Psychology and Counselling
The aim of therapy is to improve or stabilize a patient’s normal level of functioning.
How to build a case:
- Find the cause of patients problems, the root (Aetiology)
- Set out the original cause of issues and factors that will promote better well-being
- All biological, psychological and socio-cultural aspects need to be considered as they are what created the patient. These factors can create predispositions as well as precipitating factors (right now they are facing it), Perpetuating factors (makes symptoms or case worse) and of course the saving grace, Protective factors, which protect them – histpry may save them, trigger friends?
- But as people of the human race, we love our excuses – perhaps not mentally ready to change – look at what is already going on.
Look at the factors
Biological, Psychological, and Socio-Cultural are all contributing to a person’s wellness and behaviour. If one is out of balance that can affect a person’s wellness.
- Genetic and health related:
2) Brain Maturity
4) Hair loss and wrinkles
5) Change of cardiovascular function
- Cognitive – thoughts
- Personal factors – are they resilient?
The nature of our personality and temperament dictate the way we react to things.
- Society – influences along side culture
- Ethnicity – language and traditions
- Family Origin (mother, father, brothers and sisters) and extended family interactions and upbringing
- School – teachers and classmates
- Social groups – religious, hobbies and sport
The knowledge and behaviour from this associated with a group of people can stay with persons for a life time.
So how do these forces affect treatment?
I am a diabetic patient/client who comes in for nutritional advice
- Genetic predisposition? – do other family members have it or are they overweight or have a bad diet?
- What type of Diabetes? Type 2 is easier by to work with and is reversible.
- Preconceived idea that ‘treatment is not going to work’?
- Negative or positive thoughts are really a big part in healing and treatment
- Hasn’t accepted that they are sick and need help in the form of a change of diet. Happy to just deal with it.
- Friends may eat a lot of junk food or eat healthy – majority of people keep up with their friends.
- The people around us influence us
- Family diet? – It can be heard to break from the constant fatty foods if you are the only one – temptation.
- Family thoughts and values towards health?
|Predisposing||Obese family||Doesn’t like cooking||All friends eat fried foods
|Precipitating||Has diabetes||I can eat what I want, that is what meds are for||Friends encourage fried and junk foods|
|Perpetuating||Still overweight||No one else has to eat healthy||Friends don’t understand
|Protective||Junk food makes them feel unwell||Scare Factor||New friend loves exercise and used to be diabetic|
Who am I?
- Family of average weight, a few pound over
- White Australian with a mixed background
- Brown Hair, Blue Eyes
- 20 years of age
- Moderately active
- Good nutrition
- Chronic knee, neck and back pain
- Knee pain in times of romantic stress (literally my right knee gets fluid on it and the ac ligament plays up when I am in romantic strife – it is very unlucky I think)
- Predisposition for alcoholism (wish someone had told me before I started drinking – atleast I have something to shift the blame too.)
- Mental illness (anxiety and depression ( but let’s be honest who doesn’t?))
- Good immune system
- Medication is usually too strong
- Strong fight response
- Resilient in reaction to illness
- Good hygiene and health related habits
- Personality is good
- Good coping tactics (learned behaviour recently)
- Unstable stress management is improving
- Strong family network with support in both immediate family and extended. Only child – but raised as a big clan.
- Good health education
- Ethnic Background – White Australian with a mix of old school religion – belief in the holy grail = raised to have a strong moral framework
- Exposure to alcohol substance abuse, but not to poverty – school and friends
- Not active – prefer to drink alcohol – friends
- Strong moral framework – immediate family – strong ethics
- Fairly high socio-economic status as a child – family
- Many strong connections – friends, school and workplace
- Good medical care – family
Alcoholic 20 year old
|Predisposing||Alcoholic family members||I love to drink
|Precipitating||Body can’t function without it||I can stop when I want. I just don’t want to||All friends drink, to see them I should drink too|
|Perpetuating||Body craves alcohol||Withdrawals are too bad, better keep drinking||Friends pressure drinking – lack of understanding|
|Protective||Body can’t handle it||I have to do things with my life||Strong Family Support|
It is being healthy not only free from disease but being in a stable state of normalcy in regards to mental, physical and social (wealth, education and comfort )aspects.
World Health Organisation, 1948, p1“ A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” it feels like such a modern quote. According to the Jungian Psychology it is to be able to “reach our full potential and contributing to the collective well-being”
Basically, you need to be able to meet these needs:
- A full functioning body and a state of homeostasis
- Having the means to reach true potential
- State of good mental health
- Making connections
- Having access to community help in the form of welfare, education and relgion.
Restoring The Body To Normal
Normal is dependent on:
- Social Norms – culture and attitude
- Personal Norms – internal beliefs and interpretation
One who suffers, in Latin it means “I am suffering” and in Greek, it is “to suffer”.
Patient and Client:
- Client is a service, makes the person seeking help feel more of an equal, while patient can be interpreted as being weaker by persons.
A client may come and see you for a different reason than they specified. People can come with a whole lot of baggage and may just want to vent and need someone to talk to. It is important to give them time to expel all of this before getting down to the actual reason even if it is unrelated. Once they have gotten it all off their chest then begin to ask questions to narrow it don. Be sure to find out why they need your help. (Sometimes they may not even know themselves)
Works to restore a person to what was their normal, can use different techniques and approaches. A therapist role can be taken on by:
- Religious leader – priest or vicar
- Witcherwoman/ Sharman
- Doctor or someone who has had some training
- Psychoanalytic – clients overcome past conflicts and unconcious
- Holistic – help client achieve meaningful existence
- Behavioural –just look at actions and try and overcome the unhelpful behivours while increasing helpful ones
- Cognitive Behavioural –helps clients unlearn unhelpful patterns of thinking and increase better patterns of positive thinking
All therapies work towards a common goal to improve and restore a person’s functioning to normal and above.
Generic Model of Therapy
- Setting, Therapist and Client
- Requirement for treatment (why is client here)
- What are the like?
- What is their background and job?
- What environment did they grow up in or live in?
- Be clear in finding out
- Don’t let personal issues deal with session. NO COUNTER TRANSFERENCE!
- What is therapist like? Their personality? Professional experience?
- The environment of setting? Where? Layout of room? Distractions? Social Context?
- What happens in Treatment (tx)
- What are the goals of client and Therapist?
- Length of session?
- Number of tx sessions?
- Overall length of treatment?
- Method of treatment to be used?
- Clients problem is divulged
- Therapist diagnoses client
- Treatment plan is made and implemented
- Client will follow treatment (or not )
- Relationship is established
- Therapist identifies how they and the client have responded to the situation, openness, self-evaluation of control.
- Client makes the change and sees progress.
- Outcome after each session = result in a change to life situation
- Outcome after conclusion of treatment (tx) = result in a change to a life situation
- Does client function better?
- Does client feel better?
- Does the client seem to becoming more social?
- Is the client’s behaviour better?
- Has client improved?
What happened when a client cancels and doesn’t reschedule?
- In this case I would send an email to find out what happened. Feedback is important for a therapist.
- I would advise sending a reminder (god knows what people used to do before we sent reminders about appointments) a day or two beforehand.
- Cancelation Policy, in order for others to appreciate your time you need to as well, this is why having a cancelation policy will help others know that you value your own time. A 50% of the consultation fee is the regular I believe. Each patient should have a copy of the policy; you can attach it to their Consent and Clinical Records paperwork from the first appointment.
- Dealing with money can be awkward, so it is an idea to look into direct debiting sessions, for example, clients can pay upfront for a number of treatment sessions (a 3 month plan).