● Encourage clients to talk about what matters most to him or her. ● Listen actively to the client. ● Show empathy and interest in the effect that a problem is having on the client’s life. ● Acknowledge the values and preferences that matter to the client. ● Agree on what is important to the client. ● Assessing preferences matters, especially when clients defer decisions to clinicians. The counselor should ensure that the dialogue reflects important information about the options (e.g., specific procedures, risks, and benefits) and that a client’s preferences are acknowledged. Step 4: Reach a decision with the client. ● Help the client move to a decision. Ask if he or she is ready to decide or if they have any additional questions. ● Ask the client if he or she would like additional information tools such as educational materials or decision aids to help decide. ● Check to see if the client needs more time to consider the options or discuss them with others. Schedule another session if the client requests more time to consider the options. ● Confirm the decision with the client when he or she is ready to decide. Ask the client to describe the treatment options and which one he or she chose. ● Verify the next steps to be taken and timing of these actions with the client. ● Make plans to review the decision in the future. Remind the client that decisions may be reviewed and can be changed if they are not working well. ● Monitor the extent to which the decision is implemented. ● Assist the client to manage barriers to implement the decision. ● Revisit the decision with the client to determine if other decisions need to be made. The client may enter the counseling process believing that the counselor will provide the answers as the authority and that they will assume a passive role. The shared decision-making process may require time to educate the client on the five steps, and additional time for practice, based on the client’s ability to contribute and advance through the process. The counselor will need to continually assess the client’s responses to determine the next course of action as the client learns to apply the decision-making steps. The goal is to build skills for independent decision making that lead to self-reliance or autonomy rather than dependency on others. ● Schedule follow-up appointments. Step 5: Evaluate the client’s decision.
4. Remind the client that his or her participation is important. Step 2: Help the client explore and compare treatment options. ● Discussing options with the client can help build a trusting relationship. ● Assess what the client already knows about his or her options. ● Write down a list of the options and describe them in plain language. 1. Explain each option clearly. 2. Avoid using technical or medical jargon 3. Point out when there are clear differences between specific options 4. Talk about important unasked questions. ● Clearly communicate the risks and benefits of each option in a way that the client can understand. ● Offer positive and negative outcomes. ● Offer evidence-based decision tools whenever possible. ● Use and explain appropriate visual aids (graphs, charts, pictographs) to help patients understand explanations. ● Use the teach-back technique to check for understanding. 1. Ask the client to explain in his or her own words what the options are. 2. Being able to use different approaches, such as Web- based decision aids, printed handouts, or handwritten drawings, will help adapt to the different ways in which people learn and process information. ● Look for signs of decisional conflict. The client may: 1. Verbalize uncertainty about the choice or concern about undesired outcomes. 2. Waver between choices. 3. Delay the decision. 4. Question personal values or what is important to them. Discussion There will be many decisions the counselor and client will have to make in planning and delivering counseling services. The best practice is a client-centered approach for shared decision making that places the focus on engaging the client in the process based on their needs, preferences, values, and desired outcomes. The counselor takes a supportive role to assist the client in reaching a decision by providing evidence-based information on the options being considered, including risks and benefits of each. Counselors may need to assist the client in determining short- and long-term goals, identifying barriers to those goals, developing a plan of action, and taking steps to move forward. 5. Be preoccupied with the decision. 6. Show signs of distress or tension. Step 3: Assess the client’s values and preferences.
TECHNOLOGY ASSISTED COUNSELING
There are many terms to describe distance therapy using electronic methods, which include audio and video communication, including the addition of social media with all the inherent confidentiality and privacy issues. The term “distance” refers to the fact that the counseling is not face-to face with the client and counselor in the same location. A review of many studies shows mixed results in the effectiveness and security of technology-assisted counseling, often called telemental health counseling or E-therapy. Many counselors noted the convenience of the methods, especially during the Covid -19 pandemic, when face-to-face counseling was not possible. Positive outcomes include the ability to reach underserved populations in remote areas that have no access to mental health care or without transportation to travel to a care provider.
Clients with health and mobility issues, homebound, residing in care facilities, or incarcerated can access counseling through electronic methods where mental health care would otherwise be unavailable. There are several disadvantages to technology- assisted counseling that involve confidentiality, security, and privacy issues when the environment cannot be strictly controlled. Communication between client and counselor may be impacted negatively because of the distance between the parties. There is the possibility of missing important signals and cues that the client is in distress or simply not connecting with the counselor or engaging fully in the counseling process. The goal of establishing trust in the client–counselor relationship is based on open communication. Technical difficulties and equipment failure can interfere with or shut down the counseling session. This is not only frustrating to both parties but may severely damage the continuity and
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Book Code: PCTX1324
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