| Course | PAC 120 Multicultural Advocacy |
|---|---|
| Module | Module 4 |
| Paper type | Reflection skills analysis |
| Length | About 1,071 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Psychology and Addiction Studies |
| Updated | October 2026 |
Free sample paper for PAC 120 Module 4
Grief She Would Not Name: Reflecting Feelings and Meaning With a Grandmother Who Drinks Since Her Grandson's Death
Student Name
Psychology and Addiction Studies Program, Aspen University
PAC 120: Multicultural Advocacy
Instructor Name
Month Day, Year
Grief She Would Not Name: Reflecting Feelings and Meaning With a Grandmother Who Drinks Since Her Grandson's Death
Mrs. Dorothy Hayes is sixty-three, a retired school cook and the grandmother who raised her grandson, Darnell, after her daughter's death. Eight months ago Darnell died of a fentanyl overdose at twenty-two. Mrs. Hayes came to Northside, the fictional Milwaukee program used in these papers, because her pastor noticed she smelled of wine at Wednesday Bible study and suggested she talk to someone. In her first session she said she was fine, that the Lord does not give a person more than she can bear and that she only has a little wine to help her sleep. This paper analyzes how I reflected her feelings and the meaning she made of her loss. Mrs. Hayes is a composite and the program is invented, so neither should be read as a real person or place; the research is real.
Reflection of Feeling and Meaning
A paraphrase restates the content of what a client said. A reflection of feeling goes further, naming the emotion beneath the words, often tentatively, so the client can confirm or correct it. A reflection of meaning goes deeper still, naming the values, beliefs or sense of purpose that make an experience significant to the client. Reflections are the most direct way a counselor communicates empathy: the effort to understand the client's experience from the client's point of view and to show that understanding.
Why Empathy Matters
Elliott et al. (2018) conducted a meta-analysis of studies relating therapist empathy to client outcomes across many forms of therapy. Empathy was consistently associated with better outcomes, with an effect of moderate size, making it one of the better-supported elements of the therapy relationship. The relationship held across therapy approaches and was stronger when empathy was rated by clients or observers than by therapists themselves.
In addiction treatment, the evidence is especially striking. Miller et al. (1980) compared several behavioral treatments for problem drinkers delivered by different counselors. The treatments did not differ much in effectiveness, but the counselors did. Counselors rated higher in accurate empathy had clients with markedly better drinking outcomes months later, and the empathy ratings explained much of why some clients improved far more than others. Moyers and Miller (2013) reviewed this and later research and argued that low empathy is not merely neutral. Counselors who are low in empathy and high in confrontation may actually make clients worse, and they argued that empathy should be a selection and training priority in addiction treatment.
Culture and Competence
Soto et al. (2018) conducted two meta-analyses on culture in psychotherapy. The first found that therapies adapted to clients' cultures were more effective than unadapted ones. The second examined therapist multicultural competence and found that clients' ratings of their therapists' multicultural competence were associated with better outcomes, while therapists' ratings of their own competence were not. The finding is humbling: what counts is whether clients experience a counselor as understanding their culture, not whether the counselor believes they do. For reflections, this means attending to how a particular client expresses feeling and what meanings matter to her, rather than applying a single formula.
The Reflections, Annotated
| Mrs. Hayes | My reflection | Type | What happened next |
|---|---|---|---|
| "I'm fine. The Lord doesn't give us more than we can bear." | "Your faith has been holding you up through this." | Reflection of meaning | She nodded: "It has. Most days." |
| "Most days. Some nights I just sit in his room." | "Some nights the missing him is very heavy." | Reflection of feeling | She was quiet, then: "Heavy. Yes." |
| "He was doing better. He'd been clean four months." | "You're angry that it happened when he was doing better." | Reflection of feeling, premature | She stiffened: "I'm not angry. I don't get angry at God." |
| "I'm not angry." | "It's not anger. It sounds more like it doesn't make sense to you." | Correction and softer reflection | "No. It doesn't make sense. None of it does." |
| "I raised him. I should have seen it." | "You carry the feeling that you should have protected him, because you were the one who raised him." | Reflection of feeling and meaning | She cried for the first time: "I was supposed to keep him safe." |
Reflecting Meaning Rooted in Faith
Mrs. Hayes's faith is central to how she understands her loss. My first reflection recognized that faith as a source of strength, and she responded with agreement and a small opening: "Most days." My third reflection, which named anger, missed in two ways. It went beyond what she had said, and it collided with a belief that anger at God would be wrong. When she rejected it, I followed her lead, reflecting confusion rather than anger. The result was her most important statement: none of it makes sense.
I did not try to change her belief that the Lord does not give more than a person can bear. A counselor's role is to understand the meaning she makes, not to correct it. But reflection allowed her to hold two things at once: her faith and the weight that sometimes exceeds what she can carry alone. Later in the session, she connected the wine to the nights in Darnell's room, saying she drinks so she can sleep instead of sitting there. That connection came from her, after she felt understood.
Lessons for My Practice
First, I will reflect what the client has said before reaching for what I think lies beneath it, since premature reflections can feel like accusations. Second, when a reflection misses, I will follow the client's correction rather than defend my interpretation; her correction often contains the truest feeling. Third, I will treat faith and family meanings as part of the client's experience to understand, not as defenses to get past. With Mrs. Hayes, her faith and her pastor may also become part of her support, with her permission.
