This webinar was developed to inform professional counselors of ways to help clients in restricted settings to cope with feelings of loss of control.

1. By: Jada Swart
COPING WITH LOSS

2. Inpatient Psychiatric
Units
Department of
Corrections
Jail
Prison
Probation
Loss of Control

3. “exerting influence over one’s environment or the actions or behaviors of
another person”(2015)
CONTROL

4. “Control is typically a reaction to
the fear of losing control”(2015)

5. The loss of control that is felt by the client when incarcerated or in a restricted
setting often has an acute/ immediate concern which may be loss of purpose,
feelings of a lack of freedom due to the inability to leave, inability to go outside,
inability to be in home environment, inability to refuse medication, inability to
complete daily tasks, inability to work, inability to make decisions without consulting
with an authority figure, the inability to fuel the craving etc.
Be mindful of the how that person must feel in this situation
…ask yourself…
How would I feel?
How can I help alleviate the stress this individual is feeling?
If the situation cannot be altered,
How can I help this person perceive it to be less threatening and more
manageable?

6. Being empathic is key to building a healthy therapeutic relationship
with those struggling with the feelings of loss of control.

7. Behaviors and emotions that can be a result of feelings of loss of
control can include but are not limited to:
 Physical and verbal aggression
 Threatening behaviors
 Intimidation
 Labile mood
 Crying
 Isolating
 Seeking comfort
 Self mutilating behaviors
 Self sabotaging of relationships
 Defense mechanisms
 Acting in the emotional mind

8. Response to Loss Plan
1) Identify and verify the type of loss or concern and in this case it would be
feelings of loss of control.
2) Communicate the concern with the response team.
 Address any possible barriers to treatment,
countertransference, cultural, religious, or even a language barrier.
 Identify roles and encouraged responses
3) Discuss feelings/thoughts/ concerns with the client.
4) Help the client develop a goal.
5) Implement interventions that support the goal of the client.
 Distract, Relax and Cope
 Priority List
 Stating the facts
 CBT : Cognitive distortions

9. The first step is identifying the area or concern that
has caused the person to be feeling so much grief, a specific loss such as a feeling of
loss of control.
When dealing with those grieving in a restricted setting with the loss
they are feeling of control, power, and independence it is important
to stay rational and to not let ourselves become consumed by their emotions…
remember it is their emotions. We are simply there to help them cope with the grief not
to take away the grief but to help them manage it.
Recognizing the cause of the grief will help them move forward in a direction of finding
more peace.

10. Key aspects in communicating with someone in the emotional mind
or experiencing a loss
 Speak using a low volume and soft tone this will be more
warming to the client
 Stay on topic
 Use open ended questions
 Allow for the pauses and silence to occur
 Posture your body to be more open and inviting
 Another key *
 If the client is sitting on the floor , be at eye level with them,
this will remove any beliefs that you are dominating and this
allows them to feel equal. This is another simple skill that will
better support developing a relationship with those struggling
in an environment where they feel they are controlled.
 Be mindful that an individual that feels they have lost control
of her/his life will see anyone in a position of authority(staff)
As a threat and they fear that you are not going to be a help
to them but instead they fear what else they could possibly
lose.

11. Proposed Barriers
 Conflicting core beliefs which can be religion, culture, and language.
 Countertransference
 “Countertransference is not always helpful. Particularly when it is
unexamined — or, worse, unrecognized — it can indeed interfere
with effective treatment. This can occur even with positive
countertransference, as when a therapist is so entertained by a
patient's jokes that the underlying bitterness is ignored, or when
an attractive patient is never challenged because the therapist
desperately yearns to be liked”

12. Role Of The Counselor
 Be open- minded
 Take a non-judgmental stance
 Be supportive
 Listen** Allow the client to completely express themselves
 Help the client gain a different perspective
 Encourage the client to see the grey and to allow himself to
let go of the “absolutes”
 Help the client view his life as manageable
 Identify areas of his life he is in control of
 Help client develop realistic goals and encourage him to complete
them one at a time
 Be available
 Be empathic
 Encourage the outpour of emotions but in a constructive manner
not in a destructive manner ex) scream therapy

