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Change as a Process – Role of Client Resistance

12 Jun

One thing I like to say is that change is hard!  If change was easy, there would be no need for therapists, counselors, social workers, etc.  Furthermore, change is a process that is difficult and can be a lot of work and/or painful (Polcin, 2003).  It is therapeutic change, and a break down of client resistant behaviors that therapists strive to engage.  Moreover, resistance has multiple purposes and causes depending on the nature of therapeutic involvement (voluntary or non-voluntary) or extent of content to be disclosed (Sommers-Flanagan & Sommers-Flanagan, 2009).  Some examples of resistant client behaviors can include:   (1) too much talking, (2) lack of talking, (3) late/early arrivals, (4) lack of preparation or too much preparation, and (5) too much or lack of emotional control (Sommers-Flanagan & Sommers-Flanagan, 2009). (See below for References)

Lynn Shallcross wrote an excellent article on client resistance and the role of client resistance/managing that resistance as a counselor.  Click the text to go to the full article!

“You can’t change anyone else; you can only change yourself. Many counselors have used this common bit of wisdom to help clients overcome problems, but it’s crucial that counselors internalize that idea themselves, says Clifton Mitchell, a professor and coordinator of the community agency concentration in the counseling program at East Tennessee State University.”

References:

Polcin, D. L. (2003). Rethinking Confrontation in Alcohol and Drug Treatment: Consideration of the Clinical Context. Substance Use & Misuse, 38(2), 165.

Somers-Flanagan, J and Somers-Flanagan, R. (2009). Clinical Interviewing. 4th. Ed. Wiley & Sons, Inc., Hoboken, NJ.

Therapist-In-A-Box

29 Sep

Now you too can start a “Psychiatric ‘Lemonade’ Stand” Like Lucy in Peanuts.  Impress your friends and family, treat that obnoxious anxiety triggered by late night graduate school papers…

CLICK ME TO LEARN MORE

(Note: This product is meant for amusement only…not to be taken seriously.  Avoid counter-transference, multiple roles, and use at your own risk.)

Stress, Anxiety, and Health

6 Apr

Click HERE for a video by Dr. Manny on the effects of stress and anxiety on physical health.

According to WebMd, there are many different types of anxiety diagnoses.  Anxiety is a mental illness with physical, social, emotional, and psychological repercussions.  In high stress situations (such as work and graduate school), stress can trigger physiological reactions promoting anxiety reactions.

How do I deal with stress?  Well, making a list of things that decrease stress can be a start.  Hobbies, mini “breaks,” exercise, and proper nutrition can all aid in decreasing anxiety.  Moreover, small steps (such as decreasing caffeine consumption 4 hours before bed) can help improve sleep quality and enable the mind to manage stress productively.  If sleep quality is consistently low, you may want to go to a sleep center to see if you have a sleep disorder.  Sleep disorders have physiological and psychological consequences and can even mimic or cause symptoms such as: fatigue, depression, high blood pressure, etc.

The body is a complex system.  It is important to start with small interventions/actions to treat stress and anxiety and then build to more medical and/or psychological treatments.  Medical does not necessarily equal medicine.  It can mean discovering a sleep disorder – like sleep apnea – and using a machine to improve oxygen flow or REM quality.  There is even a product called ZEO that measures sleep patterns to help you improve sleep quality, and notice patterns that may be warning signs.  Click the picture to check out ZEO.  Click HERE to watch the video by Dr. Manny on the effects of stress.

 


Step 4: Communication & Initiative

5 Apr

In graduate school “effective communication” and demonstrating “initiative” are more than mere personality traits driving successful academic completion.  These particular traits, developed, can save a student from unnecessary stress and workload – and goodness knows graduate students have enough stress/work as it is.  How can doing more work actually make for less work?  Sounds like an oxymoron at first, but let me provide an example.

The school I’m attending is making some changes to their Professional Portfolio requirement and Residency curricula – they are going from a hard copy portfolio that was supposed to be turned in at the next residency to a digital portfolio that will be completed after residency. Moreover, they apparently forgot to tell the students.  Our class was still under the impression that they were completing a hard copy portfolio.  So we were all getting ready to work on it.

If I had not called to double check requirements for the portfolio we would have (1) never realized there were changes we needed to prepare for, (2) had to re-do all the work on the portfolios – we’re talking hours and hours of work, and (3) not completed the work that was actually required.

Communication in graduate school is more than communication with one’s teachers.  It involves taking the initiative to keep up with course/curricula requirements, and maintaining contact with one’s advising center (whether you go to school online or in a traditional setting).  Never ASSUME you know something.  If your curious, ask.  Now I know it can seem petty to ask for every “little” thing.  Some things, seem more important than others….it’s tempting to think “well it will all work out” or “the school would let me know if…”

Never assume a school/adviser will let you know anything.  If the question(s) seem petty, make a list of 2-3 questions and call/schedule an appointment to ask them all at once.  If an advising session (meeting with a counselor face-to-face) seems like overkill for the situation, try just calling.  The original question I had was about a form that was listed as a requirement for the hard copy portfolio.  I called about that “form” and instead discovered the whole portfolio had been scrapped.

Summary:

  1. know your course/program requirements – is there other components to the program outside of coursework or are there courses that will require work as part of their curricula
  2. if you have a question, ask
  3. make a list of minor questions and curious concerns – call and ask about them all at one time to minimize having to call back repeatedly
  4. colleges are businesses, they won’t hold your hand especially in graduate school – never assume an important email will go out to update appropriate information

Ultra secret special counseling technique:)

8 Oct

Funny video/MAD TV clip making light of the counseling process.  Note: do not do this with your clients…STOP IT…don’t even think about it! 😉 🙂

posted by eyeisyou on YouTube

Self-Care relies on Self-Monitoring To Prevent Burnout

28 Sep

Self-care incorporates recognizing the warning signs of burnout, reversing damage, and building resilience (Smith, Jaffe-Gill, Segal, & Segal, 2008).  Recognition is essential in order to understand when self-care is needed and how to incorporate it to counter burnout and fatigue.  Recognition is promoted through self-monitoring by journaling or setting aside time to reflect on personal reactions to clients, work, and stress in general (Morrissette, 2002).

Smith et. al. (2008) recommends the following tips for promoting self-care and preventing burnout: (1) start the day with a relaxing ritual, (2) adopt healthy eating/exercising/sleeping habits, (3) set boundaries, (4) daily break from technology, (5) hobbies/creativity, (6) self-monitoring via journaling etc…

(Exerpt from paper by L. Lavergne, 2010, Capella University)


Self-Care is an important part of Counseling and Professional/Personal management.  If a Counselor is burned-out or overly stressed he/she may treat clients unethically and immorally.  The wellbeing of clients/patients is ideally a counselor’s forefront concern.  However, counselors are human and subject to illness, trauma, and stress just like his/her clients.  Self-monitoring is essential to promote personal insight to prevent acting when one is emotionally compromised.

Bellow please click on the link by Smith! It’s got some great resources for Stress/Self-Care! And if you’re in Grad. School…I KNOW stress is a concern 😉 🙂

References:

Morrissette, P. J. (2002). Self supervision: A primer for counselors and helping professionals. New York, NY: Routledge. ISBN: 9781583910757.

Smith, Melinda M.A., Jaffe-Gill, Ellen M.A., Segal, Jeanne Ph.D. and Segal, Robert M.A., (2008).  Retrieved Sept. 14, 2010 from http://helpguide.org/mental/burnout_signs_symptoms.htm