, and I'm like she wanted me to be more girly. And. Do certain things and I'm more of a tomboy. Felt like she was disappointed. She was Pushing a lifestyle on me that I didn't want.

Rewrite My relationship with my mom has improved since I moved out of her house. We used to fight constantly, but now that we each have our own space, things are better. My dad, Ian, is 71 and his birthday is next month. When I was younger, he worked a lot, so I didn't see him much, but now we're pretty close. He's been a big support. I have two younger brothers, Adam, 34, and Jamie, 32. My mom has a large age gap between her siblings. She's 66, her brother is 63, and there's a 10-year gap between her and the two of them. Her youngest sister is 13 years younger. My mom and dad have been together for 37 years. My dad is loyal, mathematical, and used to be an aircraft engineer. He was always needed to fix aircraft because he had the licenses. He's very straightforward but always there when you need him. My mom is emotional and can't hide her feelings. She's very involved in our lives and always there for us. Adam is like a teddy bear until you make him angry, then he can be a grizzly bear. He works with kids with disabilities and coaches Titan football. Jamie just finished level 2 for engine electrician and is working at the new Saint Paul, putting in all the electrical wires. I'm close to both my brothers, and we have our moments like all siblings do. I live by myself with my cat, Fortune, who has been the boss of my life for 10 years.

The other stressor in my life is dealing with the estate of my grandma. My mom and aunt were pushed aside by my uncle, who has been acting poorly. My mom has basically disowned him. My other aunt is very upset with her. My mom is the oldest, and my aunt is in the middle. My uncle and aunt were the executors, but in Ontario, you need to be in Ontario to be the executor. That's been an absolute nightmare and makes her extremely upset to the point where. She dealing with the chemo. It's like she can't function. Good your dad is supporting her.

Rewrite The stress in your family is palpable, particularly because it affects your mom. This division within the family is undoubtedly a significant stressor. Your youngest brother struggles with anger issues, but he finds solace in walking the dogs when he's upset. Your dad's coping mechanisms are limited to watching TV, reading the newspaper, and walking the dogs. Your grandma was incredibly stubborn yet loving. She endured an old fracture in silence, leading to unnecessary pain. After her bones were reconstructed, she initially improved but soon deteriorated, eventually falling into a coma and passing away in hospice. The women in your family are fiercely independent, while your brothers rely heavily on your mom. Your cousin is dependent on his wife, and another cousin is a workaholic, possibly as a way to avoid substance abuse due to his anger issues. This dynamic is well-known within your family. Your uncle, a very unpleasant person, is your cousin's father. Your mom is the heart of the family, always caring for others. Your grandfather, on your mom's side, still harbors anger from his childhood and refuses therapy. He didn't have a positive role model, as his father died in a work accident when he was just ten, forcing him to become the man of the house. Your great-grandmother, a school teacher, didn't want to acknowledge her son's need for help in school, fearing it would reflect poorly on her. You've taken an interest in your family's genealogy, tracing your roots back to Ireland. This exploration helps you understand the pressures and expectations passed down through generations. Your mom's explicit expectations and the implicit ones from your ancestors can explain a lot about your self-perception and any issues you might face. Recognizing these unconscious expectations can help you understand that the problem lies in the expectations, not in you. This realization can be particularly enlightening, especially if you struggled with subjects like math and science.

Dads he still gets angry about things that are from when he was. A child. A teenager and it's like, go to therapy. No, I don't want to do that. Well, then what you're going to do? Be angry. Rewrite I understood the material, but I needed more time or tutoring, which I didn't receive. When I got home, tutoring was frowned upon, as my great-grandmother believed it looked bad. Bringing home bad grades felt like the end of the world. I remember getting a C-minus in English and being questioned about it. I was doing my homework and trying my best, but it wasn't enough. My mom probably felt like she was failing if I wasn't succeeding. She was dealing with three kids and trying to keep the house in order while my dad was at work. Her reactions were likely over the top due to the situation, not because of me. At the time, I couldn't see it that way. I couldn't go to her when things were tough because she would lash out in anger. This created a rift between us during my teenage years. School wasn't easy, so I decided to pursue culinary arts because I enjoyed cooking. However, I didn't like the politics of restaurant life and dealing with customers. The saying "customers are always right" frustrated me, especially when I couldn't control food prices. We discussed the genogram and the expectations placed on me. Our life is like a wheel, with the core being our beliefs about ourselves. Outside of that are the beliefs shaped by our environment. Each spoke represents an issue, and we can address them to strengthen our sense of self. Significant childhood memories or events can reveal pressures that shaped us. I have some happy memories, but I can't remember much of grade 8, likely as a coping mechanism. My brothers and dad didn't know how heavily I was bullied. My dad only found out a few months ago. He was surprised when I told him about my bullies. My mom never talked about it with him. I don't care about the lives of my former bullies, even if they've moved on and started families. My dad didn't understand why I felt that way. It's frustrating because being single and childless isn't everything in life. I know it's a generational expectation, but it's not my priority.