13. What not to do when counseling an individual
grieving over loss of control…
 Jump from topic to topic
 Ask closed ended questions
 Ignore the crisis
 Avoid “Why” questions
 Rush to answer the question
 Interrupt the client
 Impose personal beliefs on client for moral comfort
 Laugh at the client
 Blame the client
 De-humanize the client
 Displace feelings towards others onto client
(countertransference)

15.  Distract, Relax and Cope ( Dialectical Behavioral Therapy): A concept that
encourages the client to immediately distract their mind with a stimuli that can
occupy just as much attention as the grief or concern and then to have them
partake in a relaxing activity that they have identified earlier in treatment and then
returning to the discussion when the mind returns to the rational state or the wise
mind as stated in the DBT concepts.
 Stating the facts: having the client take out all assumptions and state exactly the
facts so that they are not furthering their emotional state by getting themselves
more fearful of loss through believing assumptions.
 CBT: Cognitive Distortions; Encouraging the client identify his thought, feeling,
and behavior. Having the client dispute the thought with facts or evidence stating
otherwise, reminding the client of what is in his control. And then, developing a
goal behavior. Also, providing the client with information regarding cognitive
distortions and encouraging him to refrain from using the negative thinking
patterns or to at least try and correct them when they are used.
 Journaling: Have the client develop a list of “what I am worried about”
-then having him circle what he has control of in that list
and crossing out what he does not have control of on that list.
Then taking that list and putting it next to or under your bed.
Only allow the client a designated time to (15 minutes)
to think about the list and areas of concern a day. Reminding him to not waste
energy on things out of his control .

16. The Foundation of Who We Are…
-Culture
-Religion
-Ethnicity
-Race
-Values/Beliefs
-Gender
-Morals
Affects How We Cope.

17. Some Unique Ways of Coping With Loss
In the department of corrections it is not uncommon for the prisoners, jail inmates
and clients at RTF’’s to become gang affiliated. For example, Hispanic prisoners
were the first to form a prison gang and are still increasingly doing so.. This
example is a display of the prisoners trying to regain control by feeling stronger in
numbers. Hispanic individuals are a minority and being involved in a gang would
be offering them more protection and also, allowing themselves to grasp on to any
type of control that presents itself.
Another cultural way individuals cope when they feel out of control is to turn to
their higher power or faith so, for example, a client that is Muslim would turn to
Allah to seek guidance and protection. In this case using faith when feeling out of
control is a comfort measure and allows the pressure of needing control to
subdue.
It is said that women often create fake families in the jail or prison setting. This is a
form of grasping control as well. When a woman is put into prison she is not only
losing her freedom but she is losing her routine and for many that is being a stay
at home mom. By creating a fake family that consists of other prisoners they have
attempted to fill the void.

18. “So there is no way to apply systems, rules or emotional road maps. Our job is to
be a presence, rather than a savior. A companion, rather than a leader. A friend,
rather than a teacher.”
- JohnWelshons- “Awakening From Grief”

19. 1) Control Issues. (2015, June 9). Retrieved June 12, 2015, from
www.goodtherapy.org
 This website offers an overview of the causes of control issues and how to
manage them appropriately using psychotherapy.
2) Reidbord, S. (2010). Countertransference, an overview. Psychology Today.
 This article offers information and an overall understanding of what
countertransference means and how it can affect treatment for both the
therapist and client.
3) Wheeler-Roy, S., & Arnyot, B. (2012, November 15). Grief Counseling
Resource Guide A Field Manual. Retrieved June 8, 2015.
 This article/ manual informs the professional of skills to communicate more
effectively with those grieving. This was one of my favorite sources
because it also highlights certain questions that can be used, the cognitive
and emotional process the person grieving is going through. I noticed that it
appears to have been modified in 2012 and published in 2004. The
information is still very valid and I could not find it in me to not share it .

20. 4) Morris, S. (2011). The Psychology of Grief- applying cognitive and behavior
therapy principles. Australian Psychological Society.
 This journal is very informative of the use of cognitive and behavioral therapy
techniques. It offers a general guideline of how to help those grieving.
5) 2011 National Gang Threat Assessment – Emerging Trends. (2011).
 This website was used as a resource to collect information about cultural
aspects of jails, prisons and restricted settings, It also provided statistics.