Coaching & Consulting – Implications for the Mental Health Profession

This is the final article of a five part series exploring unique and noteworthy trends in the mental health profession. The article discusses the rise of professional coaching/consulting and its overall impact in the world of behavioral health. The purpose for examining all of these trends is to note business opportunities and competitive influences within the marketplace.

The Rise of Professional Coaches & Consultants

In early 2007 I was speaking with a friend of mine who told me he attended a relationship workshop he found to be very informative and helpful for both he and his wife. Naturally, I assumed it was a psychologist, marriage and family therapist, professional counselor or clinical social worker facilitating the program. Since I was in the field and felt I had a good handle on the marketplace I assumed I would know the clinician. When I asked the person’s name I did not recognize it. I asked my friend if the person was a therapist and he nodded his head in acknowledgement. Since I did not know this person I looked her up and realized she was not a clinician but a relationship coach.

There are several points worth noting about this conversation with my friend. One is the fact that there are people in your community providing a variety of individual and group services who are not mental health professionals in the traditional sense. The second point is that many of the people offering these services are very good at what they do, the third is that they are business savvy, know how to market their services and how to speak to consumers, and finally there is the reality that most people outside of mental health are not aware of the distinction between a mental health clinician and a relationship coach. They see them as interchangeable, as one in the same. Let’s briefly take a look at these important points since they speak to a phenomenon that will have more and more of an effect on the mental health profession as a whole.

a. Coaches & Consultants

Coaching is growing at an international level and these professionals are involved in numerous areas that overlap with mental health services. Some of these areas include career counseling, relationship counseling, leadership counseling, life change consulting, business consulting and grief counseling. They have done an excellent job penetrating highly lucrative markets such as Fortune 500 companies, CEO level executives, Schools and high end communities. In the past there was a stigma associated with this profession, however, the stigma has lessened considerably and in many parts of the world it is virtually non-existent. In addition, many of these programs and service offerings are of very high quality. They are well researched, innovative and highly structured. I recently attended a workshop delivered by a life coach who worked with people going through significant life changes whether it be death of a loved one, life threatening illness, divorce, career change, unemployment or any number of other things. The program was well defined, unique and utilized both clinical and coaching principles. It was a very effective program!

b. Marketing & Sales Savvy

Adding to the dilemma for mental health practitioners is the fact that many coaches are experienced in all areas of business. They know how to uncover needs/opportunities and then design and market programs that will speak to potential consumers. In many ways they are ahead of the curve in terms of sales and marketing principles. They are also able to leverage technology to improve their reach and to expand their presence in the market. Another interesting aspect to life coaching is that they are very specific with regards to who their target audience is, and as a result, they craft their message accordingly. These are important lessons to be aware of as you move forward in your career. Being clear as to who you are offering services to will help you to use your time wisely when it comes to marketing and selling. The good news is that you can learn a lot researching some of these professionals and taking a look at what they do effectively and not so effectively. Some areas I recommend researching are how coaches uncover what the customer wants and how they sell and market those services. All of this should generate new and fresh ideas for you!

Want some good examples of what I am talking about when I refer to Life Coaches?

Take a look at Marie Forleo and her website: www.thegoodlife-inc.com. She is a well-known coach who has received much praise for her work. Take a moment to view the site and hear what she has to say on her audio clip. Once you read the upcoming chapters of this book you will notice that she has adopted many of the principles I propose you begin using as soon as possible! Also take note of what she proposes to offer people and how she goes about doing this. You may not agree with her proposal to “skyrocket your productivity” and/or “revitalize your relationships”, however, what you cannot argue is the fact that she has successfully hit upon the needs and wants of her specific target audience.

Another site that will give you an idea of the power and scope life coaches and consultants offer is www.simpleology.com. This is a concept offered by marketing expert, Mark Joyner. He would not necessarily consider himself a life coach, however, his Simpleology program is based on scientific and behavioral research and is designed to help people manage and make sense of their hectic lives. It proposes to offer solutions that will increase your productivity and peace of mind. In addition, he leverages the power of the Internet to reach a broad audience by offering a sophisticated learning platform complete with free modules and software tools designed to help you prioritize and manage daily tasks and goals. His program should give mental health professionals a much better picture as to the kinds of programs and service offerings behavioral healthcare practitioners can develop and promote.

This article marks the end of my series on trends in the industry. Thank you for your interest! I hope this exercise gives you food for thought along with some new ideas for you to explore.

Copyright 2008 – David Diana.

