2.00 - Adjustment Counseling & Psychosocial Issues Flashcards
Does everyone go through a grieving process?
No
What are the Stages of Grief?
8
Shock
Denial
Anger
Guilt
Bargaining
Depression
Acceptance
Advocacy
Do some people postpone when they go through the grieving process?
Yes
Are the grieving stages always gone through in order?
No
Can Numbness be a sign of shock?
Yes
Can Bewilderment be a sign of shock?
Yes
Can the inability to make decisions be a sign of shock?
Yes
“I don’t remember a thing the doctor said after I heard my child was deaf”
If a Clinician feels like their client is in shock, should they give the client time to absorb the news?
Yes
If a Clinician feels like their client is in shock, should they avoid forcing information?
Yes
If a Clinician feels like their client is in shock, should they let the client set the pace?
Yes
If a Clinician feels like their client is in shock, should they be patient?
Yes
Can emotional defensive mechanisms be a sign of denial?
Yes
Can the inability to succumb to logic be a sign of denial?
Yes
Can denial lead someone to reject their diagnosis, the implications of it, and the permanence of it?
Yes
If a patient is in denial, should the clinician acknowledge the family may have difficulty accepting the diagnosis?
Yes
(If a patient is in denial, should the clinician discuss underlying fears
Ask family what the diagnosis would mean if it were fake)
Can Resentment be a sign of anger?
Yes
Can the loss of the illusion that life is fair be a sign of anger?
Yes
Can feeling betrayed be a sign of anger?
Yes
Can assigning blame be a sign of anger?
Yes
If a client is expressing the anger stage of grief, should clinicians take it personally?
No
If a client is expressing the anger stage of grief, should clinicians take abuse?
No
If patients starts tearing in to you, excuse yourself and draw a line
If a client is expressing the anger stage of grief, should clinicians avoid being defensive and/or judgmental?
Yes
If a client is expressing the anger stage of grief, should clinicians allow client to express their feelings?
Yes
If a client is expressing the anger stage of grief, should clinicians realize that the expression of anger is critical to moving through the grief cycle?
Yes
Can feeling at fault for deafness be a sign of guilt?
Yes
Can condemning one’s self without evidence be a sign of guilt?
Yes
Can feeling like a burden to others be a sign of guilt?
Yes
Can the fear of asking questions be a sign of guilt?
Yes
If a client is experiencing guilt, should the clinician acknowledge the confusion that can arise due to lack of information?
Yes
If a client is experiencing guilt, should the clinician acknowledge that self-blame is normal?
Yes
If a client is experiencing guilt, should the clinician ask client how s/he is doing?
Yes
Can grasping at straws be a sign of the Bargaining Stage?
Yes
Can feelings of desperation be a sign of the Bargaining Stage?
Yes
Can making unrealistic demands be a sign of the Bargaining Stage?
Yes
Can making promises to god, professionals one’s self, etc. be a sign of the Bargaining Stage?
Yes
Should clinicians be aware that the bargaining stage is often a hidden stage and that the client may not talk about this openly?
Yes
Should clinicians be aware that the bargaining stage may manifest itself as lack of follow through (“foot dragging”)?
Yes
Can mourning the loss of an ideal be a sign of depression?
Yes
Can realizing the diagnosis is real be a sign of depression?
Yes
Can difficulty sleeping, concentrating be a sign of depression?
Yes
Can lack of energy be a sign of depression?
Yes
Can decreased interest in other life events be a sign of depression?
Yes
If a client is experiencing depression, should clinicians try to “cheer up” clients?
No
If a client is experiencing depression, should clinicians listen to the client’s concerns, worries?
Yes
If a client is experiencing depression, should clinicians be understanding?
Yes
If a client is experiencing depression, should clinicians possibly refer the client to a mental health service provider?
Yes
Can focusing on strengths rather than on limitations be a sign of acceptance?
Yes
Can focusing on strengths and abilities be a sign of acceptance?
Yes
Can establishing goals be a sign of acceptance?
Yes
Can viewing one’s disability as separate from self be a sign of acceptance?
Yes
To help clients find acceptance, should clinicians help clients identify strengths and needs?
Yes
To help clients find acceptance, should clinicians help connect parents with other parents who have a child that is Hard of Hearing/Deaf?
