Creating a Therapeutic Relationship Resource Package

Transcription

1 Creating a Therapeutic Relationship Resource Package

2 ABCC Model* Behaviour P I E C E S Antecedents (Causes) Physical health Intellectual capacity Emotional health, spirituality Capabilities Environment Social, cultural 1. What has changed? Individual Consequences (Results) Environment Staff 2B. What are the possible causes? 2A. What are the RISKS? Care Strategies Individual Environment Staff 3. What is the action? *Modified from: Geropsychiatric Education Program, Vancouver/Richmond Health Board 1997 P.I.E.C.E.S. Consultation Team, 2009

3 Listen When I ask you to listen to me and you start giving advice you have not done what I asked. When I ask you to listen to me, and you begin to tell me why I shouldn t feel that way, you are tramping on my feelings. When I ask you to listen to me and you feel you have to do something to solve my problem, you have failed me, strange as that may seem. Listen! All I asked was that you listen. Not talk or do just hear me. Advice is cheap: 50 cents will get me both Dear Abby and Billy Graham in the same newspaper. And I can do for myself: I m not helpless. Maybe discouraged and faltering, but not helpless. When you do something for me that I can and need to do for myself, you contribute to my fear and weakness. But, when you accept as a simple fact that I do feel what I feel, no matter how irrational, then I can quit trying to convince you and can get about the business of understanding what s behind this irrational feeling. And when that s clear, the answers are obvious and I don t need advice. Irrational feelings make sense when we understand what s behind them. Perhaps that s why prayer works, sometimes, for some people because God is mute, and he doesn t give advice or try to fix things. They just listen and let you work it out for yourself. So, please listen and just hear me. And, if you want to talk, wait a minute for your turn; and I ll listen to you. Anonymous

4 BLOCKS TO LISTENING 1. COMPARING (my kids are better I ve had it harder ) 2. MIND READING (I bet he s really feeling she really means ) 3. REHEARSING (next I ll say then I ll nail em with ) 4. FILTERING (hear only what concerns you ) 5. JUDGING (prejudge, bias, negative, labeling ) 6. DREAMING (half-listening, daydreaming ) 7. IDENTIFYING (launch into your similar experience before they can finish telling theirs ) 8. ADVISING (you re the great problem solver how about just be there listen) 9. SPARING (be quick to disagree debate put down ) 10. BEING RIGHT (shout make excuses you can t take criticism twist the facts accuse ) 11. DERAILING (change the subject make a joke of it avoid discomfort or anxiety ) 12. PLACATING ( Really Oh I know Um-hmmm don t tune in just nod your head )

5 REAL verses PSEUDO-LISTENING BEING QUIET DOES NOT MEAN THAT REAL LISTENING IS HAPPENING REAL LISTENING IS BASED ON THE INTENTION TO DO ONE OF FOUR THINGS: UNDERSTAND SOMEONE ENJOY SOMEONE LEARN SOMETHING GIVE HELP OR SOLACE

6 ACTIVE LISTENING PARAPHRASE STATE IN YOUR OWN WORDS WHAT YOU THINK WAS SAID: Do you mean? What I hear you saying is CLARIFY ASK QUESTIONS TO GET A CLEAR PICTURE. FEEDBACK IN A NONJUDGEMENTAL WAY TO SHARE WHAT YOU FELT, THOUGHT, OR SENSED. BE HONEST AND SUPPORTIVE. LISTEN WITH EMPATHY THERE IS ONLY ONE REQUIREMENT FOR LISTENING WITH EMPATHY: SIMPLY KNOW THAT EVERYONE IS TRYING TO SURVIVE. LISTEN WITH OPENNESS NEARLY EVERYONE HAS TROUBLE LISTENING OPENLY. BEING WRONG HAS VAST PROPORTIONS. YOU NATURALLY WANT TO ARGUE OR SHOUT IT DOWN. HEAR THE ENTIRE COMMUNICATION BEFORE JUDGING. PICTURE YOURSELF AS ONE WHO WANTS TO FIND THE TRUTH.RATHER THAN PROTECTING OR BUILDING YOUR SELF-ESTEEM BY HAVING TO BE RIGHT. LISTEN WITH AWARENESS DOES THE PERSON S VOICE, TONE, EMPHASIS, POSTURE, FACIAL EXPRESSION FIT WITH THE CONTENT OF HER/HIS COMMUNICATION?

