My Module 4 Reflection - The Therapeutic Response to Clients with Depression

 

This video is from Ted-Ed Talk on What is depression by Helen M. Farrell (2015)

 There was a song by The Cranberries entitled Wake up and Smell the Coffee. One of the lines says, “I was twenty-four, was insecure, do whatever it takes” incidentally reflected my so-called quarter-life crisis 20 years ago. I did not want to go out of the house and was only interested in doing household chores and play Diablo III until dawn to fall asleep. I was part of the age bracket that had had to deal with life’s many challenges before the prefrontal cortex is fully developed at the age of 25. (Nierenberg, 2016, para. 6)

Understanding what depression is, its implication and importance to increased knowledge on this topic, as well as how future HOAs can therapeutically communicate with clients who are in this situation shall be described and discussed in this paper.

Down and Under

Psychiatrists in the past diagnosed depression using different criteria. However, they used a more comprehensive definition and set of diagnostic criteria from the DSM-5 and ICD-10-CM to reconcile somehow the confusion. Depression, therefore, is described when there is a persistent feeling of sadness and loss of interest. It is considered a mood disorder. (Tamparo & Lindh, 2019, p.192) It can be minor depression that lasts for at least 2 weeks having two symptoms showing or major (clinical) depression which a person could report showing five or more symptoms for the past 2 weeks. There is a full range of signs and symptoms that are also associated with depression specifiers. For instance, a person with a psychotic specifier would show signs and symptoms of depression that are coupled with delusions and hallucinations. (Tamparo & Lindh, 2019, p.193)

 Wake up and Smell the Coffee

Therefore, the implication in the increased knowledge of defining depression would allow future HOAs a more adept therapeutic communication response to clients who are experiencing episodes of this mood disorder. In addition, future HOAs would also have the awareness of their own mood which could be positive or negative when dealing with them. There is, however, a thin line in being involved emotionally or there is a possibility that transference will occur. Communicating therapeutically with clients who have depression would mean understanding the disorder, listening to the clients attentively, encouraging the client to get professional help, and lastly providing community resources. (Tamparo & Lindh, 2019, p.199) The role of the HOA is very vital once the client with depression comes to the premises because their interaction will set the atmosphere of safety, comfort, and mitigate the feeling of being judged. It is important to note that HOAs may not even always have a great day, thus, it is crucial to recognize one’s mental state.  My personal experience of having had experienced depression would allow me to talk with the clients in a more emphatic and professional manner. Wake up and smell the coffee, as The Cranberries would reiterate, could also provide an impetus for future HOAs that nothing is always constant even momentary feelings of sadness and lack of interest in things. We just have to wake up, shut up, and smell the coffee. It may seem like they are very easy steps but for sure they take some courage and effort to do so.

     

 

References

Farrell, H. (2015, December 15) What is Depression. Ted-Ed. https://www.youtube.com/watch?v=z-IR48Mb3W0

Nierenberg, C. (2016, October 27) 7 Ways to Recognize Depression in 20-Somethings. Live Science. https://www.livescience.com/56602-signs-depression-young-adults.html

Tamparo, C. & Lindh, W. (2019) Therapeutic Communication for Health Care Professionals (4th Edition) [2.5.8484.0] Retrieved from http://texidium.com

 

 

My Module 3 Reflection on Stress and Therapeutic Responses

 Stress is part of life and without stress, life will be monotonous. However, “some are more susceptible to the impact of stress than others”. (Science Daily, 2020, para. 1). It is in this view that stress will be defined and described as well as be given insights as to how it will be dealt with as a future HOA.

Stressed is Desserts spelled backward

          Stress is being in a mental or emotional strain caused by physical, physiological, and psychological stimuli. Written in combined symbols, the Chinese expressed it in two – danger and opportunity. (Tamparo & Lindh, 2019, p. 135) Stress can be good (eustress) or bad (distress). Eustress helps us cope with the demands of everyday life as it keeps us on our toes and drives us to perform. On the other hand, prolonged exposure or experience of stress causes distress that greatly affects one’s performance and effectiveness.

