Communications Test Two

What can therapists be aware of in order to achieve more effective therapeutic outcomes?

Therapists who are aware of their own thoughts, feelings and are oriented toward the interpersonal aspects of client interactions achieve more effective therapeutic relationships and better outcomes

Explain the problem focus of dealing with stress.

2. Problem focused: Emphasizes the practical aspects of a situation: solving the problem at hand Identify the problem to be solved- learn the facts- collect info Derive an action plan with possible solutions Evaluates the Pros and Cons of each-possible consequences Developing alternative measures of satisfaction

What are the two parts of motivation?

First, needs to be a desire to achieve a goal Second, need a commitment to an action to accomplish the goal

Healthcare providers are required to communicate with:

•Patients •Staff •Physicians •Colleagues •families •SOME CASES: 3RD PARTY PAYERS

What is the social model of disability?

•Proposes that impairment alone does not cause disability, it comes from a culture where people who are different are not accepted as the "norm." •States society refuses to make necessary accommodations •Frames rehabilitation services as valuable

ICF- World Health Organization's International Classification of Functioning, Disability and Health: What does it do?

•Provides guidance needed to bring about important changes to improve the quality of life for people with disabilities •It helps therapists determine how a patient's function may be influenced by their disease, can be used worldwide

Explain the appraisal focus of coping with stress

Appraisal Focused: examine & reframe the situation to assess the meaning Compares it to something, "It could be worse!" Positively states, "this is a gift" Can be a catalyst for change Denial or avoidance- minimize the situation, protect themselves, "stall"

Define the Transtheoretical Model for Health Behavior Change and list its steps

Transtheoretical: focuses on motivation, and is a process that takes time as individual moves through the 6 stages of readiness Precontemplation- Not expecting to make any changes within the 6 months Contemplation-Awareness of need of change, pros and cons, maybe in 6 months Preparation-Planning to take action, know what they need to do and have plans to do Action-Highly motivated, doing what needs to be done Maintenance-Continue to develop, more self confidence, but may relapse Termination-Reached their goal and positive lifestyle changes have been incorporated

What are some simple measures that can make a big difference in communication?

Explaining who you are Explain why you are there Sit at eye level with your patient during the conversation Have a willingness to listen SHOW EMPATHY

T/F: Good communication skills can be learned overnight?

False: good communications skills must be practiced on a regular basis

Define self-efficacy

Self-efficacy is a person's belief in his or her ability to succeed in a particular situation.

What are three types of problems adults with developmental disabilities face?

1. Physical problems: chronic skin breakdown, poor posture, spasticity, cardiopulmonary,, contractures, degenerative joint disease, immobility 2. Cognition/communication: visual/hearing impairments, speech difficulty 3.Psychosocial concerns: lack of trust, social support/skills, passive nature

_________ and _________ communication is key to providing successful client centered care

Effective; Timely

Before we can effectively treat a client, we must develop a good ______

relationship/rapport

What are some tips for adaptive coping?

-Deal with the problem -Be realistic -Identify unhealthy stress responses -Control detrimental behavior -Remember there is no one size fits all

What are a few things healthcare providers can do to help patients cope?

-Emphasize interventions that can positively influence outcomes -Support patient's goals and assist in working towards goals -Be genuine with emotional support, "This must be a difficult time for you" -Understand the strategies of grief and encourage movement through at comfortable adjustment pace -Show empathy/comfort -Honor cultural appropriate rituals -Connect a support system -Educate patients and caregivers -Provide Hopeful perspectives -Recognize setbacks

Three steps to effectively cope:

1. Accept the loss 2. Grieve the loss 3. Learn to adapt to the changes: both cognitively and behaviorally

Give the 5 A's to behavioral change

1. Address the issue: name the problem and present the need for intervention 2. Assess the client: identify barriers preventing change 3. Advise the client: educate and explain why change is needed, i.e. benefits 4. Assist the client: negotiate an agreeable plan of care 5. Arrange a follow up: change is a long, slow process. Review, reassess, and renegotiate.

