Institute Inbrief - 18/02/2015
Welcome to Edition 219 of Institute Inbrief! Because most people who die by suicide give warning signals of their intentions, the best way to help prevent suicide is to learn how to recognise – and then respond to – those signs. In this edition’s featured articles, we outline some of these warning signs, and provide you with tips to support someone at risk of suicide.
Also in this edition:
- Latest news and updates
- Articles and CPD information
- Wellness tips
- Therapist Q&A
- Social media review
Enjoy your reading!
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Imagine Being Passionate About Your Work
And Assisting People Every Day Lead Better Lives
It’s rare these days to hear people talk about their work with true passion. You hear so many stories of people working to pay the bills; putting up with imperfect situations; and compromising on their true desires.
That’s why it’s always so refreshing to hear regular stories from graduates living their dream to be a Counsellor. They’re always so full of energy, enthusiasm and passion. There’s no doubt that counselling is one of the most personally rewarding and enriching professions.
Just imagine someone comes to you for assistance. They’re emotionally paralysed by events in their life. They can’t even see a future for themselves. They can only focus on their pain and grief. The despair is so acute it pervades their entire life. Their relationship is breaking down and heading towards a divorce. They can’t focus on work and are getting in trouble with their boss. They feel they should be able to handle their problems alone, but know they can’t. It makes them feel helpless, worthless. Their self-esteem has never been lower. They’re caught in a cycle of destruction and pain.
Now imagine you have the knowledge and skills to help this person overcome their challenges. You assist to relieve their intense emotional pain. You give them hope for the future. You assist to rebuild their self-esteem and lead a satisfying, empowered life.
As a Counsellor you can experience these personal victories every day. And it’s truly enriching. There is nothing more fulfilling than helping another person overcome seemingly impossible obstacles.
Free course: Nine Myths About Schizophrenia
Despite investment in research and treatment, the outcomes of patients diagnosed with the most severe psychiatric disorders have not improved since the Victorian period. Where are the flaws in our understanding? Mental health treatment needs a radical overhaul to bring it into the 21st century – but what needs to change?
In this free course, Professor Richard Bentall debunks nine myths about schizophrenia that affect the understanding of the public and professionals alike, and identifies signals that opinion is beginning to shift towards a more humane approach to care.
Suicide: Warning Signs and Prevention Tips
Because most people who die by suicide give warning signals of their intentions, the best way to help prevent suicide is to learn how to recognise – and then respond to – those signs. It may be helpful to think of a continuum, at one end of which is a healthy desire to live life to the fullest, and at the other end of which is a completed suicide. Somewhere on that continuum – possibly in the half closer to the healthy desire to live – we peg the first marker of three on the road to suicide. It is about the risk factors or conditions which are correlated with suicide.
Risk factors (conditions associated with increased risk of suicide)
All of the more difficult life challenges can be included in this category:
- Terminal illness or chronic pain
- Death of a relative or friend
- Divorce or separation
- A broken relationship
- Social isolation or loneliness
- Impulsive or aggressive tendencies
- Stressful life events or stress on the family
- Loss of health, whether real or imagined
- Loss of job, home, money, personal security, status, or self-esteem
- Alcohol or drug abuse
- Anxiety, depression or other mental illness (note: depression can appear as “normal effects of ageing” in the elderly. It isn’t! Similarly, teens may mask their depression by acting out. Someone in the early stages of recovery from a depressive episode is at particularly high risk, as is someone during the first two months on antidepressants)
- Previous suicide attempts
- Family history of suicide
- History of trauma or abuse (Florida Office of Drug Control, 2009)
Risk factors associated with adolescent suicide
In addition to the general risk factors above, both teenagers and older adults are at higher risk. Teens are going through emotionally turbulent years, trying to fit in and succeed. They struggle with issues of self-esteem, self-doubt, and feelings of alienation. Of the above conditions, depression, childhood abuse, impulsive and aggressive tendencies, and experience of a recent traumatic event are particularly serious risk factors. Other risk factors particularly potent for this age group include:
- Lack of a support network
- Availability of a gun
- Hostile social or school environment
- Exposure to other teen suicides
- Identification as gay, lesbian, or transgender (and the ensuing isolation) (Florida Office of Drug Control, 2009).
