helping skills midterm

wellness

provides a framework to support people’s capacity to thrive and succeed in their living, learning, working, and social roles

a critical resource for all people to achieve their life goals

made up of 8 domains

What are the 8 domains of wellness??

physical, mental, social, emotional, financial, spiritual, community, and environmental

resilience

• adapting well in the face of challenges, adversity, trauma, tragedy, threats, or whatever one experiences as a source of distress

• the capacity to bounce FORWARD from these events and use them as life’s lesson

• dynamic process that includes both individual and contextual factors that supports individuals in overcoming adversity/bouncing forward

• everyone has the capacity for resilience

• it is not something we are born with or a trait — it’s a dynamic process

• resilience is actually ordinary, not extraordinary (most people are resilient!!)

• resilience isn’t a program or curriculum — it requires that we shift our thinking about ourselves from “I have problems” to a more strengths-based approach, “I can do hard things”

• “When nothing goes right, go left” kind of culture. Everything is problemsolvable type of thinking

What are the 6 principles of resilience?

1. Self-awareness — the ability to pay attention to your thoughts, emotions, behaviors, and physiological reactions

2. Self-regulation — the ability to change one’s thoughts, emotions, behaviors, and physiology in the service of a desired outcome

3. Mental agility — the ability to look at situations from multiple perspectives and to think creatively and flexibly

4. Strengths of character — the ability to use one’s top strengths to engage authentically, overcome challenges, and create a life aligned with one’s values

5. Connection — the ability to build and maintain strong, trusting relationships

6. Optimism — the ability to notice and expect the positive, to focus on what you can control, and to take purposeful action

guiding values in helping others (non-negotiable values)

• hope — holding hope until it is internalized

• choice — creating options, working WITH rather than on

• self-determination — respect for personal decisions regardless of our opinion

• growth — focus on strengths, satisfaction, success, and skills

• anti-racism/DEIB — a focus on taking actions to ensure access, equity, belonging, and justice in helping ALL people

trauma

a deeply distressing or disturbing experience that can have significant and lasting negative effects on a person's mental, emotional, and physical well-being

3 types:

1. acute — based off of a single event

2. chronic — ongoing, multiple forms of trauma

3. complex — often in the context of a relationship, especially in childhood, “developmental insult”

MANY individual types of trauma

symptoms of trauma

• intrusive memories

• avoidance, avoiding reminders of the event

• changes in beliefs, feelings, and affective state (emotional reactions)

• reliving the event

• being on guard or hyperaroused

6 F’s of Trauma Responses

1. Fight

2. Flight

3. Freeze — when the brain is so overwhelmed people experience a paralysis

4. Fawn — psychological reaction, victim attempts to appease the traumatic stimuli to make it go away

5. Fine — self-denial, don’t want to believe it or don’t think they can handle it

6. Faint

impact of trauma

• has a profound impact on one’s emotional, cognitive, social, work functioning, and overall wellbeing

• shortens people’s lifespans and quality of life

  • ex: Minority Stress Theory (MST)

strategies to support students

• humanizing the kids (greeting students daily, using names, getting on their level, etc)

• safe spaces for kids to self-regulate

• NOT disciplining, focus on connection

  • same with not punishing students if they are late

  • focus on figuring out what the kids need

• prioritizing self care for the teachers/staff

• consistent routines

• counselor for students that everyone knows

• positive mindset and empathy

What are some evidence-based therapies for trauma?

• Cognitive processing therapy — develop coping mechanisms and strategies

• Prolonged exposure therapy — gradually addressing memories/feelings/situations in a safe space

• EDMR — eye movement desensitization and reprocessing, imagining exposure as a way of reprocessing

• TF-CBT (Trauma Focused Cognitive Behavioral Therapy) — focuses on psychoeducation, skills and practice, developing the trauma narrative, and parent sessions (12-16 sessions, linked with improved outcomes)

• Debriefing — reviewing the facts, sharing emotions, learning new skills, preparing for future experiences

• Somatic practices — yoga, reiki, tai chi, group exercise

one size does NOT fit all

• providers must be flexible with clients and be able to shift when things are not working

• WHO we work with drives our plan, not the other way around

• every person knows their own experience the best

• attunement is important (tap into how the client is feeling)

• consider your client’s identity

empathy

• feeling WITH vs feeling for

• allows us to recognize and understand the emotions and experiences of the people we are working with

• drives connection

• “I know what it’s like down there & I can help you out.”

