Grief counseling Test 3 Flashcards
1
Q
Types of counseling
A
- informational
- situational
- psychotherapy
2
Q
counseling in which a counselor shares a body of special information with a counselee.
A
informational counseling
3
Q
what type of counseling would a funeral director do?
A
informational & situational
4
Q
counseling related to specific situations in life that may create crises and produce human pain and suffering. This type of counseling adds another dimension to the giving of information in that it deals with significant feelings that are produced by life crises.
A
Situational Counseling
5
Q
intervention with people whose needs are so specific that usually they can only be met by specially trained physicians or psychologists. The practitioners in this field need special training because they often work with deeper levels of consciousness.
A
Psychotherapy (Edgar Jackson)
6
Q
what type of counseling would a funeral director NOT do?
A
psychotherapy
7
Q
styles of counseling
A
- directive
2. non-directive
8
Q
the counselor takes a live speaking role, asking questions, suggesting courses of action, etc.
A
Directive Counseling
9
Q
a phrase coined by Carl Rogers to refer to that type of counseling where one comes actively and voluntarily to gain help on a problem, but without any notion of surrendering his own responsibility for the situation.
A
Non-Directive Counseling
10
Q
non-directive counseling is also called…
A
- client-centered
- person-centered
- Rogerian counseling
11
Q
what TYPE of counseling is NOT preferred in funeral service, however sometimes you will deal with people that are so traumatized that you will have to focus in on the problem
A
directive counseling
12
Q
what TYPE of counseling IS preferred in funeral service, because it is a A non-directive method of counseling which stresses the inherent worth of the client and the natural capacity for growth and health?
A
non-directive counseling
13
Q
components of non-directive counseling
A
- Enhance the person’s capacity for social functioning; alter the person’s feelings through increased awareness; sensitively listen and observe
- Establish rapport with the client
- Assist the person to gain new perspective
- Appraise the client’s problems
- Perceive the client’s situation in several ways and communicate these to the client
- Encourage realistic appraisal by the client
- Encourage conversational flow by avoiding questions that can be answered yes or no
- Accept the client’s attitudes and feelings
- Reflect the client’s feelings back to him
- Judge the ability of the client to verbalize
- Do NOT assume the client’s first statement to be either true or complete
- Allow the client to summarize the interview
- Respect the confidential nature of the subject matter
- Write comprehensive notes upon the conclusion of the interview
14
Q
that counseling which occurs before a death
A
pre-need counseling
15
Q
a death has occurred and the funeral director is counseling with the family as they select the services and items of merchandise in completing arrangements for the funeral service of their choice
A
at-need counseling
16
Q
those appropriate and helpful acts of counseling that come after the funeral
A
post-funeral counseling
17
Q
helping people facilitate uncomplicated grief to a health completion of the tasks of grieving within a reasonable time frame. FUNERAL DIRECTORS DO THIS TYPE OF COUNSELING!!
A
grief counseling
18
Q
specialized techniques which are used to help people with complicated grief reactions. FUNERAL DIRECTORS DO NOT DO THIS TYPE OF COUNSELING.
A
grief therapy
19
Q
goals of grief counseling (Worden)
A
- To increase the reality of the loss.
- To help the counselee deal with both expressed and latent affect.
- To help the counselee overcome various impediments to readjust to after the loss.
- To encourage the counselee to make a healthy emotional withdrawal from the deceased and to feel comfortable re-investing that emotion in other relationships.
20
Q
Counseling Principles and Procedures
A
- Help the survivor actualize the loss
- Help the survivor to identify and express feelings
- Assist living without the deceased
- Facilitate emotional withdrawal
- Provide time to grieve
- Recognize “normal” behavior
- Allow for individual differences
- Provide continuing support
- Examine defense mechanisms and coping styles
21
Q
funeral directors facilitate grief by….
