Family Medicine Lecture 3 PDF

 Interaction process that facilitate meaningful understanding of self and environment and result in the establishment of goals and values for future behavior  Interactive process conjoining the counselee who need assistance and the counselor who is trained and educated to give assistan...

 Interaction process that facilitate meaningful understanding of self and environment and result in the establishment of goals and values for future behavior  Interactive process conjoining the counselee who need assistance and the counselor who is trained and educated to give assistance.  Counseling consist of a definitely structured permissive relationship which allows the client to gain an understanding of himself, which enable to take positive steps.  Structured (not social) conversation (dialogue and aimed at facilitating (rather than descriptive) a client's quality of life in the face of adversity".  Counselling can be done with Everyone, but a professional counsel should be done with educated provider.  Counselling is a structured conversation aimed at facilitating a client's quality of life in the face of adversity.  Counselling should be: ① Structured: Not social ② Conversation: Dialogue and interaction. ③ Facilitative: Rather than prescriptive or a direct advice. ① Help people Understand their problems better. ② Help people Manage their problems. ③ Help to Empower clients/patients. ④ Help people to Think Positively about their problems. ⑤ Help in Changing Behavior positively.  Family planning  Carrier development  Conflict resolution  Self development  Health, stress management  Exercise  Rehabilitation  Sanitation  Crisis intervention  Preventive measures.  ① To help individuals become self - sufficient, self - dependent, self - directed and to adjustthemselves efficiently to the life. ② To overcome many of their future problems. ③ Concerned with helping people solve their various problems. ④ To review life style & relationship ⑤ To explore, clarify & resolve personal difficulties. ⑥ To develop strength & resources ⑦ To promote wellbeing ⑧ To express thoughts and feelings ① Counseling is unique to individual. ② Counseling is concerned with total individuality. ③ Counseling is goal oriented, goal directed. ④ Counseling is a continuous process. ⑤ Counseling should be based on reliable data. ⑥ Counseling should be flexible.  Sharing and appreciating  Telling somebody what to do  Weighing up situations helping a person  Giving advice sort out the problem.  Formal teaching  Confidence building  Critical and Judgmental  Rapport building  Imposing on somebody/Spoon Feeding  Genuine and caring understanding  Dealing with feelings as well as facts. ► Good working knowledge of the problems/situations. ► Ability to communicate information in accurate, consistent and objective manner. ► Awareness of difference in culture norms, values and lifestyles. ► The proficiency to manage common psychological and clinical complications-anxiety, depression obsessive compulsive disorders and neurological symptoms. ① Understanding ⑨ Sincerity ② Sympathetic ⑩ Fact ③ Attitude ⑪ Tolerance ④ Friendliness ⑫ Neatness ⑤ Sense of Humor ⑬ Broad minded ⑥ Stability ⑭ Kindliness ⑦ Patience ⑮ Intelligence ⑧ Objectivity  Cerate a non-threatening accepting atmosphere.  Compression of other persons needs and feelings.  Positive attitude towards people with the right to make their own decisions.  Non judgmental, regards to individual rights.  Trustworthy and open about yourself in an appropriate manner.  Free from distraction  Focused  Comprehend both physical and psychological language.  Use open-ended questions.  Reemphasize one of two words in question to elicit more information.  Caring statements to check correct information.  Avoid Speculation  Follow - up  Credibility  Observant  Unbiased  Non-judgmental  Sensitive  Empathetic  Listens effectively  Lets client decide  Open-minded  Respects the rights of client   Greet client in a friendly, helpful, and respectful manner  Ask client about needs, concerns, and previous use.  Tell client about different options and methods  Help client to make decision about choice of method she prefers.  Explain to client how to use the method.  Return: Schedule and carry out return visit and follow-up of client ① ① Welcome and register client. ② Prepare chart/record. ③ Determine purpose of visit. ④ Give clients full attention. ⑤ Assure the client that all information discussed will be confidential. ⑥ Talk in a private place if possible. ②  Ask client about her/his needs.  Write down the client's: age, marital status, number of previous pregnancies and births, number of living children, basic medical history, previous use of family planning methods. history and risk for STDs.  Assess what the client knows about family planning methods.  Ask the client if there is a particular method she is interested in.  