Patience with Patients Dn Pinkstn, LCSW, CADC Kim Pinkstn, LCPC, CADC, BC-DMT, GL-CMA
Really? We have t have patience?? 3
Objectives Discuss challenges t delivering quality care External factrs Persnal challenges Fcus n key cunseling skills Build n that fundatin that we were given Refresh the cunseling spirit
What gets in yur way? Discussin: 3-4 Examples f barriers yu face t ding yur best wrk
External Cmmn Barriers Administrative cncerns: Budget, Staffing, Internal Transference and Cunter transference
I am nt what has happened t me. I am what I chse t becme. -Carl Jung
Patient Behavirs Lack f trust in general What is at stake fr the patient? Reactins t Withdrawal Persnality disrders Maladaptive relatinships Anxiety Generalized Based n lack f understanding Other Mental Health disrders
Key factrs in cunseling Research shws the type f therapy used is nt as imprtant as are the specific cunselr behavirs: Enthusiasm, Cnfidence, and Belief in the patient s ability t change. Clients are mre likely t achieve their gals when a gd and psitive relatinship exists between them and their therapist. The cunselr s interactins with the client are a pwerful tl in the helping relatinship. The Tp Ten Basic Cunseling Skills Kevin J. Drab, M.Ed., M.A., LPC, CAC Diplmate
Listening Listening is an active experience It is the ability t accurately receive and interpret messages The listener shuld be as invlved as the speaker Listening is nt same as hearing Hearing simply refers t the sunds that yu hear where listening requires fcus. Listening requires paying attentin nt nly t the stry, but hw it is tld thrugh the use f language, vice, and bdy
I m srry what? The human mind is ntriusly bad at remembering Research suggests that we remember nly 25%-50% f what is being said t us. Safe t say yu will nly remember abut an hur f what we talk abut here. Tuning ut
Why d we listen T get infrmatin T understand T learn Fr enjyment What t d? Remember key facts and ideas Listen with yur mind and bdy Active listening invlves nt nly verbal listening skills but nn-verbal listening skills
10 Principles f listening Stp talking-yu can t listen if yu are talking Studies have shwn that talking raises bld pressure and attentive listening can bring it dwn. Relax-prepare yurself t listen, clear yur mind f distracting thughts like what am I ging t have fr lunch r is it ging t rain tday ; fcus Ease the client-make eye cntact, nd r use ther gestures t encurage them t talk, help them t feel safe t talk
10 Principles, cnt. Shw empathy-wrk t understand the client; keep an pen mind t their views and pinins Have patience-dn t interrupt r try t finish their sentences; let them talk in their wn time dn t rush them; dn t start t think abut what yur reply is ging t be befre yu have heard the whle message Remve distractins-put yur wrk dwn, dn t fidget, end ne cnversatin befre yu start anther with smene else
10 Principles, cnt. Avid persnal prejudice-dn t argue r criticize the client r becme irritated by hw they are speaking. Fcus n what is being said Listen t tne-a speaker will use bth tne and vlume t keep an audience attentive. This can help yu understand the emphasis f what is being said.
10 Principles, dne at last Listen fr ideas nt just wrds-ne f the mst difficult things t d is t piece tgether bits f infrmatin t reveal the whle idea Ask questins-when it s yur turn t speak ask questins t verify yu heard the ideas cmpletely Number 11-STOP TALKING!
Like a vacatin tur guide Yu want directin if yu dn t knw WHERE t g next Yu might nt have the energy r cnfidence t lead Yu want t g where YOU want t g Yu may becme annyed Subvert the plan G in an ppsite directin Yur style and flexibility matter Ashtn M. My Way r Yurs. Drug and Alchl Findings 2006 p. 22-29
Directive style Wrks well with nn-resistant client Reslved ambivalence Recgnize the harm in their use D nt hld reservatins fr use Often demands cnfrmity t a set wrld view AA has a directive/instructive apprach Cgnitive Behaviral als has a directive apprach Ashtn M. My Way r Yurs. Drug and Alchl Findings 2006 p. 22-29
Nndirective style Intrduced by Carl Rgers Suits clients characterized by anger and resentment Patients are their wn best experts Patients feel valued, listened t and understd Takes time fr prcessing Ashtn M. My Way r Yurs. Drug and Alchl Findings 2006 p. 22-29
Regardless f Style Patients ALWAYS have the pwer t decide fr themselves what they will d The patient s values will steer their decisins and curse f their recvery We nly impact a shrt perid f time in their lives directly
The Rle f the Cunselr Recgnizing the unique relatinship we have N Quid Pr Qu It s nt persnal The pwer f bjectivity The ability t respnd ratinally and nt reactively Principles befre persnalities
Empathy is a skill Empathy Defined as-understanding anther's perceptin, feelings, experience Empathy is seeing with the eyes f anther, listening with the ears f anther and feeling with the heart f anther
Empathy is nt Sympathy Identifying with the client Sharing a similar experience I knw hw yu feel Painting silver linings
Empathy skills Verbal and nn-verbal attending Paraphrasing Reflecting Being nn-judgemental Self-awareness and vulnerability
Benefits f Empathy Better understand the needs f yur client Have less truble dealing with interpersnal cnflicts Will learn t better mtivate thers Will have an easier time dealing with negativity f thers if yu understand their mtivatins and fears
Mindfulness 30
Using Mindfulness Assists in being Present with the patient Brings yur Attentin in Fcus n the sessin Aids in being nn-judgmental Prmtes Empathetic respnses Recgnizes changes in patient respnses and allws fr flexibility in apprach
Warmth and Genuineness Warmth Caring, respect, acceptance Cmmunicating interest and cncern while recgnizing their right t make their wn decisins Des nt mean yu agree with everything they say Uncnditinal psitive regard Genuineness Yu mean what yu say Yu are hnest True t yur wrd Be yurself.be human
Dignity and Respect Dignity-the quality r state f being wrthy, hnred, r esteemed; a sign r tken f respect Respect-an act f giving particular attentin; high r special regard; expressins f regard r curtesy Everyne has the right t chse their wn paths and make their wn decisins
Encuraging and Accepting Believe in the client Accept them fr wh they are Respnding with nnjudgmental r nncritical verbal and nnverbal reactins Encurage them t make their wn decisins Accept the decisins they make.while yu use yur skills t shw them alternatives t decisins they make yu knw are unhealthy. Hpe
Nn-verbal skills 2/3 f cmmunicatin is nn-verbal! Research has shwn that clients ften rank nnverbal factrs, such as nnverbal gestures and bdy language, as the mst imprtant factr in building a cunseling alliance. Much f ur nn-verbal cmmunicatin is autmatic uncnscius Learn t listen with yur eyes
Bdy language Pstures Gestures Facial expressins Eye cntact Direct r indirect Use f vice Rate f speech Tne/vlume Mdulatin-pauses Use f Space Open vs clsed Yur kinesphere What s invlved Appearance Dress hw yu want t be addressed
In cnclusin Remember cunseling is the detail It s the little things we d that can have the biggest impact n the client-cunselr relatinship Be aware f yurself and yur client