Women in the Military May Experience Behavioral Health Issues After Combat Exposure

Wars and battles take a toll on the entire nation – ravaged locales, diminished human capital, and complete mayhem all around. However, when a country gets embroiled in wars or combats, there is one group that is affected directly – that of soldiers.

Exposure to combat or deployment in war zones can severely impact the soldiers’ mental health. Even after the war is long over, the soldiers continue to feel the pangs of the rigor. Not just men, even women in the military are as much prone to experience the agony, says a recent study. Depression, anxiety, and melancholy are what they are left with.

The research revealed that combat exposure in military women is associated with an increased likelihood of mental health problems after deployment. These women are more likely to experience behavioral health problems, like post-traumatic stress disorder (PTSD), depression, and risk drinking.

Combat-exposed women in military have 20 times higher chance of PTSD

The 2016 study funded by the National Institute on Drug Abuse (NIDA) analyzed combat exposure scores of 42,397 army enlisted women who returned from Afghanistan and Iraq. Based on their self-reported experiences, these women were assigned combat exposure scores of 0, 1, 2, or 3+.

The researchers found that the active duty and National Guard/Reserve women with a combat exposure score of 3+ had 20 times higher chance of developing PTSD compared to women who did not have any exposure to combat zones.

Even a single exposure or deployment to war zones for a brief period can raise the chance of developing behavioral health problems (PTSD, depression, and at-risk drinking) in these women, the study said. “Our findings suggest that injuries, assaults, and combat exposures experienced by women during deployment may have an additive, negative effect on their post-deployment behavioral health,” said Dr. Rachel Sayko Adams, lead author of the Journal of Traumatic Stress study.

Dealing with symptoms

Adequate measures should be taken so that these foreseeable behavioral health issues can be handled and better care can be provided to these combat-exposed women in military. Not only women, even men should be covered under such programs.

“Ongoing force-wide screening for behavioral health problems should be coupled with development and evaluation of programs to improve the psychological wellbeing of the Armed Forces,” said Dr. Rachel.

Dealing with PTSD

Behavioral health issues like PTSD can be mostly dealt with psychotherapy, but medications can also be used depending on the need. In most cases, love and support from people around can make a huge difference. The sadness and melancholy after a traumatic experience can be dissipated only when shared and cared.

The war exposed men and women in military are the classic cases of PTSD. They struggle hard to gel into the social fiber after their return from combat zones. They are always on the verge of exploding at the slightest provocation. They are fragile from inside, appear numb and disconnected.

But love and compassion from close ones can act as a soothing balm to their petrified minds. Helping them find a counselor is the first step towards reinstating their disoriented mind, so that they can mingle happily with the rest and enjoy a sense of belonging.

Recovery roadmap

Getting immediate help is the foremost step in handling mental health problems like PTSD or anxiety. Delayed treatment can worsen symptoms and complicate treatment intervention.

Health Literacy Is for the Healthy

“Health Literacy” is the ability to read, understand and act upon health information. And, more than half of the American population is not proficient on this topic. Unfortunately, the above definition is the point after which most head into the wrong direction. Unless a significant misnomer, by definition, the focus of health literacy should be two-fold, enhancement of functional literacy (period) and increased attention to the issues of health.

The general public reads very little non-commercial, health-related materials, the content being very challenging. Additionally, people consume too much sugar, consume alcohol and excesses of red meats, processed grains, artificial chemical additives, too few and unvaried fruits and vegetables, and eat too much. Many also smoke, use recreational drugs, misuse prescription drugs, exercise too little and engage in other social and recreational activities that are harmful to them physically and psychologically. Much of that which I just described and many more contributors to poor personal and public health are legally accessible and even marketed to you. The question is, who is responsible for your health knowledge and healthy behaviors (health care) versus your medical status (medical care)?

Your mechanic recommends selecting quality fuels, lubricants, and other fluids, and changing them regularly. You should manage your tires’ pressure and watch tread wear. You check your brakes’ function and monitor all for all other signs of possible malfunction. And, although there are plenty of after-market and alternative products and services by which to care for your vehicles, no clear-thinking person deviates demonstrably from use/maintenance recommendations if expecting vehicles to perform well and last. Such is because motor vehicles are sold with maintenance recommendations and schedules that you read, developing your “automotive care literacy”.