What are the three classic models for coping with stress of an illness?

1. Appraisal Focused 2. Problem Focused 3. Emotion Focused

What are the three steps to de-escalating conflict?

1. Restatement: "I understand you're in a hurry and need to see this patient now." 2. Reflection: "It sounds like your schedule is hectic and you're upset. 3. Clarification (Summary of the situation and ask for potential solutions): We can stop and take a break and you can draw blood or come back after your next patient."

Explain the emotional focus of dealing with stress

3. Emotion Focused: managing emotions, develop strategies to reduce the overwhelming and make it "easier to bear" Best for those situations which the client has "little control over" Healthy use of humor, or being able to process and express emotion Affect Regulation Therapy aims to improve the ability to produce an appropriate emotional response to any given situation. Avoid reluctance, depression or withdrawal which can develop

How to conduct a patient interview:

> if you allow a client to speak uninterrupted at the beginning for 2-3 minutes, he is able to relay 80% of all relevant information. > Use open-ended questions >Request more information to show you're paying attention >Summarize briefly what they say >"TELL ME A LITTLE ABOUT YOURSELF"

Give two reasons people use defense mechanisms and give some examples.

A. Protect the individual from tension, hurt, anxiety, pain and psychic disorganization B. Protect the self from external threats by transforming reality and tend to be a subconscious way to deal with daily life Examples: Denial Fantasy Suppression/Regression Compensation

Examples of adaptive vs maladaptive behaviors associated with emotion focused coping strategies

Adaptive: -Early denial -Emoting -Social support -Counseling -Companionship Maladaptive: -Continuous denial -Drinking -Drugs -Self-injury -Suicide -Isolation

Examples of adaptive vs maladaptive behaviors associated with problem focused coping strategies

Adaptive: -Information gathering and questioning -Problem solving -Adherence -Writing -Helping others Maladaptive: -Intellectualization -Avoidance -Nonadherence

Examples of adaptive vs maladaptive behaviors associated with appraisal focused coping strategies

Adaptive: -Reframing -Spirituality -Meditating -Painting Maladaptive: -Blaming God/others -Harmful beliefs -Fanaticism -Excessive behavior

Name three ways good communication can help provider/client relationships

Allows provider to focus on the person, not the disease. Builds a therapeutic alliance that improves both perspectives. Helps achieve more appropriate therapeutic goals.

Goals need to be: (3 things)

Be established by and with the client, not the clinician alone Need to be functional, challenging, achievable, specific, and collaborative Be reviewed: short /long term and revised if needed, not to low or to high

Describe the process of communication. What can effect communication?

Begins when sender expresses an idea (verbal and nonverbal) Receiver interprets the message by understanding/perception of the message. It can be affected by the receivers: cognition, education, age, and literacy level. It can even differ day by day.

Define coping

Coping is an adaptation to new circumstances, awareness, knowledge and growth in managing a stressful situation. It is personal and specific.

What are some psychological adaptive strategies?

Counseling Healthcare personnel Support groups Hope Returning to work Stress Management

Define communication

Defined as the interpretation of meaning from interpersonal interactions and extends far beyond verbal information to include elements of body movement, expressions and subconscious mechanisms. OR The process by which information is exchanged between individuals using words, sounds, signs or behaviors.

Factors that effect our ability to cope

Experience with previous illness and grief Impact of the illness, timeframe of how long it will lasts Expectations/Aspirations Age Life responsibilities Support

What are the cornerstones to effective rehabilitation?

Goals.

What are critical elements in rehab and are frequently used as outcome measures?

Motivation and adherence

Name a few things that poor communication skills can lead to

Negative consequences Clients becoming dissatisfied/frustrated with provider. Clients become non-adherent to treatment plan. Clients may eventually seek alternative care. Providers become frustrated and burnout.

Is "I know how you feel." an appropriate response?

No. It's better to say, "This must be difficult for you, tell me how you are feeling."

What are the five dimensions of adherence according to WHO?