Yes
To help clients find acceptance, should clinicians provide their clients information about options?
Yes
To help clients find acceptance, should clinicians help their clients formulate a plan of action?
Yes
Can working toward improved skills be a path towards self advocacy?
Yes
Can working toward better access to services be a path towards self advocacy?
Yes
Can working toward a sense of self worth be a path towards self advocacy?
Yes
Can working toward participation in aural rehab be a path towards self advocacy?
Yes
To help clients learn self advocacy, should clinicians provide clients information and support as needed?
Yes
To help clients learn self advocacy, should clinicians work with other service providers?
Yes
To help clients learn self advocacy, should clinicians be aware of recurring grief stages?
Yes
What is Informational & Adjustment Counseling?
Counseling used by clinicians to help clients accept hearing loss.
What does Informational & Adjustment Counseling focus on?
2
Helping patients learn to…
- Handle specific communication problems - Increase effectiveness of inter-personal skills.
What is Informational Counseling?
Disseminating or sharing of information.
What is Personal Adjustment Counseling?
Dealing with feelings and attitudes
Could understanding one’s Audiogram be part of Informational Counseling?
Yes
Could understanding the effects of hearing loss on communication (vowels and consonants) be part of Informational Counseling?
Yes
Could understanding the importance of visual input be part of Informational Counseling?
Yes
Could understanding the impact of speaker differences be part of Informational Counseling?
Yes
Could understanding the benefits and limitations of speechreading be part of Informational Counseling?
Yes
Could learning about Assistive Listening Devices (ALDs) be part of Informational Counseling?
Yes
Could learning Communication Strategies be part of Informational Counseling?
Yes
Could Community Resources and self-help groups be part of Informational Counseling?
Yes
Do Audiologists get reimbursed for the time they spend with patients?
No
If a person has made an appointment with an audiologist, does this mean that they have accepted their HL?
No
Many are there just to appease family/friends
_________ is considered to be a major part of AR with hearing aids.
Hearing Aid Orientation
What is PRE-Fit Amplification Counseling?
5
Understanding HL
Understanding and identifying affect from the loss
Understanding options in surgical and nonsurgical technology
Finances/technology
Rehabilitation input
What is POST-Fit Amplification Counseling?
7
Maintenance of device
Use of device
SCALE or assessment of improvement
Verification of fit
Aided results
Assistive devices
SLP/AR therapy referral
What is Accurate Empathy?
Understanding the true feelings that underlie a patient’s statement.
Responding (with reflection) to patient’s feelings, objectively.
Patient: “If she wouldn’t mumble” (blame)
Clinician: “I am sure it is difficult to not understand what is said”
Patient: “Can’t you just write me a prescription?”
Clinician: “I am sure it is frustrating to not have insurance and have to wait to get into a doctor, but…….”
What is Unconditional Positive Regard?
Accepting patients as they are
Being inclusive of hostility, anger, lack of cooperation
What is Perspective Taking?
Take another’s point of view
Involves accurate empathy and unconditional positive regard
Can a clinician be more effective when they see the client’s point of view?
Yes
Example: Patient that is laid off and has opportunity for hire, if he can hear. But no money for treatment.
What is Genuineness?
4
Relaxed, friendly attitude to patient.
Respect for their suggestions
Able to accept criticism
Communicate to patient with success
Is it important to respect the Deaf Community and individual’s choices on whether or not to mainstream?
Yes
Should clinicians refer a client to another professional when the client’s need are beyond the clinician’s scope of practice?
Yes
What is the point of Psychotherapy?
Changing a patient’s unconscious patterns and basic way of relating.
If you know there is an acceptance factor on the psychology of hearing loss, then use ______/______ counseling to get away from the sales aspect.
Information based
Research based
NOT: I know you will do well with these hearing aids, because they are the best on the market.
GOOD: The research demonstrates this is the most appropriate technology to fit your need. With that as a base, there are additional factors you will need to attend to such as….
Will the number of people an older person interacts with (and the frequency of these interactions) influence the individual’s ability to function, cope, and improve overall health?
Yes
Older person that has ______ contacts are less likely to suffer from loneliness and depression and be more interested in participating in AR program.