A
- Fulfilling their responsibility in counseling during the entire service
- Following up with post-funeral counseling (after care)
- Providing contacts for the family with other support groups
- Providing a service in teaching people about grief and healthy grieving by sponsoring and presenting educational programs in the community
22
Q
Characteristics of the Helping Funeral Director (WOLFELT)
A
- Empathy-
- Respect-
- Warmth & Caring-
- Genuineness-
23
Q
the ability to enter into and share the feelings of others
A
Empathy
24
Q
the ability to communicate the belief that everyone possesses the capacity and the right to choose alternatives and make decisions
A
Respect
25
the ability to be considerate and friendly as demonstrated by both verbal and non-verbal behaviors
Warmth & Caring
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present one's self sincerely
Genuineness
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Understanding the Helping Process (WOLFELT)
THIS CARD IS ONLY FOR REVIEW!
The relationship begins with the initial contact, a major concern of this industry is that the development of an open, trusting relationship between the helping funeral director and those persons seeking assistance underlies any approach to the helping process. While developing a relationship can be time-consuming, a skilled helping funeral director can guide this development so the relationship can aid family members in a short period of time. In reality, the development of a trusting relationship becomes critical during the “at need time” immediately following the death of someone loved. `Development of a helping relationship begins with the initial contact with the bereaved family. As soon as communication between people has been established, relationships can develop. The relationship becomes the basis for meaningful contact between the helping funeral director and bereaved family members. People in crisis are typically open to the evolution of a helping relationship with persons who have the knowledge and ability to help them
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Phases In The Helping Relationship (7)
1. Entering into helping relationship-
2. Building a helping relationship-
3. Exploration and assistance in helping the family understand their alternatives-
4. Consolidation and planning-
5. Implement and action-
6. Conclusion of the funeral process-
7. Post funeral service follow up-
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a member of the family has phoned your funeral home and informed you of the death of a family member. The family member has asked for your assistance.
Entering into helping relationship
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after the funeral, you might have a structured follow-up program to offer additional assistance to the families. You may serve as an informational and referral source for additional help-oriented services within your community
Post funeral service follow up-
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you assist the family with a sense of closure upon completion of the funeral. You might join in the fellowship that often occurs following the completion of the funeral
Conclusion of the funeral process-
32
you conduct a funeral service that follows the planning model developed with the family, you also bring together a variety of helping resources within the community to assist in this action oriented helping process
Implement and action-
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you assist the family in coming to decisions about the funeral that best meets their needs. You jointly develop a specific action plan designed to best meet their emotional needs at this time
Consolidation and planning-
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you listen and explore with the family the variety of alternatives available to them with regard to the funeral. You gather facts, explore feelings and seek mutual understanding
Exploration and assistance in helping the family understand their alternatives-
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you respond by showing a willingness to assist the family, you offer counseling on what needs to be done now. You respond with concern and care to any questions they may have
Building a helping relationship
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Developing Interpersonal Skills for the Successful Funeral Service Practice (WOLFELT)
PHASES of Developing New Interpersonal Skills
1. Initial learning-
2. Uncomfortable use-
3. Consciously skilled-
4. Naturally skilled-
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this final phase occurs only after you have completed the training and practice the skills extensively. You must use the skills on a daily basis over an extended time to get to this level of skill. When you achieve this level, the skills come naturally and comfortable without you even consciously thinking about them
Naturally skilled
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in this phase, you begin to use the skills more effectively however, you continue to be self-conscious as you use them. You are getting better at using the skills, but still feel somewhat mechanical. You begin to use language that is natural to who you are
Consciously skilled
39
in this phase, you have increased your awareness of some new ways of communication but probably experience some difficulty in using the new skills. You may feel mechanical and like this really isn’t you speaking or listening. You don’t feel spontaneous because you have to think very carefully as you attempt to use new skills
Uncomfortable use-
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this phase involves learning that some skills are available to you, that you may not have known about. This may result in a combination of excitement about learning something new and some fear about the acquisition process. But again, remember with appropriate training and practice you can acquire the ability to communicate even more effectively
Initial learning-
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9 Essential SKILLSfor Developing Interpersonal Skills for the Successful Funeral Service Practice (WOLFELT)
1. Attending or Listening-
2. Paraphrasing-
3. Clarifying-
4. Perception checking-
5. Leading-
6. Questioning-
7. Reflecting Feelings-
8. Informing-
9. Summarizing-
42
is when the funeral director physically communicates interest or gives attention to the person. (giving undivided attention by means of verbal and non-verbal behavior)
Attending or Listening-
43
is a method of trying together several ideas and feelings at the end of a period of discussion or the arrangement conference. (a brief review of points covered in a portion of the counseling session)
Summarizing
44
is sharing of facts possessed by the funeral director. (providing information that will allow the person to make an informed decision)
Informing
45
is when you express in fresh words the essential feelings stated or strongly implied of the person.
