Week 1 - Obesity Counselling PDF

Week 1: Counselling the patient with obesity, and the phenomenology of obesity Part 1 - Counselling: Helping as a Personal Journey The Demands of the Journey Constantly learning and updating knowledge. Helping is a personal, “interior” journey. Our reactions and built-in bi...

Week 1: Counselling the patient with obesity, and the phenomenology of obesity Part 1 - Counselling: Helping as a Personal Journey The Demands of the Journey Constantly learning and updating knowledge. Helping is a personal, “interior” journey. Our reactions and built-in biases can be roadblocks on our journey. The Reflective Helper Being a reflective practitioner means you commit to personal awareness. Commit to becoming aware of your automatic reactions & prejudices. Contemplate what has happened and consciously choose a plan of action. How to be Reflective Think about your experiences. Analyze your automatic assumptions, beliefs, reactions, prejudices about people with cultural backgrounds different from your own. Be aware of potential problem areas and learn to recognize when they arise. Accommodate new information rather than rejecting it without consideration. Consider journaling/recording these experiences and discussing them with colleagues, supervisors, etc. Reflecting about Differences What issues might arise when the helper and the patient differ in the following areas? ○ Culture and ethnicity ○ Age ○ Gender ○ Sexual orientation ○ Religion ○ Disability ○ Physical differences (e.g., body size) What are some other areas of diversity? Challenges you will Face Take responsibility for your own learning. Find a mentor. No “perfect” technique. Be OK being in “limbo.” Be open to feedback. Let go of your own self-defeating beliefs (i.e., cognitive distortions). Ethical Guidelines 1. Confidentiality and limits. 2. Avoid giving advice (more on this later in the course). 3. Do not impose your values on others. 4. Give specific and constructive feedback. 5. Stay with techniques you have learned. 6. Notify someone immediately about another’s suicidal ideation or intent to harm self or others. Individual Differences May have additional challenges in becoming a professional helper based on individual differences. Student progress cannot be confined to a timetable nor is it a linear process. Development is a personal journey, try not to compare yourself with others. Who Can be an Effective Helper? Nonjudgmental, warm, and caring. Good self-esteem, secure, mentally healthy. Self-examination, self-reflection, self-care. Intellectual competence, creativity, flexibility. Courageous. What Can you Bring to a Patient? Many of the characteristics can be developed, all are not necessarily inborn. Each person brings unique characteristics such as your own personal strengths. Build on your own strengths and add new skills during your journey. Six Common Therapeutic Factors 1. Maintaining a strong therapeutic relationship. 2. Increasing patient’s motivation and expectations of help. 3. Enhancing patient’s sense of mastery and self-efficacy. 4. Providing new learning experiences. 5. Raising emotional arousal and promoting emotional expression. 6. Providing opportunities to practice new behaviors. Part 2 - Phenomenology of the Obese Patient Understanding the Consequences of Having Obesity 1. Disparagement by people. 2. Stigmatization by people. 3. Reduced quality of life. 4. Psychological problems. 5. Low self-esteem. 6. Poor body image. (Haga et al, 2020, p.513) Phenomenological Findings in brief 1. Putting life on hold, in a waiting position, as though it was temporary. 2. To get to some “actual life” at some point in the future. 3. Body experienced as an impediment to being oneself. 4. Body as an impediment to moving in one’s life. (Haga et al, 2020, pp.516-519) Part 3 - Counselling the Obese Patient 5 As of Obesity Management ASK for permission to discuss weight and explore readiness. ○ Be non-judgemental. ○ Explore readiness for change. 5 As of Obesity Management ASSESS obesity related risks and ‘root causes’ of obesity. ○ Slow metabolism? ○ Increased food intake? ○ Reduced activity? 5 As of Obesity Management ADVISE on health risks and treatment options. ○ Linked more to obesity stage than to BMI. ○ Explain benefits of modest weight loss. ○ Explain need to have a long-term strategy. ○ Many treatment options can be individualized (i.e., sleep,dietary interventions, physical activity, etc). 5 As of Obesity Management AGREE on health outcomes and behavioral goals. ○ Reasonable target can be 0.5-1.0 kg/week (i.e., 5-10% of initial body weight), and then weight loss will plateau. ○ Find agreement on sustainable SMART goals. ○ Agree on treatment plan that is above all, realistic and simple. 5 As of Obesity Management ASSIST in accessing appropriate resources and providers. ○ Drivers and barriers include environmental, socioeconomic, emotional, oe medical factors. ○ Provide education and resources. ○ Refer as appropriate. ○ Arrange follow-up. 5 As of Obesity Management (Slides 16-20 from Review the 5 A’s from Obesity Canada: https://obesitycanada.ca/resources/5as/)