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Hl 16 Steps for working with four types of action

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Richard Wong

on 9 July 2016

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Transcript of Hl 16 Steps for working with four types of action

Relaxation Behaviour Change Behavioral rehearsal Steps for working with four types
of action Through exploration, clients often identify stress and anxiety as a major problem.
Helpers may then ask whether the client would like to learn relaxation techniques to calm down in the immediate moment and to be able to calm themselves down outside of session in times of stress. Step 1: Identify stress/anxiety as a Specific Problem Because doing a relaxation exercise during a session could be difficult scary for some clients, helpers may want to ask clients about thoughts and feelings before, during, and after the exercise.
The most basic one id deep breathing, which I particularly recommend for helpers when they are first doing sessions.
It’s often helpful to induce relaxation using visual imagery, such as sand filling the body or being a marionette and feeling limp with relation being “poured in.” Step 2:Teach relaxation Step 1: Identify a SpecificProblem Rather than assume clients are eager to change, it is important to allow them to explore the idea of changing.
Rather than rushing to change, clients need an opportunity to explore the pros and cons of changing and make good choices about whether to change.
Not every client is ready to change.
The goal is to encourage clients to express their feelings and thoughts about action and examine the benefits and drawbacks of changing or not changing,. Step 2: Explore the Idea of action for this problem When helpers have established that clients want to change, they can assess what attempts, if any, clients have already made.
Finding out previous attempts can avoid encouraging actions that have not worked in the past, indicate that the helper respects the client’s change efforts, and let the client know the helper is aware that the client has been attempting to solve problem.
In this step, helpers also need to asses what worked and what didn’t work in the previous attempt.
Finally, helpers might want to assess social support. Step 3: Assess previous change attempts and resourges One of the biggest benefits for clients of working with the helpers is that they can brainstorm options together.
Through collaboration, more ideas can usually be produced than can be generated by one person alone or two people working independently. The goal in this step is to generate as many idea as possible, without judgment, to enable clients to see that there are many alternatives.
By the end of this step, the helper should have a list of a number of possibilities of what the client might try. No order of preferences are necessarily known as this point, but hopefully a lot of ideas have been generated. Step 4:Generate options together The task for the helper is to help the client think through the options systematically and choose which ideas to try. Clients need to select ideas that are specific, realistic, within the realm of possibility, and consistent with their values.
By the end of this step, helpers should have an idea of the rankings of the client’s preference for option. They can then proceed to the next step. Step 6 might be quite short if the client immediately jumps into the problem solving that takes place in subsequent steps. Step 5: Evaluate the options After thinking through the various possibilities, the client comes to the point of choosing which option to implement.
By the end of this step, the helper and client should have a good idea of steps the client can take to work on the problem.If the client is eager and cooperative and seems to enjoy doing the behavioral work, the helper can proceed to step7. Step 6: Choose action options Helpers often assign homework so that the client can implement tasks that they have developed in the session.
In addition to being aware of the type of tasks assigned, it is important for helpers not to be too’’ bossy.’’
By the end of this step, the client should have choose some tasks that he or she can practice outside the session. Step 7: Assign homework Step 8: Check on Progress and
Modify Assignments By the end of this step, the client should have some success implementing the change process for one particular problem. The helper and client will then have to decide if helping is over or if they want to go back and tackle another problem. After more general exploration in which a problem with assertiveness is revealed, the helper asks the client to describe a specific example of when the problem occurred and then role – play exactly how she or he behaved. Step 1:Assess the actual behavior
in a specific situation Helpers work with clients to determine specific goals of how they would like to behave differently given that clients are much more likely to make changes when they have specific, clear goals than if goals are vague.
During this step, it is helpful to talk about the client’s values because values influence goals. Step 2:Determine goals Once the target behavior id determined, helpers can reverse roles with clients and provide a model of how clients could implement the new behavior.