Five or more
Will an individuals that does not have frequent communication partners typically seek out AR?
No
What is the Negative Feedback Loop Triggered by Hearing Loss?
Negative Reations
Emotional Distress
Withdraw
How can AR help to mitigate negative outcomes of the negative feedback loop?
By encouraging patients to become involved in small group activities that are not too demanding on his/her communication skills
Can someone’s Emotional State be influenced by hearing loss?
Yes
Can an individual’s reaction to HL influence their psycho-emotional profile?
Yes
Is Mental Health important in constructing a profile of someone’s emotional state?
Yes
Is Temperament important in constructing a profile of someone’s emotional state?
Yes
Is Sense of Self-sufficiency/Independence important in constructing a profile of someone’s emotional state?
Yes
Is Self-Concept important in constructing a profile of someone’s emotional state?
Yes
How does mental health combine with hearing loss?
Hearing loss can magnify feelings/emotional states and other existing mental health conditions
Other mental health conditions can magnify the communication related difficulties associated with HL
What is Temperament?
Refers to stable personality traits
Extrovert vs. introvert, Assertive vs. passive, Optimist vs. pessimist, Easygoing vs. easily frustrated
Can temperament affect how someone accepts and works with their hearing loss?
Yes
What sort of Self-Sufficiency is a hope of AR?
Feel more in control during communication situations by using strategies learned in AR
Will accepting of new self-image (someone with HL, HA user, etc) influence person’s desire to engage in AR?
Yes
What is Self-Efficacy?
Confidence in performing specific tasks
Can helping a person to feel they can be successful in performing a task increase self-efficacy?
Yes
Can making accurate and convincing statements about the ease of learning a skill increase self-efficacy?
Yes
Can providing realistic feedback on patient capabilities and efforts increase self-efficacy?
Yes
Can involving significant others (cautiously) increase self-efficacy?
Yes
What is the Dissonance theory?
Situations where one’s self perception does not coincide with reality
(“I can’t have a hearing loss, I’m in great shape”)
Often these individuals may object to the audiologic findings that do not agree with their own self-perception & self-image
After the grief stages, can someone’s sense of normality return?
Yes
After the grief stages, can someone accept that life goes on, albeit different than before?
Yes
Is the time frame for acceptance influenced by someone’s Emotional State?
Yes
Is the time frame for acceptance influenced by someone’s Mental Health?
Yes
Is the time frame for acceptance influenced by someone’s Temperament?
Yes
Is the time frame for acceptance influenced by someone’s Self-Sufficiency?
Yes
Is the time frame for acceptance influenced by someone’s Independence?
Yes
Is the time frame for acceptance influenced by someone’s Self-Concept?
Yes
Is the time frame for acceptance influenced by how much support someone receives from their family and friends?
Yes
What is the Primary Goal for Speech & Hearing Professionals?
Encourage self-efficacy (as mentioned above)
Should speech and hearing professionals use a patient centered approach guide the individual(s) about real benefits that are available to offset monetary and non-monetary costs?
Yes
What are the psychological costs of seeking services and adjusting to hearing loss?
(5)
Accepting themselves as having a hearing loss,
Dealing with awkwardness for asking for time off from work and having to explain the reason
Adjusting to aging
Embarrassment at entering hearing clinic or wearing hearing aids
Fear that nothing will help
“What happens to the quality of life if hearing loss goes untreated in the elderly person?”
2300 seniors surveyed. What did they say?
For a month or more during the past year, they had felt worry, tension, and anxiety
All numbers represent percentages of persons w/ the indicted hearing loss who use hearing aids.
What are some reasons for Not Using Hearing Aids?
3
Denial
Consumer Concerns (Too expensive, don’t work well, etc.)
Stigma/Vanity
What is the most common reasons cited for not using a hearing aids?
(5)
Don’t feel like they need hearing aids. (69%)
Expense (55%)
Belief that hearing aids do not work (28%)
Lack of confidence in professionals (25%)
Stigma of wearing hearing aids (16-20%)
Do most users of hearing aids report significant improvements in the quality of their lives since they began to use hearing aids?
Yes
Do half or more HA users report better relationships at home and improved feelings about themselves?
Yes
Do many HA users report improvements in their confidence, independence, relationships, and overall view of life?
