Increase Self-awareness Research Articles

Assumptions and blind spots in patient-centredness: action research between American and Italian health care professionals

To examine how patient-centredness is understood and enacted in an American (US) and an Italian group of health care professionals. An action research methodology was used. Two interprofessional groups of US (n = 4) and Italian (n = 5) health care professionals independently wrote a patient-centred dialogue between a doctor and a patient based on the same scenario. The dialogues were then translated and exchanged. Both groups independently commented on the patient-centred aspects of the other's dialogue by completing a written questionnaire. Their respective comments were then shared by international videoconference. The transcript of the videoconference was analysed via content analysis. The participants' opinions about the study were then evaluated. Exploring the patient's illness experience and handling the patient's emotions were identified as core components of patient-centred care by both the US and Italian groups, but were expressed differently in their respective dialogues. Respecting the patient's autonomy was recognised as a component of patient-centred care only by the US group. The Italian group demonstrated a more implicitly paternalistic approach. Participants highlighted the usefulness of one another's feedback to uncover cultural assumptions of patient-centred care and increase self-awareness. Results suggest that the concept and practice of patient-centred care is variable and may be influenced by culture. The study methodology improved participants' self-awareness of cultural values, and has potential as a cost-effective, experiential educational approach.

A View from Riggs: Treatment Resistance and Patient Authority—VII. A Team Approach to Treatment Resistance

Treatment resistant patients frequently require treatment modalities beyond combined psychopharmacology and individual psychotherapy. They often require a team effort to manage crises, contain anxiety, and create a psychological space for examining the impact and meaning of behavior. The use of a treatment team as an adjunctive therapeutic modality helps individual team members understand regressions as repetitions of family dynamics, unearths the underlying meaning of behavior, engages patients' authority, and prioritizes the importance of relationships in effecting change. Through engagement with team members and with the team leader's authority, patients may assume responsibility for their behavior, reevaluate familiar roles, and increase self-awareness and psychological integration. The team helps its members identify, bear, and metabolize negative countertransference, address associated anxieties realistically, and optimize the environment for change.

The Self-Discovery Programme for children with special educational needs in mainstream primary and secondary schools

ABSTRACT This exploratory study concerns the Self-Discovery Programme (SDP) designed for children with emotional and behavioural difficulties in mainstream schools. The aim of the SDP is to provide children with a range of practical relaxation skills that may enhance emotional wellbeing, increase self-awareness and promote self-regulatory behaviour. Thirty-four pupils (14 girls, 20 boys; aged 10 to 13 years) participated in the SDP. Data were collected by behavioural profiles completed at baseline by teachers, observations of the SDP at the first and last session of each (module) by an independent researcher, and reviews with teachers at the end of the SDP (i.e. at 1 year). Results suggest improvements in children's self-esteem, social competence, communication skills, behaviour and attendance at school. Children were observed using the relaxation techniques learned on the SDP during the school day. Further studies using a controlled design, standard measures of self-esteem and behaviour, and a larger sample appear warranted.

On the experience of shame in multicultural counselling: Implications for white counsellors-in-training

During the process of developing multicultural competencies, counsellors-in-training experience a wide array of emotional reactions. Through extensive instruction, observation, personal communications and training exercises, the authors have noted the commonality of shame among many white trainees participating in multicultural coursework.The experience of shame in white counsellorsin-training tends to increase as their white identity development evolves and as an awareness of racial differences, stereotypes, and prejudices becomes evident.The emotion of shame can then lead to defensive responses that can hinder empathic understanding and thus forestall the development of true multicultural competencies. Therefore, it is vital that white counsellors-in-training increase selfawareness of, monitor, and actively work through shame related to multicultural issues while undergoing the training process. This article differentiates shame from guilt, describes the link between shame and white identity development, and outlines how experiences of shame in white counselling trainees may limit their professional growth if not addressed by trainers. Steps for assessing, actively processing and following up with these experiences during training situations are summarised.

Problem solving by career assessment: Some issues clients need to consider

want to take the test that told my roommate what to do, My advisor said you have a test for undeclared students, and I need a major before I can register are familiar statements for most counselors. A problem solving model at first glance appears to be an ideal framework for career clients who request career assessment as an approach to career planning. After all, the client has sought out counseling (general orientation), states the need for career assessment (problem definition and formulation), wants to look at career options (generating alternatives), and intends to choose a career (decision making). This closely follows the process model of problem solving reviewed by Heppner (1978). Despite the fact that career assessment can do several positive things (confirm tentative choices, increase self-awareness, and generate alternatives), a second glance at career assessment raises some questions about its utility as a solution for the problem of career choice. What if career assessment is requested because the client feels a lack of confidence in his or her problem solving ability, has been avoiding career planning, or has little sense of personal control in the area of career choice? Heppner and Petersen (1982) found these factors to be important for effective problem solving. Career assessment is unlikely to be productive if the client requests it while poorly prepared to engage in subsequent problem solving. What if career assessment is the client's final effort at career planning and will lead to a premature choice that has not considered related issues? The client who requests a career assessment instrument