Risk factors associated with suicide in older adults
Owing in large part to the frequently undiagnosed and untreated incidence of depression, people over 65 years of age have the highest suicide rates for any age group. In addition to depression, the general risk factors prominent for this age group are: recent death of a loved one; disability, illness, or chronic pain; and isolation and loneliness. Not on the above list of general factors, but also risk factors for the elderly are:
- Major life changes, such as retirement
- Loss of meaning and sense of purpose
- Loss of independence (Ainsworth, 2011; Smith et al, 2012)
Emotional and behavioural changes which may be associated with suicide
Obviously, not everyone who suffers from one of the above conditions will become suicidal, but there is elevated risk. People who experience some of the above conditions will go on to experience changes in personality and behaviour; these changes comprise the second peg marking the journey towards suicide:
- Overwhelming, ongoing pain. Pain may sometimes have been at the same level for a long time, and even if the person managed to cope before, suicidal feelings may be exacerbated by having the sense that their pain-coping resources have come to be depleted. Also, precipitating events can worsen pain, causing suicidal feelings.
- Hopelessness-helplessness. More than most of the other negative intense emotions, the sense that the pain (whether physical or emotional) will continue or get worse is a strong predictor for suicidal behaviours. When feeling hopeless or helpless, the person convinces him or herself that there is no hope for the future, and no one can help: “There’s no way out.”
- Changes in personality. The person becomes sad, anxious, irritable, tired, withdrawn, or easily angered.
- Feelings of guilt, shame, self-loathing; the sense that no one cares, or that one is worthless; fears of losing control and/or harming others. People with these emotions may feel like a burden, and proclaim, “Everyone would be better off without me.”
- Decreasing interest in previously enjoyed activities, including meeting with friends and having sex.
- Social withdrawal or falling in with a group with very different standards to those of one’s family.
- Declining performance in school or work.
- Feeling rage or uncontrollable anger, or seeking revenge.
- Violent, rebellious behaviour or running away (in teens).
- Powerlessness: the feeling that one’s resources for reducing pain or sorting out problems are exhausted.
- Deepening neglect of physical appearance and/or physical deterioration.
- Changes in sleeping or eating habits (in either direction: suddenly sleeping or eating too much, or sleeping or eating poorly). Elderly people may deliberately forgo food or medications, or disobey doctor’s instructions (Ainsworth, 2011; Smith et al, 2012; Florida Office of Drug Control, 2009).
Not all people who experience emotional and behavioural changes will become suicidal, but again, the risk for it is higher. Some who do have such changes will go on to exhibit suicidal behaviours, the third and final peg marking the journey to suicide. Suicidal behaviours include the following:
- Direct statements of suicidal ideation or feelings. Some may say things such as, “If I see you again . . .”, “I’d be better off dead”, or “I wish I hadn’t been born.”
- Preoccupation with death. Suicidal people may make requests for information on euthanasia, do inappropriate joking, or read or create stories, essays, poems, or artwork with morbid themes. Teens may find music with themes of death.
- Development of a suicide plan, acquiring the means to commit suicide (such as purchasing a gun or stockpiling medications), rehearsal behaviour, and setting a time for the attempt.
- Self-destructive behaviour or self-inflicted injuries, such as cuts, burns, or head-banging. Teens may act or drive recklessly, as if they have a death wish. Others may increase alcohol or drug use, or practice unsafe sex. There may be unexplained “accidents” among young people and the elderly.
- Making out a will, giving away prized possessions, making arrangements for family members, or otherwise putting affairs in order.
- Inappropriate goodbyes, or unexpected visits to friends and family members, especially combined with saying goodbye as if they won’t be seen again.
- Verbal behaviour that is indirect or unclear, such as, “You won’t have to worry about me anymore”, “I want to go to sleep and never wake up”, “I’m so depressed; I just can’t go on”, “Does God punish suicides?”, or “Voices are telling me to do bad things.”
- Withdrawing from friends and family, increasing social isolation, having the desire to be left alone.