          Although there are different schools of thought regarding stress, one emerged as a key theory. It is Hans Selye’s general adaptation syndrome (GAS) belief that there are nonspecific reactions to stress. (Tamparo & Lindh, 2019, p.137) The figure below will describe the stages of such a theory.

                                                                      Figure 1.

       In the alarm stage, a signal is made and is making it known when there is perceived stress. The most obvious sign is pain. Next is the fight or flight stage when a person either escapes or confronts the stress. The third is exhaustion when fatigue becomes present. Lastly, the return-to-normal stage when the automatic nervous system’s craniosacral division kicks in and things get back to normal. (Tamparo & Lindh, 2019, p.139)

Stressed and then what

          The awareness of stress and its stages is imperative for future HOA because it will provide them with the understanding and the skill on how to deal with it, whether personally or professionally. The different stages of the adaptation to stress will allow the HOA to use appropriate therapeutic communication responses. For instance, when a client is in the alarm stage, it is vital to ask them where the pain is and let them describe it. The HOA’s ability when to provide detailed instructions or not, provision of privacy to clients when needed, maintaining eye contact, use of gentle and soft voice etc., are some of the concrete responses and skills that need to be learned and master which personally I deem very vital for my future career. To be more effective and efficient in adapting to stress, self-care is encouraged. Getting quality sleep is a sure-fire stressbuster, too.  One need not be guilty to have some time off and recharge. Therefore, self-awareness of what causes stress personally will help me deal with it as well as will be more emphatic towards the clients thereby attend to them efficiently.

 

                                                             References

Science Daily. (2020 November 23). Virtual reality helps measure vulnerability to stress. https://www.sciencedaily.com/releases/2020/11/201119124637.htm

Tamparo, C. & Lindh, W. (2019) Therapeutic Communication for Health Care Professionals (4th Edition) [2.5.8484.0] Retrieved from http://texidium.com

 

 

Self-Care Tips from Pixar Characters

            Self-care is any activity that can be passive or active that fosters relaxation and rejuvenation of one's whole being. 

            The image above was shared by my mother through FB messenger. Unfortunately, I could not give proper credit to whoever created this wonderful poster as I could not find one when I did a reverse image search. To the person behind this, my thanks.

             Here are the self-care tips that the characters from the varied Pixar movies give us. 

            Live every moment. Every moment counts while we are still alive. Some prefer to dwell in the past and could either wallow in painful ones or excessively nostalgic of happy memories unable to create new ones. Some are excited or anxious to live in the future. It is vital to recognize the here and now and cherish what is. 

            Cook something yummy. Food nourishes the body. The act of cooking something from scratch is also something that gives joy to yourself and to others. Food also provides the opportunity to commune and talk.

            Sing a song. Music heals the soul as a song goes. Songs give lyrics and melody to the thoughts and feelings that one has. They make us relax, inspired, joyful, or just awaken sleeping emotions that we hold dear.

            Talk to a friend. Would not it be wonderful to just have someone listen without judgment to the many things that have happened in your life? That someone is not a stranger but a friend especially when that friend throws a banter or two and you end up laughing at the silly ones.

            Find joy in the small things. A smile, a kind gesture, a cone of ice cream... Such plain things when you begin to appreciate will mean a lot.

            Dance. Dance like no one is watching is a common adage for this self-care tip. When you dance, you meliorate your cardiovascular health, balance, strength, boosts cognitive performance, challenge your brain, boost mood, can be a social activity, and can be inclusive. (Lindberg, 2019)

            Go for a run. Runners always attest that this activity gives a physical and morale boost. One would start with 1 km then crave for another kilometer, and more. It makes your heart beat faster and releases hormones that help in your overall health.

            Take a drive. Suffice to say this tip gets its nickname as joy-riding. It is when you just jump into the car and drive aimlessly for a bit of scenery or grab a pizza at a nearby city. This takes out some of the mundane environment you have been in for too long.

            Write in your dream journal. My mother used to say that when you plan, half of the work is done. Well, there may be some truth in this. Writing your dreams in a journal or daydream journal allows your mind to recall and activate your creative side, too.