7 Communication Basics Checklist Communication Skills Skill OK Usually I Need to Work on This I physically attend to others I listen carefully before talking I speak in descriptive terms I discuss negative feelings I own my feelings ( I messages) I speak clearly and specifically I use good timing I consider other s needs I encourage others to communicate with me Listening As an observer, your job is to pay attention to the supporter s use of this skill. During the interaction, give your full attention to what the peer supporter and peer say and do. At the end of the demonstration or practice period, quickly check the behavior you observed. After the practice period(s), report to the supporter the behaviors you have checked. Guidelines for effective attending are: To communicate listening through frequent and varied eye contact and through facial expression To physically relax and lean forward occasionally, using natural hand and arm movements To verbally follow the peer, using a variety of brief encouragements such as umhum, yes, or repeating the key words. Indications that effective attending is not taking place include: Little eye contact, a fixed stare, a frozen expression, stiff or tense posture, no head movements, no hand movements, slouching, topic jumping, and cutting off the peer.

8 Listening Feedback Form Qualities Displayed On each of the following scales, put a check aat a location on the continuum to reflect judgment of the qualities displayed by the supporter. Warm Concerned, Involved Understanding Open, Sharing Relaxed, At Ease Cold Uninterested Not Understanding Closed Tense Behavior 1. Maintained frequent and varied eye contact 2. Looked away from peer when talking or maintained a fixed stare 3. Displayed varied facial expressions or alertness 4. Showed little or no facial expressions or alertness 5. Used affirmative or encouraging gestures 6. Had relaxed body posture, leaning forward occasionally 7. Sat in a fixed or rigid position throughout 8. Slouched or leaned away from the peer to continue talking 9. Offered brief vocalizations that encouraged the peer to continue talking 10. Interrupted the peer and changed topics arbitrarily

9 SELF CONTROL YOUR ABILITY TO REMAIN CALM AND RATIONAL UNDER VERBAL PERSONAL ATTACK IMPORTANCE OF SELF CONTROL REFUSAL TO BE CONTROLLED BY OTHERS OR BY YOUR EMOTIONS AVOIDS FOCUSING ON SINGLE WORD OR ACTION AVOIDS POWER STRUGGLE BEHAVIOR RETAIN THE ABILITY TO MAKE SOUND DECISIONS

10 EFFECTS OF LOSING SELF CONTROL FOCUS CHANGES FROM THE PERSONS BEHAVIOR TO YOUR EMOTIONS YOUR EFFECTIVENESS IS DECREASED SOME TECHNIQUES TO MAINTAIN SELF CONTROL MAKE LISTS OF EMOTIONALLY CHARGED WORDS, GESTURES, AND SUBJECTS COMMIT LIST TO MEMORY PRACTICE SELF-TALK: ROLE PLAY DIFFICULT ENCOUNTERS WITH STRATEGIES THAT HELP YOU MAINTAIN SELF- CONTROL CONCENTRATE ON DEEP BREATHING, YOU WILL MAINTAIN CONTROL OF YOUR MIND AND EMOTIONS WHEN YOU CONCENTRATE ON KEEPING YOUR BREATHING REGULAR