Conclusion
Mrs. Hayes arrived saying she was fine. Through reflections of feeling and meaning, she named her grief, her confusion and her belief that she should have protected Darnell, and she connected her drinking to the nights in his room. Elliott and colleagues and Miller, Taylor and West show that empathy predicts outcomes, Moyers and Miller show that its absence can harm and Soto and colleagues show that what matters is whether clients feel understood. Reflection is how a counselor offers that understanding, one careful sentence at a time.
References
Elliott, R., Bohart, A. C., Watson, J. C., & Murphy, D. (2018). Therapist empathy and client outcome: An updated meta-analysis. Psychotherapy, 55(4), 399-410. https://doi.org/10.1037/pst0000175
Miller, W. R., Taylor, C. A., & West, J. C. (1980). Focused versus broad-spectrum behavior therapy for problem drinkers. Journal of Consulting and Clinical Psychology, 48(5), 590-601. https://doi.org/10.1037/0022-006X.48.5.590
Moyers, T. B., & Miller, W. R. (2013). Is low therapist empathy toxic? Psychology of Addictive Behaviors, 27(3), 878-884. https://doi.org/10.1037/a0030274
Soto, A., Smith, T. B., Griner, D., Domenech RodrÃguez, M., & Bernal, G. (2018). Cultural adaptations and therapist multicultural competence: Two meta-analytic reviews. Journal of Clinical Psychology, 74(11), 1907-1923. https://doi.org/10.1002/jclp.22679
Reading the PAC 120 Module 4 assignment instructions
Reflection is the skill PAC 120 develops in its fourth module, and the typical assignment asks you to show reflections of feeling and meaning in an actual exchange and explain why they work. Defer to the Module 4 prompt your Aspen course provides; the client is invented. Define reflection of feeling and reflection of meaning, and distinguish them from paraphrasing content. Present reflections in dialogue with the client's words before and after, so the effect is visible. Use research on empathy to explain why reflection matters. Address how culture shapes the expression of feeling and the meanings clients make. Include at least one reflection that missed, and supply an APA 7 citation for every study you discuss. Keep the client's own words exact.
Inside the PAC 120 Module 4 example
Mrs. Hayes says she is fine and that the Lord does not give more than a person can bear, then mentions the wine she drinks each night. The paper defines reflection of feeling, reflection of meaning and paraphrase. Elliott and colleagues' Psychotherapy meta-analysis supplies the empathy evidence, and Miller, Taylor and West's study and Moyers and Miller's review show its weight in addiction treatment. Soto and colleagues' Journal of Clinical Psychology meta-analyses show why clients' view of counselor competence matters. A five-row table annotates reflections, including one that labeled her anger too soon. A section on faith shows how reflecting meaning honored her belief. Three lessons close the paper, each a change the writer can make in the very next session.
PAC 120 Module 4 rubric: what earns full marks
Reflection papers earn credit for accurate definitions, for dialogue that shows reflections and their effects and for research connecting empathy to outcomes. This example shows each reflection with what Mrs. Hayes said next, so the reader can judge its effect. It includes a reflection that missed and explains why, which demonstrates honest analysis. The section on faith shows cultural responsiveness without stereotyping: her faith is treated as her meaning, not as a cultural trait. The research is reported accurately, including the strength of the empathy findings, and the lessons connect directly to what the writer will do differently with the next grieving client. Each lesson is phrased as a habit the writer can practice.
PAC 120 Module 4 help: mistakes that cost marks
Reflection papers often confuse reflection with paraphrase. A paraphrase restates content; a reflection of feeling names the emotion, and a reflection of meaning names what matters to the client beneath it. Show the client's response to each reflection. Include at least one that missed, since that demonstrates learning. Address how culture shapes the expression of feeling; some clients express grief through faith, duty or anger rather than sadness. Do not argue with a client's beliefs or treat them as defenses. Report empathy research accurately. Keep your reflections short in the transcript; long reflections are often interpretations in disguise and can leave a client feeling analyzed rather than heard. Read each one aloud before you include it.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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PAC 120 Module 4 questions, answered
What does PAC 120 Module 4 usually ask for?
Aspen's PAC 120 focuses on reflecting feelings in this module, so showing and analyzing reflections of feeling and meaning in an exchange is typical. Check the Module 4 prompt.
What is the difference between a paraphrase and a reflection of feeling?
A paraphrase restates what the client said; a reflection of feeling names the emotion beneath it, such as grief, fear or anger.
Does counselor empathy affect outcomes?
Yes. Elliott and colleagues' meta-analysis found empathy related to outcomes, and Miller, Taylor and West found it strongly predicted problem drinkers' results.
Where can I find a free PAC 120 Module 4 sample paper?
Read it free here: reflections of feeling and meaning with a grieving grandmother, annotated in a table with attention to faith and family.
Does it matter how clients rate a counselor's cultural competence?
Soto and colleagues found clients' ratings of their counselors' multicultural competence were associated with outcomes, while counselors' self-ratings were not.