            Read a book. The smell and touch of book experts say help you remember what you have just read. The printed matter uses all your senses aside from your sense of sight. Of course, there is the advent of e-books but nothing compares to the experience of actual books. 

            Meditate. This may be the most low maintenance self-care tip because you do not need anything fancy. You can just find a quiet corner or nook and just sit and close your eyes. Be aware of your breathing and just think of happy thoughts to increase mindfulness. There is also some guided meditation that you can listen to as well.

            All these Pixar-inspired self-care tips are now for you to try. What is your favorite?

My Module Two Reflection on Barriers to Multicultural Therapeutic Communication

 

          Hearing and listening are two different terms although they both involve the auditory sense. The former is the use of the faculty, which is the ears while the latter involves comprehending by interpreting the sound and the nonverbal aspects of the message sent by the sender. Listening is the beginning of understanding and understanding is the result of effective communication.  However, what happens when the message gets distorted and causes chaos that perturbs both parties. To seek  and discuss the varied reasons for misunderstanding will be a stepping stone to build communication gaps.

Barriers to Multicultural Therapeutic Communication

          Barriers create ineffective communication patterns and structures. According to Luckmann (2000) in her book Transcultural Communication in Health Care, she identified eight therapeutic transcultural communication barriers.

                                                                Figure 1

          Lack of knowledge comes first in the barriers of communication as there is an adage that says, “little knowledge is dangerous”.  There are many anecdotes describing such barrier that come out funny yet most often than not offensive, too. Thus, it is important to get to know the client’s culture and heritage to be more culturally adept. Another barrier is fear and distrust. Clients coming from different countries bringing with them their respective cultures or talking and dressing in a particular way may cause discomfort and dislike on the end of the HOA. The color of the skin of the client may also pose as a barrier as some races are superior or inferior and the way to communicate with them may differ. Bias, prejudice, and ethnocentrism are considered as barriers as well because they form negative thought processes or beliefs that hinder communication. Stereotyping is another barrier which places a person in a box. For instance, a person with tattoo has incarceration experience or no sense of self-direction and the like. Health care rituals will also pose as a barrier, when they are different from that of the client. For example, having family members accompany them while seeing the medical physician. Language is an obvious barrier even if according to Lapakko (2007), verbal is only 7% while non-verbal is 93% in communication. Absence of a common language creates a barrier when one does not speak the same language or there is no point of understanding the message.  Finally, differences in perception and expectation will become a barrier as each person will have their individual interpretation of external stimuli such as sounds, visuals, etc., and anticipation of events that proceed.

          As the barriers were discussed and identified above, we have done the first step in addressing the hindrances. Lack of knowledge; fear and distrust; racism; bias, prejudice, and ethnocentrism; stereotyping; health care rituals; language; and differences in perception and expectations are barriers that can be resolved and eliminated if the HOA learns to have an open heart and mind to accept and to learn the ways in which they will be dispelled. 

REFERENCES

 

Lapakko, D. (2007). Communication is 93% Nonverbal: An Urban Legend Proliferates. Communication and Theater Association of Minnesota Journal, 34, 7-19.

Tamparo, C. & Lindh, W. (2019) Therapeutic Communication for Health Care Professionals (4th Edition) [2.5.8484.0] Retrieved from http://texidium.com

 

My Reflection on the Helping Interview

 

          Communication is vital in everyday life. For some, communication starts upon waking up by giving thanks to the Supreme Being and closing it as the day ends. In relationships, communication is considered as the fuel to keep it going. In fact, schools offer the opportunity to learn writing and speaking to communicate effectively. There are various courses offered and in this case, Conestoga College has offered a Communication in Health Care course for medical office practice students. The elements, concepts, and techniques on therapeutic communication have been discussed so far, and which this paper will describe as well as narrate selected parts that were reflected upon.  The helping interview comprises orientation, identification of the client’s problem, and resolution (Tamparo & Lindh, 2019, p.85-86) is vital to the students who are learning how to communicate in the medical setting.