Yes
Do family members of HA users more likely to report improvements?
Yes
Does communication (the centerpiece of intimacy) suffers when a partner has change of hearing?
Yes
Are common social-emotional issues that may arise from HL include frustration, impatience, anger, guilt, incompetence, pity and/or anxiety?
Yes
Can communication difficulties be mistaken for lack of interest or unwillingness to communicate?
Yes
Can AR improve everyday communication?
Yes
Can AR intervention support normalization of family relationships?
Yes
Can AR reduce family’s emotional reactions?
Yes
Can AR improve communication strategies used?
Yes
Do the Hearing Impaired need our help to increase Family Awareness?
Yes
Does hearing loss only affect the hearing-impaired person?
No. It affects their families as well.
Should families be aware of and alert to the potential consequences of untreated hearing loss? To the benefits of using hearing aids?
Yes
Should family members who suspect that a relative has a hearing loss actively encourage the person to seek appropriate screening, diagnosis, and treatment?
Yes
Do the Hearing Impaired need our help in raising awareness among Healthcare Professionals?
Yes
Should hearing loss should be a routine topic of discussion for older persons and their doctors due to the potential negative consequences of untreated hearing loss on a person’s quality of life and family relationships?
Yes
Should physicians and other allied health professionals encourage older people to seek appropriate screening, diagnosis, and treatment for HL?
Yes
Should health professionals be aware that many older adults with significant hearing impairments tend to deny the extent of their hearing loss and to believe that they do not need treatment?
Yes
Could a simple five-minute questionnaire be administered to patients that could help identify patients in need of referral to a hearing specialist?
Yes
Do the Hearing Impaired need our help to meet the needs of the Family?
Yes
Do the HI need our help in accepting feeling of loss?
Yes
Do the HI need our help in acknowledging differing reactions among family members?
Yes
Do the HI need our help in finding support from other families?
Yes
Do the HI need our help in focusing on other children (not HI) in the family?
Yes
Do the HI need our help in having fun as a family?
Yes
Do the HI need our help in realizing that grieving is a long process?
Yes
Do the HI need our help in accepting the need to change directions?
Yes
Do the Hearing Impaired need our help to meet the needs of the Child?
Yes
Do HI children need help in talking about feelings?
Yes
Do HI children need help in facilitating a positive self-concept?
Yes
Do HI children need help in accepting a hearing device?
Yes
Do the Hearing Impaired need our help to meet the needs of the Adult?
Yes
Do adults with HL need our help in keeping their job?
Yes
Do adults with HL need our help in maintaining social relationships?
Yes
Do adults with HL need our help in nurturing family relationships?
Yes
Do adults with HL need our help in interacting with environment?
Yes
Can Family Support Systems for families with deaf/HI children include home visits?
Yes
Can Family Support Systems for families with deaf/HI children include individual and group educational program?
Yes
Can Family Support Systems for families with deaf/HI children include special groups for fathers, siblings, etc.?
Yes
Can Family Support Systems for families with deaf/HI children include parent-to-parent networks?
Yes
Can Family Support Systems for families with deaf/HI children include support groups?
Yes
Can Family Support Systems for families with deaf/HI children include sign language classes?
Yes
Can Family Support Systems for families with deaf/HI children include lending libraries?
Yes
Should Clinicians be a good listeners?
Yes
Should Clinicians be understanding?
Yes
Should Clinicians show unconditional positive regard?
Yes
Should Clinicians show warmth?
Yes
Should Clinicians be genuine?
Yes
Should Clinicians be honest?
Yes
Should Clinicians give unbiased information?
Yes
Should Clinicians be patient?
Yes
Should Clinicians be flexible?
Yes
When listening should we use eye contact?
Yes
When listening should we face the client?
Yes
When listening should we lean forward a little?
Yes
When listening should we reflect what the client says?
Yes
When listening should we read between the lines?
Yes
Can Habituation be a barrier to effective counseling?
Yes
Can being right be a barrier to effective counseling?
Yes
Can multi-tasking be a barrier to effective counseling?
Yes
As Clinicians, should we focus on the here and now?
Yes
As Clinicians, should we develop our own support networks?
Yes
As Clinicians, should we refer clients to a professional therapist when in doubt?
Yes
