COUN 221F Lecture 1 and 2 Mental Health Practice PDF

COUNA221F Theories and Practice in Counselling and Mental Health Hong Kong Metropolitan University § Discuss the concepts of mental health and quality of life. § Identify and apply the salutogenic concept for mental health. § Apply the 3-tier prevention strategies in mental health prevention and...

COUNA221F Theories and Practice in Counselling and Mental Health Hong Kong Metropolitan University § Discuss the concepts of mental health and quality of life. § Identify and apply the salutogenic concept for mental health. § Apply the 3-tier prevention strategies in mental health prevention and intervention. § Apply the concepts of bio-psychosocial model, ecological model, and strength-based approach in mental health practice. § Mental health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (WHO, 2004). § It has been often conceptualized as a purely positive affect, marked by feelings of happiness and sense of mastery over the environment (Lamers, Westerhof, & Bohlmeijer, 2011). Emotional happiness, satisfaction. MENTAL HEALTH wellbeing interest in includes life, and Psychological well-being includes liking most parts of one’s own personality, being good at managing the responsibilities of daily life, having good relationships with others, and being satisfied with one’s own life. Social well-being refers to positive functioning and involves having something to contribute to society, feeling part of a community, believing that society is becoming a better place for all people, and that the way society works makes sense to them. People in good mental health are often sad, unwell, angry or unhappy, and this is part of a fully lived life for a human being. § Mental MENTAL HEALTH health is a dynamic state of internal equilibrium which enables individuals to use their abilities in harmony with universal values of society. § Basic cognitive and social skills § Ability to recognize § Express and modulate one’s own emotions, as well as empathize with others § Flexibility and ability to cope with adverse life events and function in social roles § Harmonious relationship between body and mind § All represent important components of mental health which contribute, to varying degrees, to the state of internal equilibrium (Galderisi, et al., 2015). § Quality of Life: An individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns (WHO, 2012). § It includes subjective evaluations of both positive and negative aspects of life. § Quality of life (QoL) research has become a major area of multidisciplinary research for a variety of reasons: § Evaluate clinical outcomes such as symptom reduction but also the individual’s own perceptions of how the treatment or intervention has influenced their illness experience and their general psychosocial functioning. § A predictor of better mental health, improved overall health, superior prognosis in times of illness, reduced mortality, and increased longevity. Physical: pain and discomfort; energy and fatigue; sleep and rest Psychological: positive feelings; self-esteem; thinking, memory, learning and concentration; bodily image and appearance; negative feelings Level of independence: activities of daily living (e.g., self-care); mobility; medication and treatment dependence; work capacity Social relationships: personal relationships; practical social support; sexual activity Relation to environment: physical safety and security; financial resources; home environment; availability and quality of health/social care; learning opportunities; leisure participation and opportunities; transport; physical environment Spirituality, religion and personal beliefs § Some findings indicated that symptom severity or extent of disability are not consistently predict QoL. § It highlights the subjective nature of this concept, are influenced by individual differences in the appraisal of, and subsequent coping with ill and health. § In many instances, however, illness does affect QoL. § For example, pervasive and persistent pain and disability are generally found to be associated with a lower QoL, such as depression levels, disability and § Neurological illnesses such as Parkinson’s disease, cognitive dysfunction (e.g., memory impairment or attentional deficits) can disrupt key QoL domains such as physical and psychosocial functioning. § Furthermore, memory deficits can make it hard for some individuals to evaluate their current status against their former status in order to make meaningful QoL judgements. § Among 568 cancer patients, anxiety and depression were both related to the QoL dimensions of emotional, physical and social functioning, pain, fatigue. § Studies of the impact of pain on patient wellbeing may offer some explanation as to why depression is commonly