Health and Wellness – Ethics of self care.
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Transcript Health and Wellness – Ethics of self care.
Terry E. Waldren, Ph.D. LMFT-S LPC-S NBCC
Lubbock Vet Center
Wellness concepts are a holistic approach for working
with individuals/couples and families.
Characteristics of healthy individuals and families are
different from our clinical populations – important to
know these differences.
Being physically and emotionally healthy are two key
values for myself.
I see myself as a model for patients and clients – if I’m
not healthy then I believe I lack creditability as a
professional – the ethical connection.
Staying emotionally healthy working as therapist is a
constant challenge – issue of burnout.
Eliminating Self Defeating Behaviors – working with health issues since
1974 – critical issue is transforming identity from self defeating to healthy
patterns/behaviors.
Personal – going from smoker to smoke free person.
Research on Academic Procrastination.
Workshops on Burnout for Counselors.
Workshops on Narcissistic and Borderline personality disorders –
estimate ½ of participants showing signs of burnout.
Interim Chair & Visiting Full Professor: Health Exercise and Sport Sciences
(HESS).
Became number one degree granted at TTU in 2008.
Healthcare jobs are growing and are anticipated to grow in future.
Many courses were focusing on how to build healthy lifestyles with
children and adults.
TTU Honors College Honors Seminar–
Comparative healthcare issues between US and
other countries.
Critical issues for healthcare – going from procedures
to wellness/prevention.
Smoking as number one health issue world wide.
Chronic diseases in the elderly increasing and the
rapid increase of chronic diseases in young people as
major sources of problems/healthcare costs – for
younger people fast foods are a critical issue along
with advertising. Diet/exercise/social support key
ways to address issues of chronic illnesses.
Grace Clinic –
Working on resources for health prevention/weight loss resources –
Issue is getting cost effective resources that work –
Could not afford coaches as insurance pays very little for wellness.
Dr. Bale – CME Ethics workshop about Heart Attack & Stroke
prevention.
Many physicians leaving practice because of burnout – talking about
alternative ways of practicing medicine.
Private medicine – concierge
Once give up smoking and addictions then wellness becomes number
one set of factors for being healthy.
Physicians talking about not only physician assistants/nurse
practitioners - health/exercise bachelor degree for nutrition/exercise
awareness.
Emotional depletion
Isolation
Working with people in pain is draining and demanding
Confusion
Therapist idealized and then devalued
Repeated distorted projections each 50 minutes
Depression, sadness and vicarious traumatization
Often do not see immediate gains and/or sustained gains.
Have not found user friendly measure of psychotherapy successes.
Grandiosity and omnipotence
Increasing numbers of laws, codes, and regulations regarding confidentiality.
Often work when others are not working.
Helplessness and sense of inefficiency
Mainly working long hours in isolation
Expected to give endlessly while expecting nothing in return except fee.
Going from idealization to devaluation
Constant worry
Working with clients who maybe suicidal is draining
Grief Cycle
One way Intimacy and voyeuristic Attitudes:
Endless cycle of new patients, hard work and then termination when patients are better.
Therapist experiences deep intimacy from patients while not sharing about themselves.
Distraction
Focusing on others problems and losing track of our own needs/desires.
Inability to Shut off the Therapeutic Stance
Events that Affect Effectiveness
Codes of ethics grow each time new ones are released and more and more there are
contradictions within these codes.
The threat of Lawsuits
Our own life events (e.g. death, divorce, health provide challenges as these effect our
effectiveness
Conflicting Clinical, Ethical, and Legal Considerations:
Therapy is a way of relating and can bring this into family/friend situations.
Living in highly litigious society and working with disturbed people.
Split Personality – Public vs. Private
We have a very rigid separation between work and personal settings around issue of
confidentiality.
Burn out leading cause psychotherapists high
rate of depression, drug and alcohol abuse
and suicide.
Health Indicators
Fatigue and chronic exhaustion
Frequent and prolonged colds
Headaches
Sleep disturbances: insomnia, nightmares, excessive sleeping.
Ulcers
Gastrointestinal disorders
Sudden losses or gains in weight
Flare ups of preexisting medical disorders: diabetes HBP, asthma, etc.
Injuries from high-risk behaviors
Muscular pain, particularly in lower back and heck.
Increased premenstrual tension
Missed menstrual cycles.
Excessive Behavior Indicators
Increased consumption of caffeine, tobacco, alcohol,
over-the –counter medications, psychoactive
prescription drugs, illicit drugs.
High-risk-taking behavior: auto/cycle accidents, falls,
“high-risk” hobbies, general proneness to accidents
and injuries, gambling, extreme mood and behavior
changes.
Increased propensity for violent and aggressive
behavior.
Over and under eating.
Hyperactivity
Emotional Adjustment Indicators
Emotional distancing
Paranoia
Depression: loss of meaning, loss of hope.
Decreased emotional control.
Martyrdom.
Fear of “going crazy”
Increased daydreaming/fantasizing.
Constant feelings of being trapped.
Nervous ticks.
Undefined fears.
Inability to concentrate.
Intellectualization.
increased tension.
Relationship Indicators Attitude Indicators
Isolation or over bonding with SO/friends.
Responding in mechanical manner.
Isolation from clients.
Increased expression of anger and or mistrust.
Increased interpersonal conflicts.
Increased problems in marital and other interpersonal
relationships.
Social Isolation.
Over involvement with clients/patient using clients to meet
social needs.
Value Indicators
Sudden and often dramatic changes in values and beliefs.
http://www.zurinstitute.com/burnout.html
Site includes the aspects of counseling that
influence burnout plus it talks about effects on
therapist's family and ways to address burnout.
Site includes an extensive bibliography of
stress/burnout books and articles.
http://helpguide.or/mental/burn_signs_wym
ptoms.htm
Additional resources for burnout.
The Wheel of Wellness Counseling for Wellness:
a Holistic Model for Treatment Planning.
Good overview of utilizing a Wellness Counseling
model with research support.
Wellness Counseling: The Evidence Base for
Practice.
Reporting and describing research and ways to
approach wellness research.
Wellness of Counselor Educators: an initial Look.
Study looking a wellness in Counselor Educators.