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Hl psychosocial aspects & counseling

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  • 1. HEARING LOSS Psychosocial Aspects & Counseling The use of a audiologic rehabilitation model has been in place since the early 1980’s. The model described in Schow, will be used to provide a consistent description for effective professional patient/client interaction. The assessment component of this model is CORE.
  • 2. HEARING LOSS Psychosocial Aspects & Counseling C.O.R.E. C—Determine patient/client communication status O—Determine overall emotional participation variables R—Determine related personal factors E—Determine environmental factors
  • 3. HEARING LOSS Psychosocial Aspects & Counseling Communication Status • • • • • • • Auditory? Visual? Language? Manual? Communication—self report? Previous rehabilitation? Overall communication?
  • 4. HEARING LOSS Psychosocial Aspects & Counseling Overall Participation Variables • • • • Psychological/emotional? Social? Vocational? Educational?
  • 5. HEARING LOSS Psychosocial Aspects & Counseling Related Personal Factors • • • • • Personality type? IQ? Age? Race? Gender?
  • 6. HEARING LOSS Psychosocial Aspects & Counseling Environmental Factors • • • • • Services? Systems? Barriers? Facilitators? Acoustic conditions?
  • 7. HEARING LOSS Psychosocial Aspects & Counseling When attempting effective audiologic rehabilitation, it is important to consider how the patient/client’s hearing loss affects their overall participation variables i.e. their psychoemotional and social interactions. Of course, their related personal factors (personality type, IQ, age) must also be considered.
  • 8. HEARING LOSS Psychosocial Aspects & Counseling Four Psychosocial Aspects When interacting/counseling with patient/clients (at almost any age level), there are four fundamental aspects to consider. They are: 1. 2. 3. 4. Self-concept Emotional development (or status) Family concerns Social competencies
  • 9. HEARING LOSS Psychosocial Aspects & Counseling Self-Concept Individuals are not born with selfconcepts. Self-concepts are created by input, feedback, and reactions from those around them. These concepts can be modified over time as social interaction occurs.
  • 10. HEARING LOSS Psychosocial Aspects & Counseling Emotional Development An individual uses language to describe, interpret, and understand the abstract nature of his or her emotions. Due to progressive hearing loss or language deficits, limited self-expression may create a delay in their awareness and understanding of their own emotions as well as those of others!
  • 11. HEARING LOSS Psychosocial Aspects & Counseling Family Concerns Often, the family as well as the patient/client will experience the “grief cycle” of emotions as hearing loss is encountered/revealed. The grief cycle consists of: • Shock • Denial • Depression • Acceptance/resignation
  • 12. HEARING LOSS Psychosocial Aspects & Counseling Social Competencies Poor and/or limited communication results in poor social competence. Social competence often includes the following skills: • Capacity to think independently • Capacity for self-direction and self-control • Understanding the feelings and needs of others • Ability to tolerate frustration • Ability to rely and be relied upon by others • Maintaining healthy relationships with others
  • 13. HEARING LOSS Psychosocial Aspects & Counseling It is important to understand that, whether one is born with hearing loss, or suffers acquired hearing loss in later years; the patient client will encounter these four described psychosocial aspects of hearing loss. Let’s cover these aspects in more detail regarding acquired hearing loss.
  • 14. HEARING LOSS Psychosocial Aspects & Counseling Those with acquired hearing loss generally wait an average of seven years (after becoming aware of their communication challenges) before attempting to access hearing health care.
  • 15. HEARING LOSS Psychosocial Aspects & Counseling Hearing loss can be a symptom of a serious health issue—even if benign, the permanent effects of auditory deprivation occurs after three years of hearing loss!
  • 16. HEARING LOSS Psychosocial Aspects & Counseling The psychoemotional reactions to revealed hearing loss can involve stress, anxiety, insecurity and anger. Let’s review page #254 in Schow for additional psychoemotional reactions. Let’s also review Case #7.2 on that page.
  • 17. HEARING LOSS Psychosocial Aspects & Counseling It is interesting to note, that family members take the brunt of the stress while the person with the hearing loss is attempting to accept the fact that their communication abilities are changing. Often, the family members are blamed by the individual suffering the hearing loss.
  • 18. HEARING LOSS Psychosocial Aspects & Counseling The affected individual usually does not realize the burden their hearing loss places upon their spouse or significant other. This often results in a downward spiral to even long term relationships. Hearing loss is insidious and family concerns are often encountered before the hearing loss has been defined.
  • 19. HEARING LOSS Psychosocial Aspects & Counseling The psychosocial aspects of late on-set hearing loss can result in past life-style modifications. • No longer regularly attend church • No longer engage in jokes or humor • Only short “to-the-point” comments • Other modifications?
  • 20. HEARING LOSS Psychosocial Aspects & Counseling This psychosocial withdrawal has been shown to lead to depression. It has been commonly found when adults begin to modify or change lifestyles, that gradual hearing loss may be a contributing factor.
  • 21. HEARING LOSS Psychosocial Aspects & Counseling Several studies have noted that the more severe the hearing loss—the more severe the psychosocial and emotional problems can be!
  • 22. HEARING LOSS Psychosocial Aspects & Counseling Psychosocial Aspects of Deafness Should hearing babies be born to deaf couples? Let’s review page#257 in Schow to begin this discussion regarding the deaf culture.
  • 23. HEARING LOSS Psychosocial Aspects & Counseling COUNSELING BASICS Now that we recognize more regarding hearing loss and its psychosocial aspects, let’s better understand important distinctions for both effective counseling and proper referral to other healthcare professionals.
  • 24. HEARING LOSS Psychosocial Aspects & Counseling Counseling is designed to help people develop “here-and-now” strategies for coping with lifestyle modifications, decision making, and current social or health problems. There are two forums for counseling: 1. professional, 2. non-professional
  • 25. HEARING LOSS Psychosocial Aspects & Counseling Counseling events fall into two fundamental categories, they are: 1. Informational counseling 2. Personal adjustment counseling
  • 26. HEARING LOSS Psychosocial Aspects & Counseling INFORMATIONAL COUNSELING This form of counseling is often used by non-professional counselors, it is commonly use by audiologists and hearing instrument specialists. It is easily recognized when the professional finds that he or she is doing most of the talking i.e. one-way communication.
  • 27. HEARING LOSS Psychosocial Aspects & Counseling PERSONAL ADJUSTMENT COUNSELING This type of counseling involves more two-way communication. In fact, counselors call it facilitative communication. This approach allows patient/clients an opportunity to express how they feel— often revealing their communication goals.
  • 28. HEARING LOSS Psychosocial Aspects & Counseling PERSONAL ADJUSTMENT COUNSELING There are three steps involved to facilitate this type of counseling process. They are: 1. Help patient/clients tell their “story” 2. Help patient/clients “clarify” their problems. 3. Help patient/clients take responsibility for their communication problems
  • 29. HEARING LOSS Psychosocial Aspects & Counseling PERSONAL ADJUSTMENT COUNSELING Let’s review page #260 in Schow for better definition of this process. Note: pages 261—263 provide more detail regarding integration of this form of counseling into audiologic rehabilitation.
  • 30. HEARING LOSS Psychosocial Aspects & Counseling The C.O.R.E. model of assessment considers patient/client attitudes— including readiness for change. An empathetic, non-judgmental attitude can help patient/clients face their fears and consider “treatment”.
  • 31. HEARING LOSS Psychosocial Aspects & Counseling Patient/clients can present with a variety of psychosocial problems. When attempting non-professional counseling and you feel like the counseling may be going beyond your comfort level, always immediately refer the patient/client to an appropriate healthcare professional.