And. Rewrite Generations have always been expected to work until they can retire, but I don't see my life that way. My dad, however, doesn't always understand. He worries about me, thinking I'll end up alone, but I could meet someone tomorrow and get married. Whether I want kids is another question; they're a lot of responsibility. Even if I have kids, I could still end up alone. My mom often talks to people for hours, finding out their kids have nothing to do with them. But I visit my parents every weekend, unlike some people who don't have that family connection. When I tell my dad this is what's right for me, he worries but doesn't always understand. He says he's just worried about me, but I wish he'd say he trusts me and has my back. Our family's communication style is expressive and loud, often arguing but also laughing together. It's always been just the five of us, with extended relatives far away. We used to visit them every summer and spring break, thanks to my dad's airline job, but that stopped when my siblings and I grew up and got jobs. For about 18-20 years, we had those visits, which was pretty good.

Mm. And like we would sporadically go back ourselves with our parents, but usually with our parents. His family lives in Newmarket. Mom lives in. Basically. Sonic Chatham area. Down to your monteir. My aunt lives in London ON. Was like constantly moving around. So. So my. Grandma lived 4 hours away from Toronto. So it'd be like. That's a long ways away, I think from where 'cause you land in Toronto, I'm guessing? So it's like a 5 hour flight and then a. Hour drive. eah, that's a whole. Yeah. So the communication is expressive. Open I mean open in the way of nobody's holding back, which can be good and bad. Rewrite The communication within the family is very expressive, with no one holding back, which can be both good and bad. When conflicts arise, they eventually resolve, either through individual efforts or simply by giving it enough time. For instance, after an argument, family members might separate for a while, and then things return to normal. This process doesn't affect my relationship with my brothers, even though they sometimes get on my nerves. There's a sense of loyalty among us, despite occasional animosity, especially when my brothers, who are in their 30s, still live at home and have strong opinions about my life. My mom tends to favor my brothers, a trait passed down from her own mother, creating a patriarchal dynamic where the males are seen as more important. My dad, on the other hand, is more supportive of me as his daughter, while being harder on my brothers, expecting them to handle things on their own. This patriarchal attitude shows up in different ways within the family. As for past relationships, I don't have any friends from my school days, as those connections fizzled out. In my adult life, working in the culinary world made it difficult to maintain friendships, as my work schedule often conflicted with others, leaving me to make all the plans.

Rewrite In my twenties, I often felt invisible, especially to those outside the culinary world. My work hours clashed with typical social times, making it hard to maintain relationships. Friends would ask me to let them know when I was available, but it felt like they only wanted me around when they needed support. I had a best friend who moved to South Korea, yet we remained close despite the distance. Another friend, who works at the honeybee center, shares my interests in Marvel and other hobbies. However, a recent friendship ended in November when my friend dismissed my struggles, claiming his life was harder. This toxic behavior was the final straw, especially after he belittled the importance of my family during a difficult time. I realized I had been used and decided to cut ties. Although I am loyal and forgiving, I cannot tolerate anyone who dismisses my family's significance. This experience has made me wary of new friendships, often questioning if people will truly stay in contact. My past bullying and fizzled friendships have led me to take a cautious approach to new relationships, slowly warming up to people to avoid being hurt again.

