by Feggy Art Access to appropriate, timely, and effective counseling is essential to a family s adjustment when one of its members experiences a com
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by Feggy Art
Access to appropriate, timely, and effective counseling is essential to a family's adjustment when one of its members experiences a communication or cognitive disorder. Often a social worker does not have the skills to communicate effectively with the patient and a speech pathologist may feel that this is not part of their job either. Client progress and satisfaction, as well as family support and carryover, can be hindered if counseling is ineffective. The purpose of this article is to help both social workers and speech pathologists to better understand effective approaches to counseling those with communication or cognitive deficits.
There are some basic counseling rules to follow when working with older adults who have difficulty communicating:
Allow the patient and the family to speak first so that you have a chance to observe the family dynamics and interaction. A great opening question is, "So tell me a little about what's going on and how you think I might be able to help you?" This helps to set the tone for the remainder of the session. Is there anger? Does one person dominate the conversation? Does it appear that there might be deficits with the caregiver, as well as the patient? (i.e. the elderly spouse does not hear well, cannot see well, has trouble understanding information, etc.) Is there agreement among family members as to the problem(s) and the solution(s)?
Have a good understanding of what kinds of communication styles are typical with older adults. Understand that processing time is somewhat slower with older adults. Know that it may take a little longer to understand a new concept. Relating a new concept to something that is familiar helps to orient the patient and family to what you are discussing. Be aware that there may be repetition of previously stated information and that this is a normal part of aging. As you talk with the patient and the family, take note of communication problems that are atypical so that you can take them into account as the session continues.
Make good use of appropriate written material. It may be helpful to provide written information for the patient and their family or to write down key points for review after you have left. Just remember that vision can be impaired and materials should be of sufficient size so that they can be read easily. A bold black marker on brightly colored paper can be excellent for writing down key points that were discussed during the visit. This helps in two ways: the bold black writing is easier to see on the brightly colored paper and the paper itself is easier to find because it doesn't blend in with other papers that the patient may be trying to keep track of. Written materials should be very straightforward and simple. There should only be a few points to a page and they should be "triggers" to remember the information that was discussed. There should not be a lot of detail to the information. (Patients with communication disorders will have a difficult time processing the information and family members do not have the time to read.)
Allow plenty of time for the visit. If a typical visit is one hour, allow at least fifty percent more time for the initial session. It is important to understand that patients with communication or cognitive disorders (or both) will most likely take longer to respond to questions and/or may have speech that is difficult to understand. Some may even have assistive communication devices that make conversations slower. This first session is key to developing a relationship of mutual trust and honesty. No one should feel rushed. As questions are asked, allow the patient plenty of time to respond. A good rule of thumb is to ask a question and then silently begin counting to 10. This allows time for processing the question, formulating a response, and then providing an answer to your question. This is essential for anyone who is having difficulty communicating. If you try to fill the silence by asking the question again or rephrasing the question, the process of responding begins all over again. Allow the patient to request a repetition of the question before repeating. At the beginning of the visit, insure that family members know that you would like to hear the patient's response/comments. It is typical for family members to answer for the patient, particularly when there is a communication deficit.
Ask how you can better meet the needs of the patient when providing information. Sum up the key points that were discussed during your visit and ask what other actions need to be taken. Talk about your observations of the interaction ("It seems like it is easier for you to answer my questions when I write them down." "I noticed that it was hard for you to hear me with the television on.") Ask for feedback from the patient and their family as to good communication strategies going forward. Be open to their suggestions about what worked well and what you could do differently in future visits. At the beginning of the next session, ask again what you can do to facilitate good communication.
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Source : http://imentalhealth.net/mental-health-disorders/cognitive-disorders/counseling-in-the-face-of-a-communication-disorder
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Commonly question about Counseling in the Face of a Communication Disorder
I ve hit rock bottom. Help me before it s too late.?
So hi, I m Jamie (changed name for safety reasons). An 18 year old female, currently in college. My major is communication disorders.All semester my roommate and I weren t getting along. She would take advantage of me behind my back (like wearing my brand new expensive sneakers without asking) and she would always be rude to me and my boyfriend. One time she threw his belongings out the door cuz she said they "smelled". Hes the cleanest person I know. She s telling ppl thats her way of saying to get out.
There was an incident last thursday.