- Exhibiting a sudden sense of calm, where earlier the person was either depressed or agitated (Smith et al, 2012; Ainsworth, 2011).
A warning about the warnings!
It would be easy to be complacent about spotting potential suicides, thinking that a person is not close to suicide unless they have many of the above features. Yet many completed suicides never had multiple of the characteristic conditions, emotional or behavioural changes, or suicidal behaviours we describe here. If the person exhibits even a few of the above features in any of the categories, they need to be taken seriously.
Protective factors: the things that keep suicide from happening
We’ve been naming all the factors that put people at risk for suicide. Protective factors, conversely, reduce the likelihood of suicide. They enhance resilience and may serve to counterbalance risk factors. What are these conditions that might help to keep the person in the flesh when they are going through tough times?
- Effective clinical care for mental, physical, and substance use disorders
- Easy access to a variety of clinical interventions and support for help-seeking
- Restricted access to highly lethal means of suicide (for example, no guns available at home)
- Strong connections to family and community support
- Support through ongoing medical and mental health care relationships
- Skills in problem solving, conflict resolution, and nonviolent handling of disputes
- Cultural and religious beliefs that discourage suicide and support self-preservation (Florida Office of Drug Control, 2009).
In addition to the general protective factors above, there are several that are youth-specific. These are:
- Sense of connection or participation in school
- Positive self-esteem and coping skills
- Access to and care for mental/physical/substance disorders
- Contact with a caring adult (Florida Office of Drug Control)
Prevention Tips: Keeping your supported person in life
Despite the intensity of the urge to suicide, there are things that you can do as a support person to bring someone back from the brink. In the immediate term, they revolve around showing care and respect for the person – and for the gravity of the situation – and seeking immediate professional help. In the longer term, support will hinge on your ongoing presence in their life, encouraging them towards actions which keep them in life. Here are some tips to help.
#1 Take the situation – and the person – seriously
The indirect or ambiguous comments, the preoccupation with and joking about death, or any of the above personality changes and behaviours are all roaring calls for help, and they must be tended to very quickly; you do not know what window of time you have before the person might act on any suicidal thoughts. Don’t delay. Get face-to-face with the person right away, and give them every opportunity to download. Your job is neither to give advice nor to argue. You are not there to criticise or to lecture on the value of life. Your job at this stage is to listen compassionately (Rose, 2008). Depending on what they say, you may need to respond very quickly.
#2: Be pro-active: start “The Conversation” about suicide
If you believe that you have spotted warning signs that the person is suicidal, but they have not said anything direct about it yet, it might be up to you to start the conversation. You can use your door-opener micro-skills, with statements like the following:
“I have been feeling concerned about you lately.”
“I wanted to check how you’re doing, because you haven’t seemed yourself lately.”
“I have noticed changes in you recently and wondered how you are going.”
Important starting questions
If they acknowledge feeling suicidal or having suicidal ideation, you can ask:
“When did you start to feel this way?”
“What happened to make you begin feeling like this?”
“How can I best support you right now?” or “What kind of support do you need from me?”
“Have you thought about getting help?”
There are no magic words except those that form micro-skills responses, such as the open questions and feelings-reflecting interventions you have already learned. Through your supportive, caring presence, you are giving the person relief from being alone with their pain. Your sympathy, patience, and acceptance allow the person to unburden themselves of their troubles, ventilating their feelings. You cannot deeply do this listening if you do not respect them.
Some statements that others have found helpful are:
“You may not believe this now, but the way you’re feeling will change.”
“You are not alone; I’m here for you.”
“I may not get exactly how you’re feeling, but I care about you and want to help.”
#3: Assess their risk level
Once the person has confided that they are thinking about suicide, you need to evaluate how immediate a danger they are in. The further along their plans are, the higher the risk they are at. Those at the highest risk for dying by suicide in the near future have a plan, the means to carry it out, a time set to carry it out, and a clear intention to follow through.
The following questions can help you assess their immediate risk level.
The questions to ask
“Do you have a suicide plan?” (Plan)
“Do you have what you need to carry out your plan?” (Such as pills, a gun, a rope, etc: the means)
“Do you know when you would do it?” (Time set)
“Do you intend to commit suicide?” (Intention)
Level of suicide risk
- Low: The person is having some suicidal thoughts, but has no plan, and says that they will not commit suicide.
