helping skills midterm 2

Active listening (what is it, how it helps improve patient outcomes, what does it help establish between provider and patient)

• showing the patient that you are listening, centers their cair

• improves understanding of what brings an individual in and what they want to address

• avoids misunderstandings

• establishes trust between provider and patient

• improves overall communication

minimal verbalizations (minimal encouragers)

a way to demonstrate active listening

ex: “yes” “mm hmm” “ok” “uh huh” “go on” “i see” “i understand”

SOLER

how to demonstrate active listening

S - sitting straight and squared

O - open posture

L - lean forward

E - eye contact

R - relaxed stance

responding skills

Responding to Content: reflecting back the words someone has said, mirroring and condensing the content

Responding to Feeling: reflecting back a feeling/feelings, aka empathetic listening

Responding to Meaning: a type of response that personalizes the meaning of the person’s problem (helping them understand meaning and reasons behind a feeling or thought), orients towards action

Empathy (what is it, how it differs from sympathy, how it supports improved patient outcomes, why it is a key skill in the helping professions)

• “feeling with” vs “feeling for”

• empathy facilitates understanding!!

• so important for building and maintaining trust (the therapeutic alliance)

• goal = understand from the patient’s perspective, put them at the center

• facilitates therapeutic healing

• helps motivate the patient to work towards their goals

How can empathy be an important skill for responding to a person in emotional distress?

• builds connection and the feeling of safety

• use “fogging” to find a way to agree with something the person is saying or doing

• helps them understand the expectations and limits in an understanding way

• can help empower people, helps them feel validated and not judged

importance of identification and treatment for college mental health

• significant increase in prevalence of mental health symptoms over time

• college = important time of vulnerability and growth, especially with navigating new environments, transition to college, new social networks, changes to health behaviors

• top concerns = anxiety, depression, stress

• heightened risk for transgender individuals

• still a stigma around mental health

evidence-based strategies institutions can put in place for college mental health

• routine mental health screenings and check-ins

• stress management workshops

• peer support networks (support groups, counseling)

mindfulness meditation (what it is and what it can be used for)

• meditation and calming technique used to stay in the present moment and be intentional without judgement

• can help improve concentration, manage anxiety and depression, regulate emotions, etc.

providing feedback (steps involved in providing effective feedback and sequencing of steps)

• important to sequence feedback —> start with the positive, then offer an area of growth

• do a feedback look

1. start with “How do you think it went?”

2. ask them to identify at least one strength

3. ask them to identify at least one area they would like to im[rove on

4. offer your observations with the same sequence

self-care (effective strategies personalized, why it is important in helping professions)

• we are “instruments of helping” and need to take care of ourselves

• helps yyou acknowledge feelings, resist the “shoulds”, get more movement, build self-efficacy, intentionally seek joy, build calmness and a sense of control

phases of helping (Carkhuff)

1. Attending —> Involving (involving patient/client in the process, initiating interaction, reading the patient)

2. Responding —> Exploring (facilitates/cultivates exploration)

3. Personalizing —> Understanding (individual agrees to take on goals, enhances and facilitates understanding for the client

4. Initiating —> Action (assisting them to initiate/implement changes, leads to action

distorted thinking (what is it, what impact does it have, what are some types)

• common “thinking errors” that shape how individuals see and perceive the world

• can be recognized and changed

• involved negative feedback loops between your mind and body

  • you have to change your thoughts, your physical responses, or alter the situation to break the loop

• involves automatic thoughts

  • specific, discrete, almost always believed no matter how irrational they are, often include “should” or “ought to",” hard to turn off

• many styles of distorted thinking

  • mental filtering, polarized thinking (binary thinking), overgeneralization, mind reading, catastrophizing, personalization, control fallacies, fallacy of fairness, blaming, shoulds, emotional reasoning, fallacy of change, global labeling, being right, heaven’s reward fallacy

polarized thinking

aka binary thinking

• things are either good or bad, you have to be perfect or you are a failure, no middle ground exists

emotional reasoning

person believes what they feel must be true—automatically

catastrophizing

person expects disaster, notie prolems and start with “what if”

mind reading

without their saying so, people know what people are feelingand why they react the way they do, people believe they know how people are feeling about them

cognitive remediation (and how it can address distorted thinking)

• strategy to improve distorted thinking styles

• uses brain’s neuroplasticity to reframe, reorient thinking to improve overall functioning and wellbeing

• changing your thoughts can lead to changing your feelings, actions and behaviors, and your trajectory

3 C’s of cognitive remediation

1. Catch it

   1. identify the negative thoughts

   2. Check it

2. Check it

   1. gather evidence for or against the thought

3. Change it

   1. develop more accurate response, focusing on solutions

motivational interviewing (and principles)

collaborative, person-centered counseling, helps people make positive behavior changes by evoking their own reasons and commitment to change, gets rid of any power dynamics

principles

• express empathy

• supporting self-sufficiency

• developing discrepency

• RULE

  • resisting the righting reflex

  • understand the person’s motivation

  • listen to the person

  • empower the person

• listen for change talk!!

• spirit of MI!!

  • collaboration, evocation, autonomy

OARS

describes the microskills used in helping people make changes (for motivational interviewing)

O - open-end questions

• create space for the person to share what is important to them, wonder WITH

A - affirmations

• statements of appreciation, genuine and focus on strengths/characteristics, YOU are the mirror!!

R - reflective responding

• responding to content, feeling, meaning

S - summaries

• helps people organize their experiences, can be collecting or linking or transitions

Why is understanding an individual’s motivation to change crucial in the MI technique?

• we help them find and use their internal motivation!!!

• this is a process led by the patient, so we have to understand what motivates them so we can help them feel motivated

emotional dysregulation (and importance of invaliding environments as key contributers to dysregulation)

inability to manage intense emotions, leading to reactions out of proportion to the situation, like extreme anger, sadness, or anxiety

can be related to substance use disorders, eating disorders, and other destructive behavioral patterns

invalidating environments — a person’s emotions, experiences, or needs are dismissed, minimized, mocked, or punished, can become a major contributing factor to emotional dysregulation

Opposite Action skill from DBT

involves acting in the opposite way of what your emotions are telling you to do

helps manage emotions and reduces the intensity of emotions that aren’t serving the person well

DEAR MAN skill from DBT

skill in Dialectal Behavioral Therapy — goal is to help people change behavioral, emotional, thinking, and interpersonal patterns associated in living

D - describe the situation factually

E - express your feelings using an “I” statement

A - assert your needs in a clear and direct way

R - reinforce by providing reasons or evidence to support your position

M - be mindful of the other person’s feelings

A - appear confident with communication, use eye contact and speak calmly

N - negotiate by finding common ground in different perspectives and opinions

coaching as a helping technique

coaching = all about skill building

• principles based on the person and their strengths, self determination, integrated care, hope, choice, valued roles

• practices involved responding, being solution-focused, goal driven, action oriented, collaborative

• help them take action TOGETHER

• involves

  • rapport building

  • forming an agenda

  • prioritizing based on level of need

  • taking action through small concrete steps collaboratively

  • highlighting successes and exploring next steps

  • following up

differences between coaching vs. traditional psychotherapy

coaching = focused on present and future, focused on the goal/action, short term, building skills and supports for specific goals

therapy = led by the therapist, clinical model, often past-focused, more standard practices, process feelings and emotions