Patient-related factors: beliefs, self-esteem, diet, meds, culture, family Social/economic factors: race, transportation, literacy, income, support Therapy-related factors: dislikes (i.e. the therapist), lack of time, scheduling Condition-related factors: illness, pain, bad habits, depression, anxiety Health-system factors: continuity of care/provider, insurance, costs

Internal Locus of Control vs External Locus of Control

Patients with Internal locus of Control: Believe they can influence what will happen Self motivated, health oriented, follow treatment protocols, believe they can make a difference in their lives Patients with External Locus of Control: Believe they can not control what happens Less adherent to treatment plans because their efforts do not make a difference, may lack motivation

People with high self-efficacy vs people with low self-efficacy

People with a strong sense of self-efficacy: Optimist View challenging problems as tasks to be mastered Develop deeper interest in the activities in which they participate Form a stronger sense of commitment to their interests and activities Recover quickly from setbacks and disappointments People with a weak sense of self-efficacy: Pessimist Avoid challenging tasks Believe that difficult tasks and situations are beyond their capabilities Focus on personal failings and negative outcomes Quickly lose confidence in personal abilities

How can we practice mindfulness?

Performing self-assessment Clearing your mind of clutter Being present in the moment Understand and respect the client's feelings and beliefs and distinguish them from your own Welcome uncertainty Learn to actively listen Observe and learn from mentors Practice meditation/deep breathing/self-calming techniques Keep a personal journal to reflect on

How does appearance and attitude affect communication?

Studies show practitioners that adopt a friendly and reassuring manner are more effective than those who do not.

Define adherence:

defined as the degree to which clients follow a treatment plan

Good communication is the means by which we:

establish a therapeutic relationship with each client

Define the health belief model

psychological theories for decision making for health related choices, based upon value one places on outcomes of their health

What is a developmental disability?

•A developmental disability is defined as a severe, chronic disability that originated at birth or during childhood and is expected to continue indefinitely •Restricts an individual in 3 or more functional activities of daily living •Self care •Receptive and expressive language •Learning •Mobility •Self direction •Capacity for Independent living •Economic self sufficiency

Give examples of developmental disabilities

•Autism •Cerebral Palsy •Brain injury •Down Syndrome •Fetal Alcohol Syndrome •Spina Bifida •Behavior disorders •Intellectual disability: can range from mild to severe

•Studies show that an empathetic provider approach to client care leads to:

•Improvements in the quality of the client/provider relationship •Enhances the treatment outcomes •Enriches the providers own life.

What are the four levels of communication?

•Intrapersonal: Understanding of ourselves •Interpersonal: Sending our message to another individual •Small group discussion: communication within a group •More chances for misinterpretation •Organizational communication: several groups trying to communicate

What are some ways to improve your speaking voice?

•Need to adjust tone, volume, speed, pitch and educational level to patient •"WHAT you say and HOW you say it matters" •Remain calm, concerned and self-confident (fake it till you make it)

What are some truths providers need to recognize when it comes to patient care?

•Recognize their own limitations •Practice effective communication skills •Practice Stress Management (work/family life) •Provide factual Information and be non-judgmental •Understand that not everyone can be cured/fixed

What is the medical model of disability?

•States disabilities are medical conditions in need of ongoing treatments •Steeped in tradition of problem identification, & focuses on negative experiences

Give examples of events that would cause sudden onset of disabilities. What difficulties may these cause?

•Trauma: life and future is uncertain •Spinal cord injury: 60% ages of 13-30 •CVA: may require 24 hr care •Amputation: suffer anxiety depression/loss of limb •Return to work issues •Insurance •Adjustment/Adaption time

Good communication allows:

•Understanding of others: patients, MDs, Case managers, colleagues •Helps clarify issues •Promotes adherence and compliance

Tips for good communication:

•Use Open ended questions •Active listening •Reflective practice: (studying your own experiences to improve the way you work) •Empathy: Ability to identify and understand someone's situation, feelings & emotions •If you were the patient, how would you feel or want to be treated- "be an insider"