Reflecting Feelings
46
is a method for gaining information and increasing understanding
Questioning
47
is anticipating where the person is going and responding with a positive encouraged mark. (It is you, slightly anticipating the person's direction of thought)
Leading
48
is where you ask the person for verification of your understanding of what has been said, over the past several statements. (checks that understanding is taking place with the other person)
Perception checking
49
the process of bringing vague content in the interaction into clearer focus or understanding. (clarifying goes beyond paraphrasing because you make a guess about the person's basic message and restate it)
Clarifying
50
is a method of restating the person's basic message in similar, but usually fewer words. (expressing a thought or idea in an alternate and sometimes a shortened form)
Paraphrasing
51
Barriers To Effective Communication (WOLFELT)
1. Funeral Director Dominance-
2. The “Bombarder”-
3. Inappropriate self disclosure (focusing tot much on self)-
4. Offering platitudes or false reassurance-
5. Discouraging the expression of emotions and tears-
6. Emotional Distancing-
52
dominating an interaction with another person can be best described by the following: general sense of impatience, changing the subject, attempting to persuade and lecturing or preaching. The “dominator” often thinks he or she knows the answer before the question is even asked. He or she thinks they know exactly what people should do and likes to tell them when and how to do it. This person is often a very poor listener. Dominating behaviors communicate a sense of disrespect for a person's ability to decide what is best for self.
Funeral Director Dominance
53
might run off a series of questions like, “what was your father's date of birth?” “where was he born?” “was he a veteran?” This approach usually makes the person feel like an approach object instead of a person. Bombarding with questions communicates that the funeral director is interested in facts, not feelings. In addition, this pattern of interaction is usually difficult to change. For example: if early in the relationship you assume a strong directive role characterized by excessive questioning, the person may not consider this the expected situation and adopt a passive role.
The “Bombarder”-
54
The “self disclosure” has been known to bore people to death. He or She likes to talk about self, particularly personal experiences. This person might say something like, “when my grandfather died we decided it would be best to...” Self disclosure on your part can be appropriate on occasion; however, in general, the best procedure is to keep the focus of your helping efforts on those you are assisting.
Inappropriate self disclosure (focusing tot much on self)-
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to offer false reassurance is to distance yourself from the person you are attempting to help. When someone has experienced the death of someone loved, false reassurance often leaves feelings of loneliness, misunderstanding and emptiness. This person often speaks in cliches like, “time heals all wounds” “everything is going to be just fine” or “hang in there”. These kind of statements fail to provided the reassurance intended. Instead, the person whose feelings do not agree with such comments is convinced that you certainly do not understand. This person seems to think they can make someone's grief just go away. But again, this pattern of communication is not respectful because it does not take into consideration the person's understanding of the way things are. You will be better off exploring painful realities than to communicate an attitude of false reassurance.
Offering platitudes or false reassurance-
56
unfortunately, many people associate tears of grief with personal inadequacy and weakness. Crying on the part of the mourner often generates feelings of helplessness in friends, family, & caregivers. Funeral directors are not immune from this tendency either. Another form of detachment is to avoid discussion of painful issues. This is often done in an effort to protect the person you are helping and yourself from confronting the reality of the feelings. Discourage the experience of tears. Comments similar to, “tears won't bring him back” “he wouldn't want you to cry.” Yet crying is nature's way of releasing internal tension in the body and allowing the mourner to communicate a need to be comforted. Becoming a helping funeral director means making a commitment allowing people to share their pain with you. Obviously, you can not and should not try to discourage whatever emotions the person may be experiencing.