I was studying for an exam I had the day after and my boyfriend was teaching me calculus.
The guys in my floor knew I was trying to study and they started throwing things at my door because they thought it would be funny.
After the 3rd or 4th loud noise, my boyfriend was like "okay i got this".
He poked his head out my door and politely explained that it s really immature and I was trying to study.
One of the guys said say it to my face, and then the same guy was like "yo are you talkin to me?!?"
And i came out and i said "yes Joe (changed name), he is talking to you!"
So there was almost a fight but my RA broke it up.
I skyped my mom crying and telling her what happened. As I was talking to her, they banged on my door and sprinted to a nearby room so that I couldn t see who it was. I knew which room they were in so I banged on the door and told them to come out. No response.
Ever since then everybody on my floor has been riled up.
There was a floor meeting last night and my roommate and two other girls completely called me out on something I didn t even do. SOO now my roommate and I aren t getting along because she s a total b-word.
People come up to me and tell me she talks about me so much when I m gone.
Now I want to move into a single on a different floor but my RA suggests that my roommate and I should talk first.
YEAH RIGHT! thats only gonna make things worse.
My RA is basically forcing us to talk it out when I know for a fact that it s only gonna make things worse and it s not gonna solve anything.
I should just move off the floor and put it behind me.
Any advice? : (
Btw i suffer from depression and I barely have enough motivation in me to type this question....i do go to counseling but it s obviously not doing that much.
i would say ya you should talk to your roommate it maynot help but goin face to face shows her that ur not afraid of her
also dont move thatll make it worse than before in my opinion if i was u i would take that backstabbing b!!!! behind the woodshed and beat her @$$
What does this mean when a woman does this?
I am a hetero f and proud of it. I am retired, , a Christian conservative... I wonder if someone who is gay. could tell me what these ladies were doing, . I hear gays have ways of communicating we do not.Also, why would women not want another F to remarry.One lady supervisor flipped her hair continually in my presence, licked her lips, twitched her eyes.
She had trouble looking at me, directly. Was hired for the job when i was hired. I thought she had a nerve disorder.I never aspired to her job She was not married. They like my hsb.
I was told the other lady was gay I had little to do with her. A subject was going around the office.
I did not introduce. I said our marriage was do unto others as you would have others do unto you . This lady said if one saw a therapist, sometimes they decided differently. I was not in therapy.I
wasnot going to do this, ENGAGED women there. Met this
Fagain another job when I was trying to break into a new field of work. I did not get to work/
Someone came to my home who resembled this F. . I did not connect her with the other F i forgot she existed. We were not friends. I did call that office to speak to the boss to see what sort of reference they would give me when I made a resume. I did not call wanting to work there. I was physically battered x2 while working there. I did my work, I did everything I was allowed to do.
Another person, a F peer, college student came to my home ,kept saying she did not have a hsb. hought she was after my hs
I was not cheating in college. I saw NO ONES WORK, I had help with nothing, there was dilem NA.
I had no grants, no scholarships, on a shoestring budget. I did without in college.
we were a little above poverty level in my marriage,but getting the good grades I worked for . I was harassed out of one class. I assume I got the grade I deserved, not a cut due to her thinking I copie I did not cheat on anything in college, nada, zilch.
This woman sat there, her purse in my face, and kept saying this.
She had on a strawberry top shirt her mother gave her.
rring to several people. I think she was saying they were all straight. One of these she referred to ran me out of my apt when I first left home when I was l7 and went to work. Caused me much grief.
we shared an apartment to save expenses. I thought she was going to get into trouble.
Anyway the one in the strawberry shirt who came to my home, caused me endless trouble.
She took human communications but she clarified, validated nothing.
Assumed the worst.
. I was not doing anything wrong. My husband was not abusing me. physically. I do not know how much he was unfaithful to me or how long or if. I know nothing, vacuum of communication.
we were not doing what they talked about. WE had a very tight budget. i was not a child abuser, and loved my kids dearly, wanted more than two. I was not into marriage counseling.or AA.
I worked with the first two women.
the first one was over me as a boss, KEPT me from transferring to another job, state or fed.She helped others transfer out to surrounding counties, other gov jobs I was trapped.
The second lady I mentioned, I rarely was around. I have no idea why she had issues withme.
