9. The Basic Listening Sequence AND Stages of an Interview AND Biopsychosocial approach PDF

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Week 9 lecture notes on the Basic Listening Sequence AND Stages of an Interview AND Biopsychosocial approach, Lecturer= Nadine Pelling, Counselling Skills SP2 2018, skills based on content from Intentional Interviewing and Counseling By Ivey, Ivey and Zalaquett...

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The Basic Listening Sequence/ Stages of an Interview Wk9-

SKILL: the BLS, based on attending and observing, consists of these microskills; using open and closed questions, encouraging, paraphrasing, summarising and reflecting feelings.  ANTICIPATED CLIENT RESPONSE Clients will discuss their stories, issues, or concerns, including key facts, thoughts, feelings and behaviours. Clients will feel that their stories have been heard. In addition, these same skills will help them to be clearer with you and facilitates a better interpersonal relationship. STAGES OF AN INTERVIEW STAGE ONE - Empathic relationship: initiating the session; rapport & structuring STAGE TWO - Story and strengths: gathering the data, drawing out stories, issues, concerns etc. STAGE THREE - Goals (mutual): what does the client want? STAGE FOUR - Re-story: working, exploring alternatives, confronting incongruities and conflict

STAGE FIVE - Action (and eventual Terminating - Using work in life outside of counselling … - ‘Good’ goodbye

Biopsychosocial Approach Wk10

EXERCISE Aerobic: improves aerobic capacity and endurance Nonaerobic: improves muscular strength and endurance or flexibility/coordination/relaxation Exercise found to: enhance mind function/ emotional state/ create alertness/ creativity/ enhance sleep/ be effective for mild to severe depression and for people with physical problems Anxiety symptoms - historically mixed research results - some studies showed that anxiety was increased by exercise - “causing” panic attacks - some studies showed a reduction in anxiety - current research sates use of exercise reduces anxiety and previous “confusion” due to confusing anxiety with arousal 4 MECHANISMS OF ACTION (exercise) 1. Biochemical: Endorphin and neurotransmitter hypotheses - produced in pituitary gland, brain, tissues and have “morphine-like” quality - reduce pain - create euphoric mood - exercise produces endorphins and thus increase in mood

2. Physiological: Thermogenic hypothesis - exercise psychological benefits due to transient increase in body temperature or short-term arousal that occurs with exercise Fitness level hypothesis - exercise has physical benefits - as fitness increases also increase in wellbeing - mixed research - benefits begin before see any results - more fit=less depressed (aerobic and non) - enhanced body image with fitness 3. Psychological: Cognitive-behavioural hypothesis - exercise releases positive thoughts and feelingsbreaks downward thought-affect spiral - change overt behaviour & cognitive processes & interrupts maladaptive cognitive set Mastery - feelings of mastery, control, and selfefficacy increased - difficult task accomplishment enhances positive affect Meditative effects - time to exercise is time out of daily worries - being distracted from psychological stress - better than pure distraction activities (time out hypothesis) Additional possibilities - positive reinforcement - catharsis via large muscle activity/ anger/frustration

4. Social interaction: - Personal attention and social interaction gained by joining a fitness program / having an exercise companion

GUIDELINES FOR USE Enjoyable Positive role models Education about fitness Appropriate level Gradual start Social aspects Focus on Goals Realistic Outside the Home No Overtraining: staleness may result Behavioural addiction COMPLIANCE - Will my client’s exercise? - Compliance may be improved if one exercises with a companion or takes part in an exercise program at a gym - Support likely needed when starting a program - supervision - check on progress - at least until activity becomes selfreinforcing - Are you a positive role model? - Research shows clients very compliant HOW MUCH - Clinically depressed individuals - five weeks of 3x weekly sessions of aerobic or nonaerobic of 20-60 minutes duration

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echoed by fitness experts for health benefits the longer you engage in an exercise program the greater the emotional benefits

STRUCTURED DAILY ACTIVITIES AND A RETURN TO NORMALCY Depressive and anxiety related disorders generally include deficits in daily functioning (household roles, chores, leisure activities, social involvement, work performance). Those who show clinical improvement spend more time on chores and less time in passive leisure Return to normal activities as quickly as possible - maintain feelings of belonging and usefulness - limit labeling as ill - form of exposure therapy: limit avoidance EDUCATION AND HOMEWORK ACTIVITIES Education regarding one’s symptoms suggested as a first step in preparing client for treatment - normalize symptoms Homework to help explore circumstances and behaviours that contribute to continuation of symptoms - explain why given - follow up - client involvement SOCIAL INVOLVEMENT Social support buffers individuals form life stress - may be related to amount of external stimulation in the environment - too little/much focus on internal state Social involvement can be used in treatment

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generalize and practice skills learned reinforcement from others for healthy behaviour

FINAL NOTE Remember the above use of biopsychosocial activities is in ADDITION to counselling and medication for some people Activities and medication help with problem/symptoms Counselling and self exploration and acceptance help with long term adjustment and life positives...