  • see their world, appreciate them as human beings with no judgement, understand their feelings, communicate your understanding

therapeutic alliance

• the collaborative and trusting relationship between provider and client

• most powerful factor in a positive outcome for the person

• rupture and repair

• provide a safe space where people feel supported, heard, seen so that they can take healthy risks to change, grow, and heal

• unconditional positive regard

  • have trust and HOPE

promoting agency

• empowering people to decide for themselves their goals, the action steps they want and need to take to achieve those goals

• encouraging self-determination

• we guide them but THEY make the decisions — we are partnering with them

the helping contract

• when we work in a helping role, we are working FOR the person

• we collaborate with them to help them achieve their goals

• contractual relationship

nonmutuality

• ALL work you do to help must be based on the interests and needs of the person NOT YOU

• patient-centered

• NOT mutual relationship

• our ethical responsibility is to instill professional boundaries

• our needs are NOT to be met in a therapeutic relationship

cultural competence

• a set of attitudes, beliefs, knowledge, practices, policies, and structures that enable healthcare professionals to work effectively and respectfully with people who identify with different cultural and social groups

• a process, develop a greater sense of self-awareness

• can sometimes rely on generalizations (can be “checked off” on a list)

cultural humility

• a life-long process of self-reflection and discovery in order to build honest and trustworthy relationships

  • reflect on your own cultural identities with an openness to different cultural identities

• recognizing where you stand and the privilege you hold

• recognizing that you can never truly know how another person is feeling

• get comfortable in discomfort

• decenter yourself

• learn how to assess your biases

• improves relationships and outcomes

5 R’s of cultural humility

1. Reflection — reflecting on how you approach your work with individuals in a healthcare setting

2. Respect — treating people with respect, honoring their dignity, rupture and repair

3. Regard — holding others in the highest regard, don’t allow biases to interfere

4. Relevance — cultural humility = regular part of care, relevant in every encounter

5. Resiliency — asking if this practice is enhancing your global compassion and fueling your personal resiliency

What is the importance of cultural humility in healthcare?

• person-centered approach

• levels playing field (sharing power)

• respects patient knowledge

• associated with better outcomes

• improves patient experience

• addresses healthcare disparities for historically marginalized groups

• social justice!!

microaggressions

brief and commonplace daily verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults towards people who are different

3 types of microaggressions

1. micro-assaults: intentional

2. micro-insults: often unintentional

3. micro-invalidations: denying a person’s lived experiences, thoughts, or feelings

macroaggressions

• large-scale or overt aggressive actions towards a certain race, culture, gender, or group

• occur at the systemic or institutional level

  • ex: homelessness, racial profiling, gender healthcare polities

6 principles that guide ethical behavior in helping

1. Autonomy — commitment to respect the capacity of a person to make informed and un-coerced decisions, person is “expert” of their experience, respecting cultural differences

2. Non-Maleficence — commitment to “do no harm”

3. Beneficence — engaging in activities that are aimed at helping others, stay in scope of practice

4. Justice — commitment to fairness in treatment, meeting people’s diverse needs fairly

5. Veracity — commitment to be truthful with those we help, being open, honest, accurately communicating

6. Fidelity — commitment to honor the agreements of the helping contract

stigma

• negative belief towards diverse individuals

• central factor affecting quality of and access to necessary health care

  • creates barriers to health, wellness, housing, employment, social and recreational opportunities

prejudice

• negative eeling for a person or a group because of their diversity

• form of exclusion

  • limits people’s rights

discrimination

• a negative behavior based on false beliefs, negative attitudes, feelings or muths that the general public has about diverse people

• perpetuated in harmful policies and practicies 

4 types of health-related stigma

1. Anticipated — fear of future stigma

2. Experiences — fear from your own experiences

3. Perceived — based off of beliefs about anticipating/experiencing stigma

4. Internalized — becomes a part of a person’s self view, self-fulfilling prophecy

How can you disrupt the cycle of stigma, discrimination, and prejudice?

• Remember to meet people where they are at — their identity, their humanness, their experiences

• Person-centered care = choice you can make as a healthcare provider in any discipline

• Keep central “one size does NOT fit all”

• Remember that people are the “experts of their experience”