11 SETTING LIMITS PROTOCOL: 1. POINT OUT THE SPECIFIC BEHAVIOR THAT IS INAPPROPRIATE 2. SAY WHY IT IS INAPPROPRIATE 3. GIVE CHOICES (CONSEQUENCES) YOU MUST GIVE POSITIVE CHOICE FIRST! 4. ALLOW TIME 5. CARRY OUT CHOICE (CONSEQUENCE) REMEMBER: S A F E T Y C O M E S F I R S T BEFORE YOU INTERVENE HAVE SUFFICIENT STAFF ON HAND AND KNOW WHAT THE CHOICES ARE THAT YOU WILL OFFER. DON T OFFER WHAT YOU CANNOT PROVIDE OR BACKUP; DON T GET CAUGHT UP IN A POWER STRUGGLE, Got cha, or Button Push REACTION. Adapted from: The Art of Setting Limits (VCR tape); National Crisis Prevention Institute, 3315-K North 124 th St., Brookfield, Wisc

12 101 THINGS TO DO WITH THE PERSON WHO HAS DEMENTIA 1. Clip coupons 35. Read aloud from label 2. Sort poker chips 36. Dye Easter eggs 3. Count tickets 37. Make a basket of socks 4. Rake leaves 38. Take a walk 5. Use the carpet sweeper 39. Reminisce about the first day of school 6. Read out loud 40. String Cheerio to hand outside for birds 7. Bake cookies 41. Make a fresh fruit salad Look up names in the phone 8. book 42. Sweep the patio Read the daily newspaper out 9. loud 43. Color paper shamrocks green 10. Ask a friend, neighbor, church 44. Fold towels acquaintance who has a baby or young child to visit 11. Listen to polka music 45. Have afternoon tea 12. Plant seeds indoors or out 46. Remember great inventions 13. Look at family photographs 47. Play pictionary 14. Toss a ball 48. Paint a sheet 15. Color pictures 49. Cut out paper dolls 16. Make homemade lemonade 50. Identify provinces and capitals 17. Wipe off the table 51. Make a family tree poster 18. Weed the flower bed 52. Color a picture of our flag 19. Make cream cheese mints 53. Cook hot dogs outside 20. Have a spelling bee 54. Grow magic rocks Read the Reader's Digest out 21. loud 55. Water house plants 22. Fold clothes 56. Reminisce about the first kiss 23. Have a calm pet visit 57. Play horseshoes 24. Cut pictures out of greeting cards 58. Dance 25. Wash silverware 59. Sing favorite hymns 26. Bake homemade bread 60. Make homemade ice cream Sort objects such as beads by 27. shape or color 61. Force bulbs for winter blooming 28. Sing Christmas carols 62. Make Christmas cards

13 Say "Tell me more" when they 29. talk 63. Sort playing cards by their color 30. Put silverware away 64. Write a letter to a family member 31. Make a Valentine Collage 65. Dress in red on a football Saturday Play favorite songs and sing 32. together 66. Pop popcorn 33. Take a ride 67. Name the Prime Ministers 34. Make a cherry pie 68. Give a manicure 69. Make paper butterflies 86. Cut up used paper for scratch paper 70. Make a May basket 87. Take care of a fish tank 71. Make homemade applesauce 88. Trace and cut out leaves 72. Finish famous sayings 89. Ask simple questions 73. Feed the ducks 90. Finish Bible quotes 74. Mold with Play Doh 91. Paint with string Look at pictures in a National 75. Geographic 92. Cut out pictures 76. Put a simple puzzle together 93. Read classic short stories 77. Sand wood 94. Put coins into a jar Rub in hand lotions with a 78. pleasant scent 95. Sew sewing cards 79. Decorate paper place mats 96. Put bird feed out for birds 80. Arrange fresh flowers 97. Clean out a pumpkin 81. Remember famous people 98. Roll yarn into a ball 82. Straighten underwear drawers 99. Make a birthday cake 83. Finish nursery rhymes 100. Reminisce about a favorite summer 84. Make peanut butter sandwiches 101. Decorate Christmas tree 85. Wipe off patio furniture Source Unknown

14 Pro-Attention Plan Name Sun Mon Tues Wed Thurs Fri Sat A. P. A. P. A. P. A. P. A. P. A. P.