Counseling Midterm Flashcards
How does psychologically informed practice differ from biomedical practice?
biomedical: addresses physical impairments based on biomedical concepts to reduce symtpoms
psychologically: incorporates PT beliefs, attitudes, & emotional responses into PT management
Be able to identify informational vs. personal adjustment counseling
Informational - education, discussing the nature of a disorder or situation, treatment considerations, prognosis, community resources and health preservation. provider driven. not treating the whole patient. using our knowledge to counsel the patient. ex : discussing HA technologies, discussing realistic expectations when patient expresses frustration.
Personal - addressing feelings/emotions/thoughts/beliefs, helping patients and families adjust or cop with feelings about disorders or situations. patient driven. treating the whole patient. understanding the emotions of the individuals and the family. listen to the patient as they express anger with their HA’s falling out of their ears, nod your head in agreement when patients tell us that they are sad that they will have to wear HAs, patient explaining they are concerned they will lose their license.
Name several cultural elements that are difficult to see (cultural iceberg example)
Beliefs and Values – Deeply held ideas about what is important, right, and wrong.
Attitudes toward authority – Cultural perspectives on how people in power are treated or respected.
Role of family and community – Expectations around family roles, obligations, and community ties.
How would the difficult-to-see elements affect audiologist-patient interaction?
Beliefs and Values: Patients may have cultural beliefs about health, disabilities, or medical interventions that affect their attitude toward hearing aids, cochlear implants, or therapy recommendations. For example, some cultures may view hearing loss as a normal part of aging and may resist treatment.
Attitudes toward Authority: Some patients may defer completely to the audiologist’s recommendations, while others may be more skeptical or seek second opinions based on how they culturally view authority figures in healthcare.
Role of Family and Community: Some patients might involve family members in every step of the healthcare process, including diagnosis and treatment. Audiologists may need to engage family members more directly to facilitate decisions and ensure follow-through with treatment.
Define cultural humility. Why is this important?
a lifelong process of self-reflection and learning that aims to improve how people of different cultures are treated and understood but one starts with an examination of one’s own beliefs and cultural identities
race, ethnicity, gender, religion, beliefs, language, sexual preference, socioeconomic status, geographic location, ability/disability, age/generation, among others. It is important because it helps mitigate the unconscious biases that can negatively impact our daily interactions and
helps providers build trust with patients and improve health outcomes
What is the difference between professional counseling and nonprofessional counseling?
professional - mental health professional uses their professional training to help clients find ways to solve pervasive life problems. outside of our area. help patients and families make the practical changes in their lives that will help them develop
-resulting in a more positive adjustment, more positive embracing of the technologies available to them and a more acceptance of the residual communication difficulties they may still experience. refer for professional counseling - unremitting parental guilt over child’s HL, persistent intolerance of residual communication needs, family becoming emotionally withdrawn from the patient with HL, families have unrealistically high expectations.
nonprofessional couseling - provides strategies for coping with life in the context of the current problem. deals with the present moment, the current problems. within our area of expertise. important to build rapport with the patient, this relationship is very crucial for counseling as well as for treatment
What is within the boundaries of the audiologist’s area of expertise and what is outside of those boundaries, and would warrant a referral for professional counseling?
w/in
Temporary emotional upset of having difficulty coping with hearing or balance disorder
outside
Once these emotion feeling become prolonged then it is okay to referral out but
marital counseling, substance abuse, domestic abuse, clinical depression should be referred out
referral warranted
Once we feel we can no longer provide support or when we feel uncomfortable/unfit to provide support
For audiology-related concerns, when should you refer a patient for professional counseling?
Unremitting parental guilt over child’s hearing loss
Persistent intolerance of residual communication needs (parents or spouses)
Parent/spouse becomes emotionally withdrawn from patient with hearing loss
Parents/spouses have unrealistically high expectations
What are the goals of personal adjustment counseling?
Help patients and families make the practical changes in their lives that will help them develop:
A more positive adjustment to their own conditions and disabilities
A more positive embracing of the technologies available to them
A more positive acceptance of the residual communication difficulties they may still experience
What are some important considerations when recommending professional counseling?
Important to be familiar with local resources
Refer to mental health professionals who are familiar with hearing impairment.
Educate local professionals as needed
Psychologists in school programs for children with hearing loss are often a good resource
Additional suggestions
Places with multiple providers are a good option
AARC (Adult & Adolescent Recover Counseling) in Mesa
People who specialize in grief and depression
People who do CBD for pain management (esp. for tinnitus referral)
What are the 4 core counseling microskills? What are examples of each?
active listening - nodding head, eye contact, restating and summarizing
nonverbal communication - facial expressions, eye contact, physical gestures
silence - sets a gentle pace, can be used to organize thoughts
empathy - understanding or seeking to understand the experience of another
What is the difference between empathy and sympathy? (not emotional dimension but how you are regarding the patient having emotions)
Empathy involves feeling with the patient. It is the ability to understand and share the patient’s feelings, seeing the situation from their perspective. When you are empathetic, you validate their emotions, creating a sense of connection, and acknowledge their experience without necessarily offering a solution. You might say something like, “I can imagine how overwhelming this must feel.”
Sympathy, on the other hand, is more about feeling for the patient. You recognize their emotional experience, but you remain more detached, acknowledging their situation without deeply engaging with their feelings. Sympathy may come across as more distant, and while it expresses concern, it doesn’t foster the same level of emotional connection. A typical sympathetic response might be, “I’m sorry you’re going through this.”
What are the three different question types as discussed in class?
content questions - seeking further information or clarification
confirmation questions - confirm opinion or position an asker holds
questions with affective base - rooted in emotions
Why is it important to address underlying emotions for questions that might appear to be asking for information?
patients may be asking for or giving information, or may be expressing a problem but also have underlying emotions that could impact their healthcare
-if we go straight to content, the patients will likely go along with that and thus the opportunity to talk about emotions is lost
What is the goal of motivational interviewing?
an empathetic, person centered counseling approach that prepares people for change by helping them resolve ambivalence and builds confidence to change
-can use open questions, affirmations, reflective listening and summaries
With regards to the topic of social style, review the dimensions that give the 4 quadrants (pace/assertiveness and people-focused/emotive and task-focused/controls emotions). Recall that the reason the terms are different is because there are different models for this. Review the table below and be able to ask questions about how one might need to make adjustments when working with someone of a different social style.
analytical - control and asks. need to be right, slower paced, more of asker and slower to respond. Adjust to work with others - understand that you may need to pick up the pace or offer stories on how people have benefited (amiable)
driving - control and tells. need for results, faster paced, quicker to make decisions and more likely to express emotions. Adjust to work with others - understand that other people may need you to slow down a bit and how people may be oriented more towards emotions
amiable - asks and emotes, need for personal security, slower paced, wanting to gather info and more expressive with emotions. Adjust to work with others - understand that you need to pick up the pace or be ready for technical questions (analytical)
expressive - tells and emotes, need for personal approval, faster paced, showing emotions more but still making decisions faster. Adjust to work with others - understand that either you need to speed up (driver) or slow down
-left and right is asks to tells
-up and down is controls emotions to emotes
when there is high tension, what do all social style’s tend to do
-analytical will withdrawal
-driving will take charge
-amiable will get steamrolled
-expressive will confront to reduce personal tension
