Psych 6233 - Discussion post

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Memorial University of Newfoundland *

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6233

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Psychology

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Dec 6, 2023

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docx

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Week 1: DQ #1 A good counsellor is aware of cultural differences and ensures they continue practicing self- awareness. When working with individuals of different cultural backgrounds and with different beliefs and values, a therapist needs to consider the possibility of these factors influencing any assessment they administer. The Canadian Counselling and Psychotherapy Association (2020) states that a counsellor should consider all aspects, such as diverse factors that may be influential in determining appropriate accommodations and performance. Counsellors should proceed with taking precautions in the selection, administering and interpreting assessments as the results may not represent the client's historical background and presenting issues (CCPA, 2020). As a clinician who is aware of their clients' diversity, they need reliable resources. Hence, the client is more likely to have a successful therapeutic experience. For example, suppose a client and clinician have different first languages. In that case, the clinician needs to have availability to professional translators, assessment materials, and educational resources to ensure they are aware of the cultural differences. For example, a clinician will want to use these resources to help inform the client of therapeutic processes appropriate to their understanding (Hays, 2017). DQ #2 Hi Shannon! I enjoyed reading your response to this week's discussion. I currently just moved to Moncton, NB. Its diverse population continues to grow, which is excellent but can also be problematic when providing services. I work with VIVA, a therapeutic benefit for children with Autism. We have several clients whose families are moving to the province, and English or French is not their first language. As you have stated, this can be a barrier when providing services and developing a relationship with our clients. Finding an individual who can translate for us is difficult for many clients. We urgently need translators, but unfortunately, we do not have the funding for it. This makes it difficult to interact with families as language is a significant barrier, and sometimes the families are unsure of what we offer or express to them. Although I am not currently providing mental health counselling services to my clients, I still work with them and their families. I should be able to give accurate care to the children, but sometimes this gets lost in translation and becomes challenging. DQ #3 I enjoyed reading your post; it made me think of the significance of biases that can be implemented within therapy. Clinicians need to have self-awareness when interacting with clients. They may hold unconscious biases which can influence their connection with their clients. The unknown preferences can often impact clinical assessment, decision-making, and reasoning (cite). Aside from influencing clinical judgement, biases can often affect the development of a therapeutic relationship (note). Distorting conclusions can make clients feel misunderstood and affect their therapeutic success (reward). To help eliminate clinical biases, psychotherapists could use different techniques. Therapists

could continue to educate themselves on cultural diversity, use mindfulness or use personal reflection (cite). Having self-awareness is essential when working with any individual in a therapeutic setting. As clinicians, we want to refrain from unloading our beliefs or values on the client. The best way to do this is to continue working on self-awareness. Yager, J., Search for more papers by this author, Kay, J., Kelsay, K., Psychiatry, D. of, Send correspondence to Dr. Yager ([email protected])., J, M., K, P., Al., E., E, B., EH, F., L, D., J, Y., D, B., D, D., LE, B., V, L., Sánchez-Bahíllo, RD, S., … J, G. (2021, January 15). Clinicians’ cognitive and affective biases and the practice of psychotherapy . American Journal of Psychotherapy. https://psychotherapy.psychiatryonline.org/doi/full/10.1176/appi.psychotherapy.20200025 DQ #4 This process is like what we use at work when doing intake assessments. When working with families, we have a form that requires the parent's consent to allow the origination to communicate with other professionals involved with the child's intervention (i.e., Physiotherapist, Speech Language Pathologist, Paediatrician, Social worker, etc.). It is the only way to communicate with them and collaborate, if necessary, legally. Although my experience is from an ABA and communication standpoint, my experience can transfer over to a counsellor's perspective. Clinicians are legally obligated to take responsibility for their clients, regardless of context. It is essential that the counsellor protects the welfare of the client and maintains their trust and respect (CCPA, 2020). To help promote the client's interest, counsellors can work collaboratively with the client and other professionals to help develop a solid therapeutic plan that includes the client's needs, values, and essential contextual background (CCPA, 2020). Accepting consent for releasing information is not only important for the counsellor legally, but it can also help to work with other professionals to develop a plan best suited for the client. Sometimes you need multiple people to provide ideas to help give your best service in protecting the client's welfare. Week 2: DQ #1: Hi Spencer, It seems as though several people are interested in the topic of death by suicide and how to assess it during counselling sessions. Your post mentioned the SAD PERSONS Scale (SPS; Hays, 2017). You noted how Katz et al. (2017) indicated that it is a popular form of assessment used across many clinical settings. Although popular, you also mentioned that they cannot predict future suicidal ideations. As someone who experienced loss from death by suicide, I am not sure if there is an assessment to determine if someone will be suicidal in the future, but we can take precautions as counsellors and implement risk factor screenings. It may be a step we want to take with clients who express past and present ideations. For example, if the answers reflect conflict