The Helping Interview

          According to Tamparo and Lindh (2019),  the helping interview is a frequently- used communication tool in the medical setting that involves the health care professional and the person in need of medical intervention (p.85). The figure below will describe its components.

           Control factor, risk/trust, genuineness, sympathy and empathy, and sincerity are vital elements during orientation. It is in this phase that both will have their respective initial impressions of each other. Thus, it is necessary for the health care professional to provide a safe, comfortable space for the client as trust is being built. The next component is identifying the problem of the client. Knowing the roadblocks to communication allows the health care professional to avoid them. Moreover, skills in responding, sharing observations, knowing how to acknowledge feelings, clarifying and validating, and reflecting and paraphrasing are needed in this phase. It is also important to note that at this phase, levels of need are identified to address them. Tamparo and Lindh(2019) states that “recognizing that clients have different levels of need helps professionals to focus their attention correctly.”(p.93) Lastly, a resolution to the client’s need is the final phase of the helping interview by which addresses and answers the client’s questions that they had primarily and provides an explanation of what they are experiencing medically.

          The helping interview may present itself with only three components, yet its importance in communication in health care is very significant as various skills are needed to be acquired and developed by us students as we become health care professionals in the future. It is also relevant to highlight the need to properly and communicate with confidence and empathy towards the client. The word client itself was new as patient is usually the practice in identifying the person in need in the medical setting. The client as an identifier is more empowering and proactive. Knowing this key concept of communication in health care proves to be beneficial in every student’s future endeavors if they are being practiced and implemented.

REFERENCE

Tamparo, C. & Lindh, W. (2019)  Therapeutic Communication for Health Care Professionals (4th Edition) [2.5.8484.0] Retrieved from http://texidium.com

 

Why I am wearing Blue Filter Lens Eyewear

 

             I finally got my new eyewear from Premier Optical in Waterloo after a week.  Prior to that, I was encouraged to use blue filter lens eyeglasses as I am always in front of the screen. I am somehow familiar with the term 'blue filter"---see it in the mobile phone options. It supposes to protect your eyes from strong light emissions from the screens. 

            "Blue Light is a part of the visible light spectrum, between 400 nm and 500 nm; making it one of the shortest, highest-energy wavelengths. Digital devices and LED lights to emit blue light from about 430 nm to 500 nm with an intense spike at ~ 455 nm." This is an excerpt which I got from the BluTech website. Sounds nerve-racking? It is! So to put it simply, it protects our eyes from harmful light emissions. You may compare it to wearing polaroid sunglasses. It also serves as anodyne eyewear for us digital people.

            I understood now why it seems difficult for me to fall asleep or that I feel easily tired after being in front of the computer for too long. So far, I have been wearing my blue filter lens eyeglasses and it helps a lot with my sleeping hygiene and my eyes do not get easily feel obnoxious. 

               My thanks to Premier Optical for having convinced me and for taking care of my vision health. 

                

Migrating from Philippines to Canada via Family Class - Spousal Sponsorship

More than 200 days here in Canada and slowly experiencing the colder weather; I could not believe that our more than four years of waiting to be literally together as a couple and as a family just fly by and in December we will be celebrating our 5th wedding anniversary!

I had been perusing the Immigration, Refugees, and Citizenship Canada website when we got engaged last 2014. A month after we got married, I started to get familiar with the forms and required documents.  That year 2015, the forms were quite ambiguous and I could not still put a fine thread to sew my thoughts on them.  However, in 2016 when Canada had a new prime minister, Justin Trudeau, the forms and requirements changed.

First, Sponsoring Applicant (the one who is in Canada) only had to provide his/her financial documents to prove financial undertaking. Second, the relationship document requirements become very comprehensible. As an outland applicant (Principal Applicant) living outside Canada, I only had to provide 10 pages of proof of communications as well as 20 photos establishing the development of the relationship. Meanwhile, I had to capture our old conversations and scan our letters to each other as well as the letters of those who know about our relationship and print them.

To understand further the application process, I will illustrate the flow that we had been through. This is also the general pattern of the cases that I have gathered on my research and social media pages that cater to this kind of endeavor.