Discuss any client concerns about risks vs. benefits of modern methods (dispel rumors and misconceptions).  ③  Tell the client about the available methods.  Focus on methods that most interest the client, but briefly mention other available methods.  Describe how each method works, the advantages, benefits, possible side effects, and disadvantages. ④  Help the client to choose a method.  Repeat information if necessary.  Explain any procedures or lab tests to be performed. ⑤  Explain how to use the method (how, when, where).  Explain to the client how and when s/he can/should get resupplies of the method, if necessary. ⑥  At the follow-up or return visit ask the client if she is still using the method.  If the answer is yes, ask her/him if she is experiencing any problems or side effects and answer her/his questions, solve any problems, if possible.  If the answer is no, ask why she stopped using the method and counsel her/him to see if s/he would like to try another method or re-try the same method again.  Make sure she is using the method correctly (ask her/him how s/he is using it).  Simplest to do  Counselior give advices, make decision based on what she thinks is in the the best interest of client.  Expects the client to follow her advices  Completely directed by counsellor.  Counsellor is passive mainly listener.  Client is active expresses herself freely and tells the counsellor what he/she wants.  After careful reflection and clarification, makes her own decision.  the main function of the counsellor is to create an atmosphere in which the client can work out his problem.  Neither counsellor nor client controlled.  Methods of counselling may change from client to client or even with the same client from time to time.  It is highly flexible.  Freedom of choice and expression is open to both the counsellor and the counselee.  HIV positive men and women specially trained to hear the concern of clients and offer support and referral services.  In this, counsellor is open about his her HIV positive status and shares experiences with client.  It is the process that is carried out as one to one interaction followed by group approach.  It addresses the client issue through following process:- ① Sharing feeling about similar experiences. ② Share information about availability of HIV/AIDS prevention, Treatment and care services. ③ Narrate their success stories to the peers and convey messages of positive thinking. ④ Supports client in becoming more involved in community activities  Greet the client in a friendly and respectful manner.  Ask the client about Family Planning needs.  Tell the client about different methods / services.  Help the client to make her/his own decision about which method/service to use.  Explain to the client how to use the method/services she/he has chosen.  Return visit and follow-ups of client scheduled.  ①  Introduce yourself & establish rapport (create a good and comfortable environment).  Defining the objectives and roles. (you must explain to the patient that you are not giving solutions, you are only directing)  Allow the client/ patient to negotiate.  Observation skills: Verbal and nonverbal cues.  Sensitivity and response to emotions. (sensitivity can be a good thing such as respecting the person in front of you, or a bad thing like getting sad and upset over any slight thing). ② ① Obtain information about the client/patient. ② Attempted intervention. (trying anything before) ③ Allow patient/client to talk freely and express himself. ④ Use facilitative questions (open-ended). ⑤ Understand the patient's world.  ③  This is the formal phase of counseling  Explain your understanding of the problem. (By summarizing what he said and allow him to correct you).  Sharing information/understanding. ④  Help the patient/ client to answer the questions: ① What do i do to solve the problem? ② How do i make it happen? and also.... ③ Counselor is supportive/ agent of change....but non directive. ④ End by Termination and referral  Not a good style of counselling.  Counsellor-centered.  The counselor direct the patient/client.  Allow the counselor to control the situation all the way through (the only advantage)  Patient/Client-centered.  Allow client/patient to tell his story in his own way.  The role of counselor is to create an atmosphere in with the client can express himself more freely (make the patient feel comfortable).  Stress on emotional elements and development of insight.  Alternating between patient-centered and counsellor-centered styles.  Client-specific (tailored according to situation and client). (Change your style according to the patient personality (needs experience)).   family is talking about their experiences, so get an understanding of their difficulties  Focus on changing behavioral pattern  Use of drugs to help to manage health problem ① Resistance of counselee ② Counselor with different culture ③ Counseling individual with strong emotions ④ Counselor burn out ⑤ Lack of physical facilities