The western medical professional community markedly fails to train its cadre well in subjects of prevention, health maintenance, and safe. high performance, physical fitness for the masses. This also includes failure to train them to care substantially about the health literacy of their clientele. Nationally, we spend a lot of money on a Center for Disease Control, Planned Parenthood [primarily STD/STI and services for sex-related diseases], and local public health agencies (focus upon epidemiology, primary medical care, local epidemics management). And, we wrangle politically over the role of government versus the private sector for the provision of all services, particularly those that are values-based. However, public health literacy (education) is a non-revenue generating activity and receives minimal attention.

While in the public many clamor for inalienable rights to comprehensive medical care, the general public doesn’t march for the rights to universal health literacy. Nor does it ask the government to require the market to be more responsible for promoting products, services and social behaviors consistent with universal health. Yet, we must not allow the government, nor the socially and financially empowered to suggest that speaking against “unhealthy” environments, foods, untoward products and behaviors (and effects of) is inappropriate, and thereby “politically incorrect” behavior, unless you want current vocal ideologies to drive health care and not literacy.

Wellness Coordinators: Approach Employee Health Holistically (You Can’t Afford Not To!)

There are multiple determinants to health. And you do want to address as many as you can through your work site wellness program, correct?

Essentially, in the workplace setting, employee health is determined as a function of individual practices, organizational practices and the greater community in which the organization resides. In order to approach employee health holistically then, the workplace wellness program must address these three levels.

Individual Health Determinants

Researchers estimate that the individual determinants of health account for up to an estimated 40% of how healthy an individual is. At the individual level, biology, genetics, age and gender all impact individual health. Researchers estimate that these physiological determinants of health account for approximately 10% of how healthy an individual is.

Researchers have also found that an individual’s experiences in childhood impact how healthy they are in adulthood. Experiencing trauma in childhood adversely influences how healthy they are in adulthood.

Individual lifestyle factors, personal health practices and coping skills also play a significant role in how healthy an individual is. Researchers estimate that these could account for up to 40% of how healthy an individual is.

The traditional approach to worksite wellness has typically focused on individual health and lifestyle factors and personal health practices in particular.

Organization Determinants of Health

Researchers have clearly established that a person’s health is also determined by social and economic factors, as well as individual factors. These are commonly classified as the social determinants of health. Research has estimated that the social determinants of health account for between 15 – 40% of how healthy the individual is.

Management practices in the workplace contribute significantly to employee health and wellbeing. Management practices can either contribute to or detract from employee health and wellbeing.

The work environment clearly influences and impacts the health and psychosocial wellbeing of employees. There is extensive evidence on the connection between the workplace and employee health and wellbeing. Many workplace conditions profoundly influence employee behavior, health and wellbeing.

If the workplace is unhealthy, why would we ever expect employees to be healthy? It is for this reason that effective, successful 21st century worksite wellness programs focus just as much on organizational health, as they do individual employee health.

Community Determinants of Health

Employees and employers do not exist in isolation. Both are influenced by the community in which they live, work, play and operate. Typical community determinants of health include the physical environment (air quality, water quality, sanitation, etc.), the social environment and the cultural environment. Included in the environment is access to healthcare and social services.

While healthy employees are good for an employer, healthy work places are good for the community. Being seen as a great place to work is good for the employer, but also good for the community. The more great places to work there are in the community, the healthier the community will be.

Through corporate social responsibility type initiatives, employers are also contributing to the health of the community.

Worksite wellness in the 21st century is more than just a focus on the health status of employees. Worksite wellness encompasses programming and interventions at the organizational and community levels as well.

Sensory Loss in Older Adults – Vision – Behavioral Approaches For Caregivers

As we age, our sensory systems gradually lose their sharpness. Because our brain requires a minimal amount of input to remain alert and functioning, sensory loss for older adults puts them at risk for sensory deprivation. Severe sensory impairments, such as in vision or hearing, may result in behavior similar to dementia and psychosis, such as increased disorientation and confusion. Added restrictions, such as confinement to bed or a Geri-chair, increases this risk. With nothing to show the passage of time, or changes in the environment, the sensory deprived person may resort to repetitive problem behaviors (calling out, chanting, rhythmic pounding/rocking) as an attempt to reduce the sense of deprivation and to create internal stimulation/sensations.

This article is the first in a series of three articles that discuss the prominent sensory changes that accompany aging, and considers the necessary behavioral adjustments or accommodations that should be made by professional, paraprofessional, and family caregivers who interact with older adults. Though the medical conditions are not reviewed in depth, the purpose of this article is to introduce many of the behavioral health insights, principles, and approaches that should influence our caregiving roles. This article addresses age-related visual changes.