- Moderate: The person has suicidal thoughts and a vague plan which may not be very lethal (for instance, they plan to take just a few too many prescribed medications, but not a huge number of them). The person says they will not commit suicide.
- High: The person has suicidal thoughts and a specific plan that is highly lethal. The person says that they will not commit suicide.
- Severe: The person has suicidal thoughts, a specific and lethal plan, and says that they will commit suicide.
As stated above, do not worry that, by talking about suicide, you are bringing it into reality. If they are thinking of killing themselves, it already exists as a potential reality for them. In inviting them to open up about it, you are reducing the immediate threat by offering them caring, which may lead to them having hope that there is a way out besides suicide. If they are actively suicidal, you have some more immediate work.
#4: Be prepared to act quickly in a crisis
Get crisis help. If suicide seems imminent, call a local crisis centre, dial 000 for emergency services (in Australia), or take the person to an emergency department. The emergency mental health team may need to come. Especially if the person is actively suicidal, it is important for you to remain calm; it sets the emotional tone for the whole conversation and makes it easier for the person to tell you what they need. If you seem panicked or overwhelmed by the person’s intentions, the person will feel that they cannot confide in you, and you will not be able to help as much (Rose, M.P., 2008).
Remove all means of suicide. Take any guns, medications, knives, and other potentially lethal weapons away from the vicinity. If you are at their house, you don’t have the option of putting the person into a padded cell, but you can reduce the ease with which they could die by suicide.
Stay with them. Under no circumstances should you leave an actively suicidal person alone! You must stay with them until the urge passes or more professional help arrives. There are no exceptions to this rule; your presence might be the only factor preventing them acting on their plans (Rose, 2008).
#5: No secrets
Do not agree to keep suicidal plans a secret! This person needs your help. Keeping secrets will only ensure that the person does not receive the help that they need. All professional medical, psychological, and emergency services organisations have strong policies in place to protect the privacy of their clients/patients (Rose, 2008).
#6: Urge professional help
The person may not believe that a doctor, counsellor, psychologist, or other health professional can help them. You may need to use patience, persistence, and all your skills of persuasion to get them to treatment, but it is worth the effort. You should not and cannot tend to this by yourself (unless, of course, you are qualified to do so). You can get advice and referrals from crisis lines. You can be pro-active about locating a treatment facility, and you can drive the person to the doctor’s appointment, when you have secured one.
#7: Make a safety plan
Once the person is out of immediate danger, work with them to develop a safety plan: a set of steps that they commit to following if they have another suicidal crisis. Jointly list triggers that are more likely to bring on a crisis for the person; these could include anniversaries of losses, stress from relationships, employment issues, and abuse of alcohol or drugs. Make sure to list contact numbers of all relevant health professionals: doctors, psychiatrists, counsellors, etc. Put down the names of family members and friends who have agreed to help out in an emergency.
#8: Plan to follow up on their treatment
If medications are prescribed, you can have a role in helping to ensure that they are taken as directed. And, much more easily than the doctor or psychiatrist, you can observe your supported person for side effects from the drugs. If they appear to be getting worse, you are better placed than most to make a call to the treating professional to let them know. There are many medications, and it often takes patience, persistence and time to find the right treatment for a particular person.
#9: Assure the person of your support over the long haul; offer it proactively
Supporting someone through a suicide attempt and the subsequent period of recovery is about offering compassion and a solid listening ear, and about letting the person know that they are not alone; you care. Note that it is not about doing the person’s healing for them; only they can commit to getting better and making the decision to stay in life. Similarly, you cannot take responsibility for them, and it will not be your fault if they do self-harm further down the track.
That said, your most potent role is, again, a pro-active one. It is one thing to say, “Call me if you need anything.” Many depressed or suicidal people will not reach out on the strength of that. Your more effective role is to regularly call or drop in to see how they are going, or to invite them out. You are thus powerfully backing up your “lip service” of caring with actions that show it, and your supported person has a much greater chance of staying on the recovery track (Smith et al, 2012).