The one I shared the apt with went on to get a master s degree. I really never got to do anything I wanted to do but marry and have kids. They did their best to ruin that.
The one who came to my home, stalked me to my home, was sent, I think by one of the ones in the office on some vendetta. She caused me to not be able to get work in my new profession.
She aided and abetted an attorney who literally made my life hell on earth, made my life one of adversity. I lived in poverty from grad to when my dtr grad. &went to direr poverty, homeless shelters with no income .after college...never before. That went on several years.
Then I had to work in min wage work, slightly above for years, ruining my teeth, legs, harming my lungs. a nightmare.
I never hated gays. I simply am not, never was one. I never had a sexual feeling for a F in my life nor made advances to one.
I was wondering what sort of thing would provoke gays to this behavior. Preferred to be home with
my kids until they were older, but we needed money for a decent place to live.
I had Raynards syndrome. from whiplash to my neck from a car wreck when I was l8. never treated. This has nothing to do with homosexuality. As I understand being gay it is gender preference....women/women for intimacy, men/ men for intimacy.
My husband did not seem to prefer men...strange looking men if he did. I have always preferred men. I am very F in every way.
CAN you enlighten me about communication. Once in church I sat by this guy..i knew him since I was a little girl. had no interest in him, toook his watch, made drawing pulling motions onit. Hated him
after.
Huh?
Can a Borderline Love?
Don t know where to start- basically I ve been in a relationshp for 4 years. I did something really stupid, and now we re giving eachother space as he decides to leave or stay. My counselor says she s pretty sure I have a mild case of borderline personality disorder. I m going to see her again tomorrow then to my psychiatrist to get a formal diagnosis in 2 weeks.Before any of this happened and I started going to counseling regularly again, I had realized that what I was doing in my relationship was wrong. I had no idea there was a clinical reason- I just thought I wasn t experienced enough in relationships and never saw a healthy one before (my mom was single when I was born). First, I started with my anger and talking more respectfully to E (my boyfriend). Then I started working on being okay with him hanging out with his friends... That s a work in progress to this day, but shortly before this happened I decided that NO MATTER WHAT I was going to work on not having panic attacks and just letting him be with his friends- this was BS and it was going to stop. And in between that in the past 3 years I ve been working on effective communication, being able to take criticism and hear about my flaws and being okay with him having interests that have nothing to do with me. I have made MILES and MILES of progress on those things. I did it because I realized I was hurting E and our relationship... And because I love him- or at least that s what I say.
According to most sources online, borderlines are extremely immature and the love they feel is not like real love- it s out of need, not out of affection. I don t know how this is possible? Maybe I either don t have borderline or I m just blind. Before, I had been okay with being single. I didn t need to be in a relationship. I was doing good- then my boyfriend when I was 16 waltzed into my life then broke up with me, and there came E. I guess he saved me- classic borderline thing, I hear. But I needed to be saved from pain- not from being alone!
They say if you don t love yourself, you cannot love someone else. But I DID love myself before I my previous failed relationship crushed me. I was 15, hoping I d find a gun to commit suicide before the summer was over and I had to face more failure in high school. A chain of events lead me to realize that I COULD do so many wonderful things and I WAS a great person, and I got better and swore I d never let myself feel that way again, because my life was worth living. And after I found E, I SHOULD have regained whatever self-worth I had lossed in the previous relationship! (Please don t say "Oh, well that must be his fault"- that s true. Neither should you say "Oh, well maybe you weren t meant to be togther"- that MIGHT be true but it s nothing to do with him or our relationship- it would be due to whatever is wrong with me.) Maybe it was because I let my guard down or maybe it was because I behave like a worthless peice of crap in a relationship, therefore I start to feel that way? (Most people would never guess anything is wrong with me- even the ones that really know me.)
Anyway, my question is can mild-case borderlines love? (Like REAL love that emotionally stable adults feel.) I want to repair our relationship, but I realize that it most likely won t work. I just want to know if I should tell him I need more time for counseling if he does decide to stay/put off another relationshp until I get better if he leaves OR if I m okay and can work on our relationshp/find a new relationship while I m getting better...
(And BTW, I am not telling you about what happened or how much I want to stay with him or why or any of that in this thread, because I just want the answer to THIS question and I would have to write you a novel for you to fully understand.) Thanks for any help!
I m borderline. I love.
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