with family, sleeping issues, marital/job loss, or isolation (Steele et al., 2018), we could determine if suicide is something we need to go through with the client. If so, we must manage our approach as the least restrictive to keep the client safe (Steele et al., 2018). Hays, D. G. (2017). Assessment in counselling: Procedures and practices (6th ed.). American Counseling Association. Katz, C., Randall, J. R., Sareen, J., Chateau, D., Wald, R., Leslie, W. D., Wang, J., & Bolton, J. M. (2017). Predicting suicide with the SAD person scale. Depression and Anxiety, 34(9), 809– 816. https://doi.org/10.1002/da.22632 Steele, I.H., Thrower, N., Noroian, P. & Saleh, F.M. (2018). Understanding Suicide Across the Lifespan: A United States Perspective of Suicide Risk Factors, Assessment & Management. J Forensic Sci, 63: pp. 162–171. https://doi.org/10.1111/1556-4029.13519 DQ #2: Working in an outpatient setting in a largely populated area is swift pace and involves an extended amount of wait times. From personal experience working within Halifax and its surrounding areas, it can be overwhelming due to high demand and time constraints. Time management would be an essential factor in this type of situation. A counsellor wants to be able to provide appropriate services to the client, but time can be influential to that process. It would be beneficial to begin the process with a screener to work with time demands. Hays (2017) explains that a counsellor can obtain general information about the client and their presenting symptoms, as well as their significance of them, by using a screening tool. With the particular clientele I will be working with, a screener I would use for passive suicidality, I would introduce the PHQ-9 (Patient health questionnaire). This screener is a tool used for depression and addresses passive suicidal ideations (RHIhub Toolkit, (n.d)). To be more efficient, I can introduce the SCL-90-R. This screener takes 15 minutes to conduct and would be beneficial as it is used with diverse populations (Hayes, 2017). Hays, D.G., (2017). Assessment in Counseling: Procedures and Practices. American Counseling Association. We are screening for and addressing suicide risk in clinical settings . RHIhub Toolkit. (n.d.). https://www.ruralhealthinfo.org/toolkits/suicide/2/screening-tools DQ #3:

Hi Danielle, I enjoyed reading your post. Dr. Rick mentioned that the structure may be best if a counsellor needs evidence in a law-suite situation. However, my viewpoint is similar to yours. In your post, you discuss providing the client with an opportunity to discuss relevant information a counsellor may not catch if they conduct a structured interview. Both have pros and cons, but it is up to the counsellor to determine which type of interview would be most beneficial in the given situation. Working with clients to develop a relationship where they feel comfortable and confident in their counsellor and the information they release is essential. When a counselling session feels natural, clients are more likely to provide more details because they feel a sense of safety. DQ #4 When considering cultural considerations, it is essential to remember that talking about mental health illnesses in some cultures is frowned upon, which can lead to more significant issues. We want to ensure our clients feel heard and their feelings are validated. To help advocate our self- awareness, we can make it evident during our sessions. Individuals who experience suicidal ideations do not always express it. They often deny or tell you what you want to hear, like they are okay. This can be relatable to feeling shame about their mental well-being, or they may want to avoid hospitalization, speed discharge, or it may be a defence against suicidal impulses (Oquendo & Bernanke, 2017). Another thing to consider is that some individuals may suffer transient but intense suicidal thoughts that are not captured within an assessment (Oquendo & Bernanke, 2017). Research suggests it may be beneficial to conduct evaluations that measure a patient's cognitive processing to gain insight into the client's risk of suicide (Oquendo & Bernanke, 2017). Week 3 DQ #1 Thanks for asking a question, including specific cultures. Although the question asked about modifying an assessment to reflect culturally detailed information, it brought my mind to one population, the Indigenous. As Canada's diverse population grows, it is also essential to note the Indigenous people. The NWA (Native et al.) is the first tool developed to measure the impact cultural interventions have on an individual from a whole-person and strengths-based view (Thunderbird, (n.d)). The assessment has been determined to be a reliable way to measure changes in wellness in several different areas, such as gender identification, cultures, and age (Thunderbird, (n.d)). The team that developed the assessment were individuals within the native community. The tool is a product of the Honouring Our Strengths: Indigenous Culture as Intervention in Addictions Treatment (Casl) (Thunderbird, (n.d)). The research team comprised community elders,

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