Rewrite With only 15 minutes left, we won't be able to address all the remaining questions, so let's move on to your medical history. Have you experienced any illnesses, head injuries, surgeries, or hospitalizations? I once had an accident while curling in high school, where I slipped and hit my head on the ice. Although I didn't go to the hospital, I felt like I might have had a concussion because I couldn't move my head for about a week. Fortunately, it eased up eventually, and I've never had a broken bone. This accident happened when I was 17, during my graduating year in June 2007. Regarding your lifestyle, how would you rate your physical health on a scale from 1 to 10, with 1 being poor and 10 being excellent? I'd say I'm around a 5. After work, I usually make dinner and either ride my bike or watch movies on Netflix. I also take care of my demanding cat. My sleep is generally okay; I go to bed around 7:30 or 8:00 PM and wake up around 4:00 or 5:30 AM, depending on whether I'm doing overtime. Sometimes I have trouble falling asleep due to overthinking, but eventually, I manage to sleep, often with the help of my cat. On weekends, I spend Sundays with my family and Saturdays doing chores or going for walks, as long as it's not raining. I don't use substances, but my uncle, my mom's brother, drinks and smokes a lot, which has led to two heart attacks and a couple of bypasses. As for addictions, I don't gamble because I used to work as a chef in a casino, and employees weren't allowed to gamble there. I do tend to work a lot, partly due to financial insecurity from losing my job during COVID. I now work at Costco as a forklift operator, which offers a more stable schedule with weekends and holidays off. Despite some complaints from my coworkers, I appreciate the setup. Overall, I feel a bit weak and hopeless, but I'm recognizing that this is a good place for me. It's important to remember the loving part of yourself that sees this as a positive environment, pushing through any negative beliefs. Rewrite Sure, let's focus on anything that surprised or interested you. If nothing stands out, that's fine. I'm curious about your thoughts, especially regarding Fred. You mentioned feeling guarded and wanting to be more open. This sounds like a goal we can work towards. By being here and handling this, you're already making progress. We can explore what makes you shut down and how you handle it. Is there any insight or opening around that sense of helplessness? Sometimes opening up gives more insight, and we can explore that further. It seems like this stems from your upbringing and possibly your parents' upbringing. It's great that you're aware of these patterns showing up now. Anything else you can think of? Saturdays work better for you in person, so let's plan for next Saturday at 1:15 PM. I'll book 90 minutes again and see how it goes. I'll remind you in an hour. I'll send you the invoice, and you can pay with a credit card or e-transfer on the website. The website accepts Visa, and PayPal is also available. If there are any problems, let me know. PayPal is still used quite a lot in Vancouver, especially for parking. Feel free to message me with any questions or thoughts during the week. Stay open to any dreams or thoughts that come up, as we've opened doors and memories might surface. You don't have to figure anything out or worry about it until Saturday. Thank you very much, and take care. See you next time. Bye.

The client reports he has not stayed long enough in treatment for mental health services, so he has not learned how to deal with mental health symptoms. Depression/anxiety/numbing/Emotional/physical dysregulation: hyperarousal/adjustment to trauma/Anger: Per reports, the client has a history of feeling trapped, feeling annoyed, struggling with his temper, feeling anxious, isolating, having flashbacks, and struggling to pay attention. The client reports that he would rather sleep all day. The client has reported that he struggles to express himself and keeps his emotions in. The client reports that he has calmed down and does not get angry. Per reports, the client has a history of "increased depressive symptoms of anger, lack of sleep, and decline in functioning." The client has lost weight since the last intake interview. The Client has a history of suicide and tried to hang himself.

substance use/addictive behaviors: The client was 10 years old when he began smoking marijuana and drinking alcohol that he got from his father. He said he started using cocaine at 11 and he stated he got it from 'friends' or acquaintances that had access. Around the age of 12 he started to use Opiods. Additionally, he has used mushrooms and ecstasy. His records indicate that he was referred for substance abuse treatment at 14 years old at Depot-Wabash County. The client disclosed a history of running from treatment programs, including an 8-month period on the run. The client identified cocaine, mushrooms, ecstasy, and alcohol as substances he uses, with tequila being his primary choice while on the run. He described alcohol consumption as providing a sense of calm, while the other drugs led him to become impulsive and aggressive.

traumatic grief: Per reports, the Client found his mother dead and blames himself for not doing more to help. family/living: The client has a history of being bounced around with family and friends and then going back to his father's home when that living situation did not work out. He reported that he once again moved into a different friend's home due to the lack of food, clothing, electricity, and running water in his father's home. Medication complaint: The client has a history of snorting his medication.
school: The client was previously kicked out of school due to his behaviors and is now attempting to obtain his GED. Oppositional (Non-compl. w/auth)/conduct/decision making/legal/ impulsivity: The client has a history of fighting and getting upset but reports that he does not anymore unless someone disrespects his family. Jaxsun Keepes was admitted to HRC on 6/6/24 as an Initial Commitment for harassment/telephone and cyberstalking. Jaxsun had created a fake social media account and threatened to burn a house down with his peers. In the threats, he provided details of the peers' homes, including the layout of the windows/bedrooms. The client also had bullets in his possession. The client has threatened to harm others. The client was under investigation for homicals threats via social media. The client has a history of being on the run and reported that when he feels trapped or has cravings, he leaves the facility. The client reports that when he runs for weeks to months at a time. He also has a history of fighting at school. The client has a history of lying. Client disclosed a past involvement with gang activity as a member of the Black Disciples Independent living skills: CLient reports he does not know how to cook for himself. The client reports knowing how to microwave and bake pre-made food.

Client continues to maintain sobriety. No reports of reoccurrences or cravings over the past week. This writer and client discussed setting realistic goals.

I want a ppts presentation for the first day at school How do I present myself, and how do the children present themselves through activities?