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Dr. Tommie Robinson – ASHA Schools Conference July, 2014Pittsburgh, PACounseling in Communication Disorders
A major key to clinical success is dealing with the EMOTIONS of our clients and their families. A major key to clinical success is dealing with the EMOTIONS of our clients and their families.
People may not make progress in therapy or follow through with our recommendations for improvement People may not make progress in therapy or follow through with our recommendations for improvementCone: foundation is dealing effectively with emotional issues
A person with a communication disorder may experience a host of feelings such as anger, depression, shame, embarrassment, and inadequacy A person with a communication disorder may experience a host of feelings such as anger, depression, shame, embarrassment, and inadequacy
World Health Organization (WHO) has a health classification system: World Health Organization (WHO) has a health classification system:International Classification of Functioning, Disability, and Health (ICF)
There is an unfortunate tradition of “sweetness and light” in client counseling. A person has a problem. The person is sad and depressed, and we try to cheer that person up. Sometimes this degenerates into a debate, with the interviewer trying to persuade the person not to feel miserable. A person who feels depressed, anxious, and fearful does not want to count his or her blessings. There is an unfortunate tradition of “sweetness and light” in client counseling. A person has a problem. The person is sad and depressed, and we try to cheer that person up. Sometimes this degenerates into a debate, with the interviewer trying to persuade the person not to feel miserable. A person who feels depressed, anxious, and fearful does not want to count his or her blessings.
That person wants you to feel miserable too, and to share and identify with him or her on the same level. Thus, you are given a basis for communication…start with where the person is…and agree that it is a sad state of affairs that would make anyone sad and depressed. Then, using this bond…you can assist in solving the problem. The main ingredient is empathy. That person wants you to feel miserable too, and to share and identify with him or her on the same level. Thus, you are given a basis for communication…start with where the person is…and agree that it is a sad state of affairs that would make anyone sad and depressed. Then, using this bond…you can assist in solving the problem. The main ingredient is empathy.
B. Counseling by:** B. Counseling by:**- 1. Informing
- 2. Persuading
- 3. Listening and Valuing—help clients become congruent
Medical model; information-based Medical model; information-basedLuterman 2008, p. 1: “….we adopt an attitude of detached concern and proceed to control the clinical interaction by delivering set speeches.”Usually we give the diagnosis and then suggestions for what clients and families can do
Counseling by persuasion--poor approach--clients do not own their behaviorThe professional takes the responsibility for the decision, not the clientPeople often don’t follow through because the decision has not come from inside them
A. Case History Questionnaires A. Case History QuestionnairesIdeally, we can read these and think about clients before they comeSaves time during the first interview; makes you seem prepared“I understand from this form that...can you tell me more about that?”
1. Spectator observation 1. Spectator observationThe observer is physically apart from the client (e.g., one-way mirror)We are in there with the person
1. Introduction 1. IntroductionAn interview is a serious conversation between two parties conducted for one or more important purposes.There is 1) a purpose, and 2) a plan of action, and 3) good communication
2. Information-getting interview— we need both objective and subjective info.** 2. Information-getting interview— we need both objective and subjective info.** Subjective info—how the client feels about the problem3. Information-giving (more later)
Make recommendations specific rather than general Make recommendations specific rather than general E.g. “Have your child read a list of 10 /r/ words once a day” instead of “have your child practice at home”Say to the person “If you were to explain this to ****, what would you say?”
Provide info in writingUse clear, easy-to-read, illustrated materialsProvide materials in patient’s primary language; use an interpreter if necessary
1. Making personal contact 1. Making personal contact2. Explaining the process3. Providing realistic hope for improvement4. Planning for termination
I’m glad we’ve been able to work together. I think that perhaps, at this time, due to ZYZ reason, continued therapy is not the best use of your time and money. I’m glad we’ve been able to work together. I think that perhaps, at this time, due to ZYZ reason, continued therapy is not the best use of your time and money.I think you might be happier/better served by ------ person/facility.
Phone numbers Phone numbersWebsitesEtc.!
No matter how much we want to stay clinical and fact-based…. No matter how much we want to stay clinical and fact-based….It is important to address the emotional, human side for our clients and their families
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