Discouraging the expression of emotions and tears-
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1. A sense of personal distance
2. Avoiding discussion and painful issue
Distancing can occur in helping relationships in different ways. Detachment occurs when you simply perform the required tasks while maintaining a sense of personal aloofness and distance.
At a distance, but in view (in this situation, the people with whom you interact will probably feel isolated and sense a lack of the characteristics of warmth and caring.
Emotional Distancing-
58
Crisis Intervention Counseling
Qualities and Characteristics of a Crisis
THIS CARD IS FOR REVIEW...LOTS OF INFO...
1. A crisis is a period of heightened psychological accessibility which will last for approximately 4 to 6 weeks. The person is less defensive than usual and more open to outside intervention and change
2. A crisis is usually stimulated by an outside precipitator or emotionally hazardous situation. Precipitators are always situational and frequently of an interpersonal nature.
3. Crises are normal reactions to emotionally hazardous situations, not signs of mental illness.
4. The individual's appraisal (perception) of the emotionally hazardous situation greatly determines both the occurrence and seriousness of the crisis.
5. The more seriously threatening an individual's appraisal of an event, the greater the likelihood for primitive coping behaviors.
6. Persons in crisis tend to pull away from contact with “significant others.” Positive interpersonal relationships tend to foster positive resolution of a crisis, while lack of interpersonal contact tend to lead to a slower or less adaptive outcome.
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Potential Crises:
While every death creates a crisis for the survivors, some circumstances may heighten the need for crisis intervention counseling.
Some examples are:
1. Suicide
2. Homicide
3. AIDS
4. SIDS (Sudden Infant Death Syndrome/Crib Death)
“Just because the body is small, does not mean the loss is small.”
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Factors that must be considered for each potential crises:
Mortality- high or low
Time Factors- short vs. long duration
Created Incidence- Suicide/Homicide
Seasonal Influences- deaths during the holidays
Racial/Ethnic Considerations- different groups react in different manners
Medical Factors- Recent research regarding the cause of SIDS helps suppress parental guilt
Recent Research on suicidal behavior in families helps to lesson anxiety
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Grieving challenges...
1. Cause
2. Investigation and interrogation by authorities
3. Severity of the loss
4. Relational problems (family, marriage, siblings, & significant others)
5. The funeral director's role will vary depending on the circumstances of the death
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ABC method
A. ACHIEVING contact with the person in crisis:
B. BOILING down the problem to it's essentials, continued:
C. COPING with the problem
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Types of aftercare...
a. phone contact
b. personal contact
c. letters/cards
d. literature (pamphlets, books, audio-visual)
e. community educational programs
f. professional aftercare programs
g. referrals to support groups or professional therapists
64
Caring for the Caregiver:
| Funeral Directors should be aware of:
Their own grief
Their own feared losses
Their own anxiety and personal death awareness
65
Funeral directors are encouraged to explore their own losses:
1. Reinforce the funeral director's understanding of mourning.
2. Exploring your own history of losses provides the funeral director with an awareness of resources available to the bereaved.
3. The funeral director can identify any irresolution from prior losses.
4. Looking at one's own grief can help the funeral director be aware of his/her own limitations in working with certain kinds of families and grief situations.
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7 Characteristics of Stress and Burnout:
1. Exhaustion and loss of energy
2. Irritability and impatience
3. Cynicism and detachment
4. Physical complaints and depression
5. Disorientation and confusion
6. Omnipotence and feeling indispensable
7. Minimization and denial of feelings
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10 Guidelines for Caring for the Caregiver:
1. Recognize that you are working in area of care where the risk for burnout is HIGH.
2. Create periods of rest and renewal.
3. Be compassionate with yourself about not being perfect.
4. Practice setting limits and alleviate stresses you can do something about.
5. Learn effective time management skills.
6. Work to cultivate a personal support system.
7. Express the “personal you” in both your work and play.
8. Work to understand your motivation to work in funeral service.
9. Develop healthy eating, sleeping, and exercise patterns.
10. Strive to identify the unique ways in which your body informs you that you are stressed.
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Carl Rogers is responsible for...