associated with QoL, as pain is strongly associated with depressed mood. § In terms of coping response, avoidant coping is likely to be beneficial to QoL where a person is unable to exert control, and they suggest that approach coping in these situations could lead to frustration when control is not forthcoming. § In a study of 230 adults with chronic pain, found that those who did show acceptance of their pain, many QoL indicators were higher, including reduced pain symptomatology and disability, less depression and pain related anxiety, a higher amount of time per day spent up and about, and a greater likelihood to be working. § Longitudinal study of Chinese cancer patients revealed many of the same physical, psychosocial and emotional responses to cancer reported in Western studies. § The authors note that their sample differed from Western samples in their emphasis on family support, and in the patients’ indirect indication of distress through symptom report rather than through direct interpersonal communication. § Understanding childhood QoL is important because any effects of impaired QoL may be cumulative and affect later development. § Among younger people who have suffered an acute stroke, being unable to return to work has been associated with reduced life satisfaction and subjective wellbeing, whereas this would not concern most stroke patients who are post-retirement age. § The salutogenesis theory was introduced in 1970s by Antonovsky, a medical sociologist interested in stress theory, who gave a fundamental contribution to health research. § The salutogenic model of health explains why people in stressful situation stay well and even can improve their health. § The ability to use resources such as finances resources, knowledge, experience, self-esteem, healthy lifestyles, culture, social support is § It is defined as a way of seeing life and the ability to successfully manage the many encountered during life itself. § It has three components: stressors that are § Cognitive component of comprehensibility (C) which refers to the extent to which one perceive the stimuli that confront one as consistent structured and clear. § Instrumental or behavioral component of manageability (Ma) which is the extent to which one perceives that the resources at one’s disposal are adequate to meet the lives demands. § Motivational component of meaningfulness (Me) which refers to the extent to which one feels that life makes sense emotionally. § Experiences of consistency are the basis for the development of comprehensibility. § In positive cases, children have feelings of security and acceptance in social relations (Krause & Lorenz, 2009). § The component of meaningfulness is increased when children have the possibility to participate in decision-making processes. • Experiences of self-efficacy are the basis for the development of manageability. • This component grows if the children experience the acceptance of their individual progress. § Health promotion includes promotion of preconditions of the development of SOC components, and providing participation and involvement are the keys to success in health promotion. § Participating in socially accepted activities creates a feeling of belonging and develops and strengthens the self-worth. § Tier 1 universal prevention, refers to programs delivered to all population with the goal of increasing protective factors in the environment, such as “Whole School Mental Health Promotion Strategies”. § A randomized controlled trial involving 215 youth found that the program led to higher identity cohesion and selfesteem, better grades, and lower depressive symptoms one year later (Umaña-Taylor AJ, et al., 2018). § Experiences of adult support at school have been linked with more academic engagement, fewer absences and suspensions, lower risk of externalizing and internalizing behaviors, increased resilience (Venta A, et al., 2018). § Tier 2 selective intervention are more targeted and specialized services delivered to support who are atrisk. § Fung and colleagues (2019) recently evaluated a 12week, school-based mindfulness intervention with AA with elevated mood symptoms. Researchers found a significant treatment effect for internalizing symptoms and perceived stress. § With increased awareness, school staff are likely to have better understanding of potential struggles experienced by immigrant-origin youth and families and be able to work with these youth and families in a more supportive manner (Torres SA, et al.,2018). § Tier 3 intensive or individualized intervention, refers to programming directed at addressing the needs of people experiencing the most significant mental health problems. § Research of Cognitive Behavioral Intervention for Trauma in Schools indicated that students experienced