Counseling In CMDS - Midterm

What are the Five Themes of Interest?

• Wellness and Positive Psychology

• Living the Catastrophe, Dealing with Crisis

• Change

• Who are the experts?

• The importance of Stories

Theme 1 - Wellness and Positive Psychology

• identify areas in their life that are currently positive

• focusing on how to improve and increase their perception of wellness and physical wellness

• teaching a patient to recognize and appreciate small steps in progress

Theme 2 - Living the Catastrophe, Dealing with the Crisis

• guiding patient to accept and identify all the aspects of their current circumstances and the changes that have occurred because of it

• Finding tools and strategies that can be used to help manage the changes that are occurring

Theme 3 - Change

• changes in ability to communicate

• overall quality of life

• occupational and financial resources

• self-perception and role in their relationships

Theme 4 - Who are the experts?

• acknowledging all the people that have expertise related to the patient and their experience with their CMDS

  • CMDS healthcare professional

  • medical team (ENT, neurologist, etc.)

  • patient, family members, and caregivers

  • educational professionals

  • social worker, psychologist, etc.

theme 5 - the importance of stories

• being able to hear the client’s perspective of events related to their cmds

• being able to predict to some degree what treatment path might be successful for a client (without promising)

• allow a patient to feel heard and give them time to describe the events without feeling rushed

• gives you info about how to develop a positive relationship with a client

aspects of communication counseling

• to receive information that the individual, family, and caregivers are comfortable sharing

• provide information

• aid clients in clarifying their perspective, ideas, attitudes, emotions, and beliefs

• provide alternative strategies for communication behaviors that might influence success

  • talk about the “risks” that patient feels when communicating or what makes communication scary

goals for families in counseling process

• grieving

• achieve understanding of their circumstances and the change that’s taken place

• developing coping skills/strategies

• make peace with their diagnosis

• identifying adaptions that can be made in daily activities

• capitalize on strengths

• live as fully as possible

Components of an interviewing experience

• opening

• body

• closing

Opening Component of an interviewing experience

• introduction: include credentials

• explanation of what is going to happen in the interview

• provide a moment for questions

• any permissions that might need to be taken care of, if applicable

• transition statement

Body Component of an interviewing experience

• questions about the interview topic: consider how to structure the questions

• funnel sequence v. inverted sequence

  • funnel would begin with open ended questions and move into specifics

  • inverted would being with specifics and move into more open-ended questions

• how to prepare/what to prepare

• transition statement

Closing Component of an interviewing experience

• provide some type of verbal appreciation for their time and effort

• reiterate that the information shared is confidential

• offer opportunity to ask questions

• next steps

• provide contact information

• potentially summarize what was said

Positive Psychology

• identify areas in life that are positive and help a person focus on the small successes and joys

• shifting from pursuing “happiness” to general wellness and quality of life

  • very important for patients because their general outlook can impact their ability to make progress in therapy

PERMA Acronym

• positive emotion

• engagement

• relationships

• meaning

• accomplishment

PERMA: Positive Emotion

positive affect, reminders of good memories and positive aspects of their lives and expectations for the future

PERMA: Engagement

losing oneself in an activity or endeavor, being truly “in the moment”

PERMA: Relationships

involvement with others, sharing, kindness, etc.

PERMA: Meaning

belonging to or serving something bigger than oneself

PERMA: Accomplishment

pursuing and achieving a goal just for the sake of doing it

What are some character strengths and/or desired counselor characteristics?

• kindness and empathy/sympathy

• patience

• confidence

• integrity

• fairness in treatment

• openmindedness

What is the 4-pronged approach to anger?

• compliment the patient on something they did well

• disarm the person by finding something to agree on

• encourage the person to talk about why they feel angry

• engage in feedback and negotiation

What should you do when dealing with an angry client and you feel unsafe?

• call a colleague into the room to finish the session with you

• terminate the session for the day

• call on your supervisor for support

What are some general guidelines for interviewing and counseling?

• establishing rapport

• know your own strengths, weaknesses, and biases

• when asking a question, listen to the answer, don’t be focused on planning your next statement and/or question

• know when enough is enough - interviewing and counseling can be draining to the clinician and the client

How can you prepare for interviewing and counseling?

• decide what you need to complete the interaction and what information you want to collect beforehand

• know who you are interviewing, their background, what information was collected/provided before your interaction

• prior to the interview, make sure patient knows what to expect, time commitment, etc.

• schedule an appointment so there’s sufficient time

• secure a private setting

• consider how you may react to information provided by the client

What should you do during the interview/counseling?

• maintain control of the interaction

• explain why the information requested is needed

• provide accurate information and avoid lecturing

• be alert for inconsistencies and handle them in a non-confrontational manner

• understand the different between fact and the patient’s interpretation

• agreement does not mean a patient following through with recommendations

• be aware of human tendency to say what a person wants to hear rather than how they actually feel

• consider the type of questions asked (open, primary, secondary, etc.) and the sequencing (funnel v. inverted funnel)

What tools or skills can be used in an interview?

• verbal behaviors

• orientations

• interpretations

• evaluations

• neutral or social verbalizations

• non-verbal behaviors

• summaries

• reflections

• clarifications

• confrontations

• self-disclosure

tool or skill can be used in an interview: verbal behaviors

can use these to seem engaged or disengaged

• encouragers

  • verbal: saying things like “that’s interesting, tell me more”, etc.

  • nonverbal: heading nodding, eye contact, etc.

tool or skill can be used in an interview: orientations

establishes you are the leader in the room

• “here’s what we’re going to do”

• “here’s how long it’s going to take”

tool or skill can be used in an interview: interpretations

verbalizing a way a patient feels to give them a new perspective

• “you said that this event made you feel defeated, can you tell me more?”

tool or skill can be used in an interview: education

positive/negative judgements about an action, behavior, etc.

• use sparingly

tool or skill can be used in an interview: neutral or social verbalizations

interactions that don’t directly relate to the purpose of the interaction

tool or skill can be used in an interview: Non-verbal behaviors

• facial expressions

• head nodding

• body posturing/leaning

• eye contact

• silence

• touch

tool or skill can be used in an interview: summaries

reiterating the information that the patient has provided using their own words

tool or skill can be used in an interview: reflections

shorter than summaries - more often reflects the client’s exact language

tool or skill can be used in an interview: clarifications

information gathering technique used to clear up any information that is unclear.