#10: Encourage a healthy lifestyle
We all know that exercise, good diet, and a proper sleep regimen, plus forgoing alcohol and drugs, are hugely important components of recovery from most health threats. Those aspects, plus soaking up the healing effects of sunlight and fresh air every day, are no less crucial aids on the road to recovery from a suicide attempt. And therein lies the challenge. If someone is so down that they are considering making their body stop working altogether, how easy will it be to convince them to go 180 degrees in the opposite direction: not just towards life, but towards a healthy life? Your role as support person may be critical in swinging by with your track pants and trainers on, to bring them with you on the walk. Or you may suggest that you get together for a shared meal, and you help them learn (or remember) how to make simple, nutritious, delicious dishes that induce a sense of wellbeing. Your support is key; your own healthy lifestyle adds a heartening force of example to the persuasion.
There is another reason for you to encourage someone’s recovery by modelling a healthy lifestyle. It takes courage and tremendous emotional reserves to deal with and fully support someone who is severely depressed and/or suicidal. There is much evidence to show that carers looking after someone who is mentally ill (including depression and anxiety disorders as examples of mental illness) puts those carers at highly elevated risk of depression themselves. A recent study showed that 56 per cent of carers in such situations develop either “moderate” or “severe” depression. A further 9 per cent fit the clinical description of “mildly depressed” (Cummins, R.A., Hughes, J., Tomyn, A., Gibson, A., Woerner, J., & Lai, L., 2007).
Thus, your own example-setting of adhering to healthy lifestyle practices will help you as well. And you also need to know very clearly where your emotional support is coming from, as you care for your suicidal supported person. To whom do you turn when you feel overwhelmed or discouraged? Get those people lined up now. If you do not, you may find that by the time you need those relationships in place, it is too late.
Ainsworth, M. (2011). What can I do to help someone who may be suicidal? Metanoia.org. Retrieved on 26 March, 2012 from: hyperlink.
Cummins, R.A., Hughes, J., Tomyn, A., Gibson, A., Woerner, J., & Lai, L. (2007). The Wellbeing of Australians – Carer Health and Wellbeing. Australian Unity Wellbeing Index Survey 17.1, Report 17.1, October, 2007. Retrieved on 24 February, 2012 from: hyperlink.
Florida Office of Drug Control. (2009). Understanding & Preventing Suicide: A Customizable PowerPoint Training. Florida Office of Drug Control. Statewide Office of Suicide Prevention and Suicide Prevention Coordinating Council. Retrieved on 27 March, 2012 from: hyperlink.
Smith, M., Segal, J., & Robinson, L. (2012). Suicide prevention: Spotting the signs and helping a suicidal person. Helpguide.org. Retrieved on 26 March, 2012 from: hyperlink.
Rose, M.P. (2008). Suicide prevention: Crisis intervention and suicide prevention: A guide for the campus community. Retrieved on 26 March, 2012 from: hyperlink.
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A healthy heart is both physical and emotional
We all know that we should exercise, eat sensibly, and generally take care of ourselves for good heart health. What might not be as clear is how good emotional health yields good health for the physical heart. With February being Heart Research month, it’s a great time to take a fresh look at how that happens.
Love between the molecules
There is exciting news! Groundbreaking research from the U.S. National Institute of Health has identified the biological mechanism that allows our emotional health to create good heart health. Candace Pert and her team have found a love affair going on within our molecules. Bits of protein on the ends of our cells form receptors, which collect chemical information our bodies need. But they can’t get it around to all the body alone; they need the help of ligands, which carry the information. Ligands – typically meaning, peptides and hormones within the body – bind with the receptors when they sense a good match in what Pert calls “love on a molecular level”.
But when we bottle things up and don’t talk them through, feel “down” for long periods of time, or don’t have good social support, we reduce the flow of peptides (ligands) coming through our body, which stresses our system causing, blockages and weakness. Suddenly our many receptors have no “lover” to mate with, but they still want to get matched up. So they bind with another type of ligand: viruses. The result is physical illness.