significantly reductions in PTSD and depression symptoms (Kataoka, et al., 2003). § Traditional biomedical model has limited usefulness with current patterns of illness and the health challenges of the 21st century. § Integrates biological, psychological, and social influences in order to understand health and vulnerability to illness and successfully treat disorders. § Addresses limitations of a traditional medical model that attempts to cure disease. We are not healthy until we become sick. Mental problems are not clearly distinguishable from physical problems. Genetics Physiology Gender BIOLOGICAL FACTORS Age Vulnerability to stress Immune system Nutrition Medications Personality Self-efficacy Personal control Optimistic bias PSYCHOLOGICA L FACTORS Social support Stress Coping skills Diet Risky behaviors Adherence to medical advice Poverty Ethnic background SOCIOLOGICAL FACTORS Cultural beliefs Racism Living with chronic illness § Health and illness are caused by multiple factors and produce multiple effects § Body and mind cannot be distinguished in matters of health and illness § Multidisciplinary approach § Explicit the significance of the relationship between patient and the practitioner § It views human development as the result of the interactions between a person and their environment. § The ecological systems theory is conceptualized as concentric circles with the individual at the center. § Each subsystem can influence a child’s behavior in another setting, with variable risk and protective factors influencing behavioral outcomes. § Not only do these systems affect the individual, but the characteristics of the individual (e.g., gender, ethnicity, values) also influence his or her experience of the systems. § Strengths Model was developed in an American context in the 1980s and has been refined over the years through application and research in the United States and other countries (Onken, 2014). § It create a sense of accomplishment, contribute to satisfying relationship with family members, peers, and adults, enhance the ability to cope with stress, and promote social and academic development, can be used to promote mental health and resilience. § Exclusive focus on client’s difficulties can lead towards negative forms of labelling in which a client is viewed and starts to view themselves as a cluster of deficits (Rashid and Ostermann, 2009). § Proponents of SBA can lead to a more holistic picture of client. § Research has identified that higher overall levels of strengths are related to lower likelihood of both being a bully and being bullied (Donnon, 2010). § Strengths are also described as protective factors, which provide a buffer against risk factors (Barwick, 2004). § For example, human strengths act as buffers against mental illness, include courage, future mindedness, optimism, interpersonal skill, faith, work ethic, hope, honesty, perseverance, and the capacity for insight (Brendtro, Toit, Bath & Van Bockern, 2006). § Strengths-based approaches contribute to a sense of personal empowerment and greater life satisfaction (Hanks, Rapport, WaldronPerrine, & Millis, 2014). § It also contribute to satisfying relationships with family members and peers (Gingerich, Kim, & MacDonald, 2012), and enhance one’s ability to deal with adversity and stress (Gingerich et al., 2012). § Chinese people tend to experience or express emotions in a less intense and less frequent manner than their Western counterparts and tend to behave in a way that prioritizes harmony with family, and community (Bond, 1993). § It contrasts with the Western individualistic notion of recovery through individual autonomy and empowerment (Robbins et al., 2019). § The Chinese are more likely to view themselves as part of a larger group, inseparable from society, families, and peers (Tse & Ng, 2014). § In the Chinese context, family personal identity and other social relationships are seen as primary and essential in the creation and maintenance of personal identity (Yeh et al., 2013). § People spoke about their families and their caretaking roles as sons/daughters or as parents as being protective against the effects of their mental illnesses. This accords with the Chinese (xiao, 孝). § The spiritual and religious strengths of Chinese, such as harmony with the will of Heaven, balancing opposites, accepting fate, and fulfilling virtuous expectations, and engaging in religious activities that nurture these qualities and provide social support. § Daoist perspective adds insight to the strength’s perspective that any situation or ability can be an asset and even perceived liabilities can be transformed into strengths; some of our participants explained that their adversity was an opportunity for growth. This is also closely related to the increasingly popular