How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 35

This book is in B&W, not color - Print page in Grayscale for Correct view! • Counselling and psychological therapy: having someone to talk to is an important part of treatment. A person with acute psychotic symptoms may need to know that there is someone who can understand something about their experience and provide reassurance that they will recover. As recovery progresses, different forms of psychological therapy can:    help the patient and those caring for them (on ordinary location) learn how to keep stress levels low in order to prevent further episodes help the patient and those caring for them (on ordinary location) recognise early warning signs that a further psychotic episode is developing and help the patient learn ways of reducing the impact of hallucinations and delusions. • Practical assistance: treatment often also involves assistance with employment, education, finances and accommodation. What the generalist nurse or healthcare officer can do 1. Communication (engagement) (The section on communication was adapted from ‘The guide to communicating with people who have serious mental health problems’, developed by Katie Glover when she was at START, a Homeless Mentally Ill Initiative Project in London.) In order for the healthcare team to help the patient, the patient has to feel that the team is on their side and be prepared to communicate and, at least to some extent, to cooperate with the team. A trusting relationship with any member of the healthcare team is therefore important to the success of the treatment. Building such a relationship is especially hard with a patient who is psychotic as, at least in the acute stage, they may believe that you intend to harm them. When you talk to the patient, it is likely that you will have to adapt your usual communication style as the patient’s memory, concentration and tolerance levels may all be reduced. • Talking with someone with a severe mental illness:      Never leave someone who is mentally ill to guess your intentions or the intentions of other members of the healthcare team. Their imagination will run riot. Always explain why you, the doctor or other person wants to talk with them. Try to ensure that the environment is comfortable and safe for both you and the patient. Ask where in the healthcare centre the patient feels safe/OK to talk. Remember that social interaction can be very stressful for the patient and be prepared to acknowledge this: ‘I can see how hard this is for you. I appreciate you making the effort to talk to me’. Be warm and friendly but also prepared to spend time in silence. Always be aware of cultural issues. If you are not sure, ask. Finding out as much as you can about the patient’s culture will help communication. • Talking with someone who is hearing voices. If you are not sure someone is hearing voices at this particular time, ask them. If they are, do the following:      Acknowledge the difficulty and distress that voices cause. For example, ‘It must be really difficult for you having this conversation. I really appreciate you making the effort’. Do not challenge the fact that the patient can hear voices. They are real to the patient. However, you can say in a gentle and matter-of-fact way something like, ‘It’s your brain playing a trick on you just now’. Talk clearly and slowly if necessary and be prepared to repeat questions. Be prepared to take longer even for a simple matter. If someone is obviously in distress, ask them if they have had enough. Be prepared to come back later. For [email protected] Property of Bookemon, do NOT distribute 37