The emotional-heart health connection goes way back
Scientists and health researchers have long been gaining ground in understanding the connection between our emotional-hearts and our physical heart health. In the 1940s, William Reich claimed (unpopularly) that failure to express sexual emotions caused cancer. More recently, Dean Ornish and his researchers have noted:
“Study after study has shown that people who feel lonely, depressed, and isolated (i.e., who have poor emotional health) are many times more likely to get sick and die prematurely – not only of heart disease but from virtually all causes – than those who have a sense of connection, love, and community.” Ornish adds that “the ability to be intimate has long been seen as a key to emotional health; I believe it is essential to the health of our hearts as well.”
Men with depression, notes Dr Matthew Bambling, “have a 71% higher heart disease risk, and are more than twice as likely to die of heart disease as non-depressed men.” It’s not even necessary to have diagnosed depression. Ongoing anxiety, feelings of hopelessness and sadness can more than double the risk of coronary heart disease.
The physical connection with the mental/emotional level is often found in stress hormones. When we think depressing thoughts or experience anger, hostility, and frustration, our hypothalamus releases a corticotrophin-releasing hormone, which stimulates the release of cortisol and norepinephrine. When too many of these hormones are released, the body cannot balance itself. When this happens, chronically elevated levels of these hormones contribute to hypertension, insulin resistance, and diabetes: all well-known risk factors for heart disease. Stress is known to cause the body to take longer to clear heart-damaging fats from the bloodstream, and it also triggers a lack of blood flow to the heart, increasing the risk of death in people with heart disease.
What to do: the role of connection
The importance of exercise, eating sensibly, and generally taking care of ourselves for good heart health is already well known. What hasn’t been as well-understood is the connection between physical heart health and the strong social support found in satisfying life relationships, of all sorts. Positive emotional connections – whether it is more through a good network of family and friends, being a member of a community group, or simply joining clubs you like – gives significant protection from heart disease and can be beneficial for people who already have high blood pressure.
And there is more. As crucial as the outer connection (with other human beings) is to our heart health, the connection to our inner selves may be even more vital. If we must always receive outer validation rather than following the dictates of our heart, we create the stress that begins all the chain reactions I outlined above. Ayurvedic author David Frawley says “how we feel in our hearts is the measure of who we really are.”
So the next time you find yourself saying, “Oh, my heart’s not into that”, you might want to respect the feeling. Being true to your own heart reduces stress, ensuring your physical and emotional heart are in the best shape possible, and we now know that means your molecules are probably meshing well.
Written by Dr Meg CarbonattoB.S., M.A., and Ph.D.
This article was originally published in Asteron Life’s Balance Blog. AIPC regularly contributes to Balance’s wellbeing blog category.
Psychotherapy vs. CBT for Chronic Pain
Pain can have a profound social and psychological impact on those who suffer from it, and also those who care for them. What can you as a counsellor, psychotherapist, or psychologist do for such a client? While “talk therapy” admittedly does not always have the same quick response time as, say, painkilling medication, it can be hugely effective in helping the chronic pain client to come to a place of acceptance, opening the door to the establishing of a new life: one which accommodates the changes that have occurred.
We look at both psychotherapy and cognitive therapy, including under the latter’s umbrella the myriad techniques for working with one’s mind and attention to change the relationship with pain.
Creative Therapies and Intellectual Disability
There is wide agreement among writers on issues of intellectual disability that there isn’t much agreement on the effectiveness of counselling and psychotherapy with clients who have intellectual disability; the state of the art is “controversial” (Prout, Chard, Nowak-Drabik, & Johnson, 2000; Bhaumik, et al, 2011; WWILD, 2012). Prout et al cited historical reviews of Eysenck (1965) and Levitt (1971, both in Prout et al, 2000) which concluded that treatment with psychotherapy yielded no or minimal benefits when compared to untreated individuals.
Several years later, the meta-analysis of Smith and Glass (1977/1983) yielded the opposite conclusion, pointing to the general effectiveness of psychotherapy. None of these reviews, however, addressed the specific question of effectiveness with those who have intellectual disability. When such reviews began to be conducted, they consistently showed that psychological treatments were not effective, or at least that the question remained unresolved (Butz, Bowling, & Bliss, 2000; Matson, 1984; Prout & Strohmer, 1998).