notion of posttraumatic growth (Ho & Bai, 2010). § It must be alert to possible incongruences between Western-derived strengths-based approaches and non-Western cultural contexts. § It is also important to have a clear understanding of how a person views recovery and the meaning they attach to the word “strengths” before introducing the actual tools. How the Chinese culture influence the meaning of mental health? How the Chinese culture affect people from consulting counsellors? And their views on psychotherapy? How the Chinese culture affect the application of psychotherapy? § In recent years, many guidance programmes set their goal on improving the capacity of the students’ resilience, hope that they will be able to remain optimistic and positive in the face of adversities § Resilient people can turn adverse situation around and make life more endurable. The ability to make realistic plans and being capable of taking the steps necessary to follow through with them. A positive selfconcept and confidence in one’s strengths and abilities. Communication and problemsolving skills. The ability to manage strong impulses and feelings. § Barwick, H. (2004). Young males: Strength-based and male-focused approaches, A review of the research and best evidence. New Zealand: Ministry of Youth Development. § Bond, M. H. (1993). Emotions and their expression in Chinese culture. Journal of Nonverbal Behavior, 17(4), 245–262. § Donnon, T. (2010). Underlying how resiliency development influences adolescent bullying and victimization. Canadian Journal of School Psychology, 25, 101-113. § Fung J, et al. (2019). A randomized trial evaluating school-based mindfulness intervention for ethnic minority youth: exploring mediators and moderators of intervention effects. Journal of Abnormal and Child Psychology, 47(1):1–19. § Galderisi, S., Heinz, A., Kastrup, M., Beezhold, J., & Sartorius, N. (2015). Toward a new definition of mental health. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 231-33. § Hines-Martin, V., Speck, B. J., Stetson, B., & Looney, S. W. (2009). Understanding systems and rhythms for minority recruitment in intervention research. Research in Nursing and Health, 32, 657-670. § Ho, S. M. Y., & Bai, Y. (2010). Posttraumatic growth in Chinese culture. In Posttraumatic growth and culturally competent practice: Lessons leaned from around the globe. Wiley, (pp. 147–156). § Kataoka, S.H., et al. (2003). A school-based mental health program for traumatized Latino immigrant children. Journal of American Academy and Child Adolescent Psychiatry, 42(3):311–8. § Krause, C. (2011). Developing sense of coherence in educational contexts: Making progress in promoting mental health in children. International Review of Psychiatry, 23(6): 525–532. § Lamers, S.M.A., Westerhof, G.J., & Bohlmeijer, E.T. (2011). Evaluating the psychometric properties of the Mental Health Continuum-Short Form (MHC-SF). Journal of Clinical Psychology, 67:99-110. § Onken, S. J., Craig, C. M., Ridgway, P., Ralph, R. O., & Cook, J. A. (2007). An analysis of the definitions and elements of recovery: A review of the literature. Psychiatric Rehabilitation Journal, 31(1), 9–22. § Rapp, C. A., & Goscha, R. J. (2012). The strengths model: A recovery-oriented approach to mental health services (3rd ed.). Oxford University Press. § Robbins, S. P., Chatteree, P., Canda, E. R., & Leibowitz, G. S. (2019). Contemporary human behavior theory: A critical perspective for social work (4th ed.). Pearson. § Shelley Taylor. (2009). Health Psychology. (7th ed.). McGraw-Hill. § Torres SA, et al. (2018). Immigration policy, practices, and procedures: the impact on the mental health of Mexican and Central American youth and families. American Psychology, 73(7):843–54. § Tse, S., & Ng, R. (2014). Applying a mental health recovery approach for people from diverse backgrounds: The case of collectivism and Individualism paradigms. Journal of Psychosocial Rehabilitation and Mental Health, 1(1), 7–13. § Umaña-Taylor AJ, et al. (2018). A Universal intervention program increases ethnic-racial identity exploration and resolution to predict adolescent psychosocial functioning one year later. Journal of Youth Adolescence, 47:1–15. § Venta A, et al. (2018). Contribution of schools to mental health and resilience in recently immigrated. School Psychology, 34(2):138–47. § World Health Organization (WHO). (2004). Promoting mental health: concepts, emerging evidence, practice (Summary Report). Geneva: World Health Organization. § World Health Organization (WHO). (March 2012). Programme on mental health: WHOQOL user manual. § Yeh, K. H., Yi, C. C., Tsao, W. C., & Wan, P. S. (2013). Filial piety in contemporary Chinese societies: A comparative study of Taiwan, Hong Kong, and China. International Sociology, 28(3), 277–296.