Non-directive (client-centered and person-centered)
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Rogers was willing state his own position clearly, and hear you out and listen to your position carefully. He asked, "Can we learn from each other?" He was not interested in winning arguments.
Avoidance of Argument
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Rogers was the first person to record and publish complete cases of psychotherapy.
Case histories
71
. Open, authentic, communication in which the way I present myself to the world matches what I think and feel at a deeper level. (Incongruence is similar to Jung's persona, or wearing a mask." It may be conscious deception or unconscious self-deception.) Rogers writes, "I have found, in my relations with persons, that in the long run it does not help to pretend to be something I am not."
Congruence
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The person-centered therapist consciously avoids control over, or decision-making, for the client, so that the client becomes responsible for himself or herself. This changes the power relationship between therapist and client by putting the control over decision-making, as well as the responsibility for decisions, in the hands of the client.
Avoidance of Control; Responsibility for self
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Rogers was deeply curious. He wanted to really sense, hear, feel what life was like for the other person. He had a phenomenological attitude.
curiosity
74
Rogers views our schools as generally rigid, bureaucratic institutions which are resistant to change. Applied to education, his approach becomes "student-centered learning" in which the students are trusted to participate in developing and to take charge of their own learning agendas. The most difficult thing in teaching is to let learn.
education
75
to try to take in and accept a client's perceptions and feelings as if they were your own, but without losing your boundary/sense of self.
Empathic understanding
76
If new evidence shows that our opinions, views, and hypotheses are mistaken, it leads us closer to what is true. This is learning, and though sometimes painful, it leads to a jore accurate way of seeing life.
The facts are always friendly
77
Rogers' term for an "ideal personality." A person who is open to her own experience, lives in the moment in an existential fashion, and is fully connected to her own stream of consciousness, which is constantly changing. She trusts her organism and does what "feels right" in a situation. To be "fully functioning" is not a finished state, but a direction we can be moving in.
The Fully-Functioning Person
78
Core concepts for non-directive
Congruence
'Unconditional positive regard'
Empathetic understanding
Self-actualization
79
Rogers thought there were three selves in us: the self-concept, the real self, and the ideal self. The self-concept is the way a person sees him- or herself. The ideal self is who one would like to be or ought to be. The real self is who one actually is.It is the amount of agreement between the self-concept, the real self and the ideal self. The more congruence, the more psychological health there is within the client. If a person’s idea of who she/he is bears a great similarity to what she/he wants to be, that person will be relatively self-accepting. It’s the aim of Person-Centred Counseling to increase the client’s congruence.
Congruence
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To create an atmosphere of psychological safety within the counseling relationship, Rogers believed the therapist should have unconditional positive regard for the client – that is, not judge the client’s character. If the client feels that his/her character is being evaluated, he/she will put on a false front or perhaps leave therapy altogether. Low self-regard, or low congruence, is the result of the client’s having been judged in the past. Parents, teachers, and other authority figures often act as if the child has no intrinsic value as a person unless he/she behaves the way they say he/she ought to behave. Thus, their regard is conditional. The Person-Centered therapist gives unconditional positive regard as a partial antidote for the client’s earlier experiences.
'Unconditional positive regard'
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The person-centered therapist should sense the client’s world as if it were her or his own. However, the therapist must sense the client’s emotions without getting bound up in them. Two processes foster empathetic understanding: reflection and clarification. Reflection occurs when the therapist repeats fragments of what the client has said with little change, conveying to the client a nonjudgmental understanding of his/her statements. Clarification occurs when the therapist abstracts the core or the essence of a set of remarks by the client.
Empathetic understanding
82
Rogers took the approach that every individual has the resources for personal development and growth and that it is the role of the counselor to provide the favorable conditions (which for Rogers were congruence, empathy and unconditional positive regard) for the natural phenomenon of personal development to occur. He often saw personal development as the process of a person becoming more fully themselves.
Self-actualization