Helpers should start with relatively easy behaviors first rather thn major behaviors to maximize the possibility of success. Step 3:Provide a model One major principle that helpers can think about in providing feedback is to encourage clients to be empathic with the other person.
Another principle is that it is often better not to apologize a lot because apologies invite the other person to find solutions.
Another helpful technique is to br a “broken record” and keep repeating yourself when the other person doesn’t listen. Step 4:Do another role – play and
provide feedback/coaching Step 5 & 6:
Assign homework and modify on
the basis of experiences Decision Making Step 5:Follow up Step 4:Evaluate the results and
revise the weightings Step 3:Rate the options based
on the values Step 2:Values clarification Step 1:Articulate the options How are you feeling?
What can make you feel better?
How does this anxiety/ stress have influenced your daily life?
Let's try a relaxation exercise...... 1. Get as comfortable as possible in your seat. Remove everything from your lap and put your feet firmly on the floor. Close your eyes.
2. Relax your body starting from your toes up through your head shrug your shoulders and release the tension. Breathe deeply.
3. Pick up a word, sound, prayer, thought, or phrase. Pick something that fits with your beliefs and feels comfortable to you. Repeat that phrase each you breathe out.
4. Let all your other thoughts go. When you find yourself thinking about something else, don't worry, just passively let it go and return to repeating.
5. Do this for 3 to 5 minutes and then sit quietly for a minute. Breathe exercise
Mindfulness
Muscle Relaxation What is the first thing that you would like to be different?
What do you specifically want to change in your life?
Describe your dreams for the future. What would you need to change to make those dreams become a reality?
Tell me about the last time you got angry. Describe the situation to me as fully as possible. What are the benefits of changing?
What are the benefits of not changing?
How would changing make you feel?
What keeps you from changing?
What goes through your mind as we talk about changing?
What feelings are you having when you contemplate making changes in your life?
How would other react to your changing.
or
Your haven't thought much about whether you want to change.
It's exciting for you to think about doing something new. What have you tried before?
Describe the strategies you have used in trying to change.
or
What parts of what you tried worked?
What parts didn't you work?
What problems did you encounter that made it difficult the last time.
What was going on in your environment when you tried last time?
What thoughts and feelings were you having?
or
Sound like you've tried lots of things to help you overcome your depression.
You soundfrustrated that after all your efforts, notheing happened
or
How much can you rely on other people to help you with this problem?
How do other respond to you about this problem?
How would other react if you change? If money or time were not an issue, how would you try to change this problem behaviour?
What would you suggest to someone else in this situation?
What about talking to your boss?
Maybe you could....
or
When I have trouble remembering all the things I have to do, I make a list.
I try to keep a routine and brush my teeth right after my shower. Which options seem most appealing?
Which options seem least appealing?
What are your values about the different alternatives that you might try?
What options go against your values and beliefs?
or
What are the advantages of practicing relaxation each night?
What are the disadvantages of practicing relation each night?
What would make it difficult to practice relaxation? Antecedents Behaviours Consequences It is generally preferable to look for ways to increase positive behaviour than to decrease negative behaviours because it is easier to change in the positive direction.
The choose behaviours must beservable, hehavoural, and specific rather than broad and vague, because behaviours are easier to work on and monitor for changes.
Helpers target specific behaviours to change the outcome because the specific behaviours are within one's control, whereas the outcome is not.
The principle of 'baby steps' is also important! Rather than expecting the client to make huge changes immediately, small changes are more likely to attainable. Once the target behaviour is identified, baseline information is gathered, realistic goals set, and reinforcers identified, the helper works with the client to figure out how to modify the behaviour. this process is very creative because each client is different. Guideline or disclosure of strategies: p.338
See how client respond to the guidance: p.338
Assess the facilitating and restraining forces: p.339 How did it go last week when you tried to talk to your mother? Tell me exactly what happened?
What was it like for you to exercise 15 minute a day?
or
Last week we suggest that you study 30 minute before you took a break, but that seemed like it was too long. What would you think about trying to study for 15 minutes and stopping as soon as you have a a hard time concentrating?
or
It seems that you had some trouble keeping up your end of the bargain about getting home before curfew several times this week.
page 341 example. p.347
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