Q&A with Toula Gordillo (Clinical Psychologist)
Q. I have a fourteen year old daughter who wants to go to parties. I am concerned about the company she is keeping, the ‘bad influences’ and that there may be alcohol at the party. How do I set boundaries without her resenting me? I had a bad experience as a teenager and I just want to keep her safe.
A. If you tell your teenager that they cannot go to the party, they will likely resent you for spoiling their fun. They might jump out of window and go anyway (if they are a rebellious teen) or sulk around and get angry with you, reminding you at every opportunity how you ruined their life! If, however, you tell them a story about a young person that you know (or read about) who went to a party and had a negative experience, or if you are comfortable to share with them your own story (briefly), they may be more inclined to listen.
For example, you could tell your son/daughter about the fourteen year old girl who had her drink spiked and woke up naked the next day, or about the fifteen year old local boy who got drunk at a party, decided to walk home and got hit by a car. Your teen will probably be more likely to listen if you tell them a story that creates an image in their mind. The more vivid the message, the more likely they are to listen to the message. It may be a factual story, one in which you were involved as a teen/pre-teen or one that you have heard from local people, newspapers, TV etc.
To set boundaries effectively, make sure you approach/communicate with the young person in a way makes them feel they are in control of their own lives. By telling them a vivid story (obviously not too graphic), but one in which they can build a vivid image in their mind or something they really don't want, they can still feel in control (the opposite can be true for something that they really do want i.e. to remain healthy)! Then ask them, gently, if they still want to go to the party. Chances are, they might think twice about it. They will at least be more likely to be careful if they do go!
Using a story that creates an image, and then asking them questions about the story in a positive, supportive manner is far more likely to be an effective way of setting boundaries than simply saying "No!"
Note to Counsellors/Psychologists: Counselling parents of teens and pre-teens can be quite challenging. Using a combination of Positive Psychology, Narrative Therapy and Story Image Therapy & Tools (SITT), you can create positive changes in a young person’s life. By educating the parents in the value of stories and images, discussed in a positive environment, can help to create behavioural changes and provide important psychological information to young people.
Toula Gordillo is a Clinical Psychologist, AIPC private assessor/tutor and regular contributor for Institute Inbrief. Toula has an extensive work history as a Clinical Psychologist, Teacher, and Guidance Officer. For more information, visit www.toulagordillo.com.
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- Basics of Interpersonal Therapy
- Treating Post-Natal Depression with Interpersonal Therapy
- Treating the Traumatised Client (course series)
- Dealing with Dementia
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Graduate Story – Louise Roberts
Deciding to study with AIPC was the best decision I could have made. The process was easy and comfortable and the whole AIPC team were professional, encouraging, supportive and patient. At the time when I made the decision to go through AIPC and complete the counselling diploma I had no idea just how life changing it would be. I now get to do what I love. I get paid to support, listen to, and talk with people while they are navigating change in their lives, and to assist with facilitating change and growth, and to encourage them to be the best version of themselves they choose to be. For me, it just doesn’t get any more exciting than this.
Since completing my diploma in Counselling, I have gone on to complete a diploma in Clinical Hypnotherapy and also a Cert IV in Workplace Training and Assessing. Putting these skills together has given me the courage to start a private practice offering Counselling services, psychotherapy, NLP, stress relief, meditation and relaxation classes and I just love it!!
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"The deepest secret is that life is not a process of discovery, but a process of creation. You are not discovering yourself, but creating yourself anew. Seek therefore, not to find out Who You Are, but seek to determine Who You Want to Be."
~ Neale Donald Walsch
Many students of the Diploma of Counselling attend seminars to complete the practical requirements of their course. Seminars provide an ideal opportunity to network with other students and liaise with qualified counselling professionals in conjunction with completing compulsory coursework.
Seminar topics include:
- The Counselling Process
- Communication Skills I
- Communication Skills II
- Counselling Therapies I
- Counselling Therapies II
- Legal & Ethical Framework
- Family Therapy
- Case Management
Not sure if you need to attend Seminars? Click here for information on Practical Assessments.
Click here to access all seminar timetables online.
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