CHANGES IN VISION THAT ACCOMPANY AGING

A. The changes in vision that accompany aging include:

1. A loss of elasticity of the lens; this means the person is no longer able to focus or accommodate to changes in lighting conditions. (Starting in our 40’s, glasses are needed to see fine print). It also means the older person cannot adjust to sudden changes in lighting, resulting in an uneasiness when leaving a bright room to enter a dark hallway, or finding seats in the dark in recreation rooms, or theater. Going in the reverse direction can be equally difficult: from a dark room to a bright area.

2. Decreased pupil size; the light reaching the retina is reduced, requiring more light to see. This results in the need for lighting 3x to 4x what younger people need to see clearly

3. A loss of transparency; with age, there is a yellowing of the lens in the eyes, making color discrimination more difficult, especially blue and green. Warmer colors, such as reds and yellows are perceived best, explaining why bright colors are preferred.

4. More susceptibility to glare, and longer time is needed to recover from the effects of glare;

5. Eye diseases and disorders, such as cataracts causing a clouding of the lens; glaucoma, resulting from increased pressure of fluids in the eye, damaging the optic nerve and impairing vision. Glaucoma, the number one cause of blindness in U.S., in advanced stages results in yellow halos around images. Macular degeneration may occur, where vision is distorted, and images appear different sizes or different shapes, and are missing a central element. Visual disorders may be secondary to stroke, in which the eye can see the image but the brain cannot interpret the images. Diabetes may result in disrupted blood flow to the retina, causing diabetic retinopathy and a loss of vision, and blindness, in extreme cases.

B. What are the effects of visual loss on the older adult?

1. An increased dependency on others;

2. A sharply reduced quality of life (changes in activities in daily living and instrumental activities of daily living, reduced connection with outside world);

3. And, a fearfulness and reduced tendency to venture outside.

C. What are the effects of vision changes on demented elderly?

1. With the losses in visual acuity, other problems in cognitive functioning are heightened, such as difficulty processing unfamiliar faces and settings;

2. Because the person with dementia already has difficulty learning new behaviors, he or she is less able to learn new habits to compensate for the visual losses (e.g., learning to use visual aids to identify articles of clothing or other possessions;

3. There is likely to be an increased disorientation and confusion, as the search for structure and external cues is strained.

PRINCIPLES FOR CAREGIVERS

The following principles apply to caregiving approaches with older adults who have diminished sensory function. Increased sensitivity and insight to the needs of these individuals improves their quality of life and improves our effectiveness:

1. Observe the behavior of the person, and look for cues and signs of pain or discomfort;

2. Help the person work through the emotional impact of the sensory changes, allowing expression, acceptance, and support of the grief and sadness accompanying these losses;

3. Do not try to fix the unpleasantness; acceptance and support goes a longer way toward healing than a quick fix or a patronizing attitude;

4. Reduce excess disability by maximizing whatever functioning is still left, such as proper eyeglass prescriptions, or functioning hearing aids;

5. Consider assistive devices (phone amplifiers, large text books, headphones, and the Braille Institute for a variety of useful visual aids).

Approaches for impairments in vision:

1. Address the person before you touch him or her, identify yourself, let him or her know when you are leaving, speak normally, and do not shout;

2. Describe his or her surroundings to help orient and familiarize the person to the environment, tell him or her location of belongings, and if things have been moved;

3. Use as much contrast as possible, e.g., red objects on white background is better than black on a gray background, or blue on green background, (consider switch plates on walls, toothbrushes, combs);

4. Avoid moving quickly from a bright room to a darkened room, or v.v. Make sure the visually-impaired person takes the time for the pupils to adapt to the changes in lighting;

5. Introduce yourself every time you come into contact with the person, and explain what you are going to do because there are no visual cues;

6. Help to identify others in their environment with colored clothing, name tags with large print, etc.

7. Clean eyeglasses regularly, provide adequate lighting, and avoid glare;

8. Provide night lights, and arrange furnishings in the environment for safety and ease of mobility.

Even with normal aging, functioning of our five senses is not like it was when we were younger adults. This article offers caregivers who work with visually-impaired older adults some insights into the special needs and adjustments that will turn unpleasant, frustrating situations into more caring, helpful, and sensitive interactions. By integrating these behavioral approaches in the delivery of the health care with older adults, we can favorably impact the management of these conditions.

Copyright 2008 Concept Healthcare, LLC