1. Acknowledgment of Receipt - This arrives as an email or in some cases through post stating that they have received your application. Usually, the Sponsoring Applicant (SA) gets this one. Upon receipt, it signals that the application package has passed the primary intake stage - preliminary documents are complete and forms are filled out properly. Our waiting time was about 35 days before we received our receipt. It was our second attempt since our application was returned after 53 days the first time. This time you can also link your application with the Gckey or eCas. All you need to key in are the details of the Principal Applicant/PA (the person being sponsored to come to Canada) for Gckey or in eCas you can key in the details of the SA or the PA. Just follow the instructions as they are quite straightforward.

2. Medical Request - It arrived as a notice in Gckey about two weeks after receiving the acknowledgment of receipt.  In some cases, if the application is not linked with the Gckey, the PA receives it just the same in the email.  You are given 30 days to comply and have your medicals done at any IRCC accredited panel of physicians.  In the Philippines, the accredited ones are IOM, St. Lukes, and NHSI. You can find the respective payment schedule on their websites. Once done with the medicals, Gckey will update and indicate the status of whether one passed or need to undergo treatment. We did our medicals last June 8 and the status updated after two days. 

3. Sponsor Approval - This signals that the SA is eligible to sponsor the PA considering the criminal and financial statuses.  The SA will be responsible for the PA for two years. An email to the SA and a status update in eCas will reflect. Sponsorship Approval received on June 2, 2018.

4. Transfer to Local Visa Office email - An email stating that the application package has been transferred in our case to Manila was received last June 9, 2018.  Other application packages sometimes will be transferred to visa offices wherein the PA is usually situated.  Some will be transferred to London, Hong Kong, etc. Processing times also vary depending on the volume or sometimes complexity of the case.

5. Local Visa Office Processing - A status update in eCas will reflect as "....processing..." indicating that they have started to review the application locally. Ours updated last June 13, 2018.

6. Request for Additional Document - This happens when the Visa Office needs a newer or corrected document. In our case, I (PA) need to furnish them with an NBI clearance that has my maiden name and not the married name. Good thing, getting an NBI clearance has never been a hassle. It only took me a few minutes (I got mine in Baguio City). Then using the mobile scanner, I uploaded the document through GCkey after two days upon receipt of the request letter. I received the request letter on September 13, submitted on September 16, and got a status update that it has been uploaded successfully after 24 hours.

7.  Background Check in Progress/Process - Status update in GCkey will reflect that a background check is on the process. This process takes days, weeks, or even months. In our case, it took about a week after I complied with the additional document request. It was September 20 when I got a status update.

8. Pre-Arrival Invitation - This is an invitation for newcomers to Canada.  It's a one and a half-day seminar to give participants an idea at the same time setting expectations and helping new immigrants settle.  In my case, I attended in Cebu City at a hotel and it was an interesting experience.  The Pre-Arrival is not compulsory though and I think it's only Canada that is providing such seminar of the like other than the regular PDOS that the Philippine government is giving and making it mandatory. Our Pre-Arrival invitation was received through our GCkey the day after our passport request.

9.  Passport Request - Finally the much awaited! Received ours on September 27, 2018.  This is an email informing the PA of his/her eligibility to come to Canada as a permanent resident. You have 30 days to comply as you need to send your passport and other document needed by the Visa Application Center, which is VFS Philippines. They function as the middleman because the Visa Office will only stamp the passport with a Canadian visa if everything is complete and VFS takes care of it.  One has to be very wary because the photo needs to be correct following the photo specifications. Ours was returned because we submitted a different spec. But it was very quick since I sent the package prior to the cut-off time and it was also returned back before the cut-off time. You can send your passport through the courier or submit it to VFS personally.  Of course, the walk-in submission is faster than the courier submission as it took ours 10 days to come back with the visa.

All in all our process was from April 13, 2018 to September 27, 2018, few days shy of six months but a much shorter wait time than the processing time stated in the website slated at 12 months.  There were some cases that only lasted for about four months! Waiting time for sure is dreadful yet one just has to believe in the process coupled with lots of prayers. Then unexpectedly, your time will come and it will surely be worth the wait.