“AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

greenspun.com : LUSENET : Module Ten : One Thread

EXAMPLE

Julie, you are very disappointed that professionals like myself and my colleagues could be so prejudiced that we miss out on understanding you as a person who is distressed.

-- Alex Chew (achewoct97@hotmail.com), May 14, 2001.

In choosing to use her name, my intention was to personalised our interaction and close the gap between 'them' ‘they’ (the nurses, doctors etc) and ‘people like me’ Julie. She seems to experience this as not being understood. This is also in line with the 'therapeutic use of self'. In reflecting her emotional experience of disappointment and at the same time without avoiding the negative perception that she has of the 'professionals' inclusive of myself, I was using immediacy ‘I – You’ dialogue in acknowledging and therefore accepting her feelings and her right to have them without having to defend, explain or justify myself or avoid including my ‘self’ in it. It could be further developed by seeking clarification e.g. Is that how you feel when you think of someone like me as the nurse, Julie? Or use of echoing e.g. … people who have disrupted and ruined your life? moving the exploration forward. Advanced empathy also be attempted rather than leaving it as just ‘distressed’ with further reflections of her deeper feelings e.g. …and it angers you too Julie, that the pain inflicted onto you by those responsible has been easily dismiss as distortions of your perception rather than the reality of your experience.

-- Anonymous, May 28, 2001

Answers

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

It must be awful for you to feel angry, fearful and depressed because you cannot find a deep appreciation and empathy for past and present experiences. And worse still when people are dismissive of the pain and hurt you have encountered making you feel as though You and your perception of things has ruined your life. How would you describe your pain and hurt Julie?

-- Janice Pedersen (jpedeoct98@hotmail.com), May 14, 2001.

To begin with I did not use Julies' name this was a mistake as it would have personailsed our interaction. However, in order to understand her thoughts, attitudes and behaviours I did endeavour to discover how she felt. Because of the very personal nature of feelings 'reflecting' is essentail in order to achieve mutual understanding of the expressed feelings.Reflecting allowed me and the client to choose a mutually acceptable 'feeling term' that best conveyed the emotion felt at the time. Angry and fearful are strong feeling words and when I reflected them back to Julie during exploratory responding this showed that I had been actively listening. These responses are extremely important, particulary in the initial stages of a relationship, for it is the nurse's ability to empathize with the client that facilitates the building of trust and confidence, establishing a sound foundation for counselling. I then moved on to advanced empathy in the second part of my reponse with reflections of her deeper feelings e.g ' and worse still when people are dismissive of the pain and hurt you have encountered making you feel as though you and your perceptions of things has ruined your life'. I finished my response by probing and questioning which is the technique of a 'novice' however, I managed to stay with her feelings and kept the question open.

-- Anonymous, May 29, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Alex, If you say to Julie that '...understanding you as a person who is distressed', that means you see her distressed. Julie can see herself distressed from your eyes. Your answer makes her realize herself distressed. Do you think her self-esteem will be affected?

-- Anonymous, November 05, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Alex, Are you suggesting that Julie is denying her own feelings of disappointent in herslf as a professional (lack of self-esteem)?. Therefore, rationalising her own behaviour by projecting her feelings of disappointment onto professionals whom she once positively indentified with in her capacity as a nurse?

-- Anonymous, November 05, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Alex, i think your analysis is very good on the therapeutic use of self, but don't you think by actually saying that "you are very disappointed" is more of a confirmed fact that Julie is disappointed, and does this not leave room for Julie to turn around and say how do you know that i am disappointed? secondly the use of "professionals like myself", i feel is more of becoming defensive in drawing that dermacation line to make Julie aware that you are a nurse (professional) and she is a patient, which could hinder the therapeutic use of self. lastly, i feel that by saying to julie, "you as a person in distress" she could view this as another nurse analysing what she is saying and putting into a "neat box" called distress. i look forward to hearing from you alex.

-- Anonymous, November 07, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Nina, I understand it is very hard to you. It's part of your illness.It is nothing to do with silly or funny. Maybe you need some help to cut down your rituals, not to stop at the moment.

-- weidong wei (wweiapr99@hotmail.com), November 05, 2001.

I tried to show my understanding to Nina, also I identified that was her illness. The reason why I identified that is because I wanted her to know she might need help. And she need to think about it to do something about it consciouly. Maybe she feel hurt in short term, but in lon term she can help herself and get help from services as soon as possible. I belive the rapport should build on the trust, honesty, empathy and understanding.

-- Anonymous, November 08, 2001



Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

julie, you are sad and feel that nurses like us could be so inconsiderable to your caring.

-- Anonymous, November 09, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Julie, i understand that you are angry and do not appreciate having being diagnosed with BPD, you have a right to be. you feel that there is lack of empathy and this makes you distrustful of people. Julie when you refer to people, does that refer to me? (silence). Julie, i understand that you feel hurt by being labelled attention seeking and you now feel the problem is you and the way you perceive things. if the situation was different julie and staff appreciated and did not always question you perceptions, how would it make you life better?

-- Anonymous, November 11, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Julie, i understand that you feel hurt by being labelled attention seeking and you now feel the problem is you and the way you perceive things. if the situation was different julie and staff appreciated and did not always question you perceptions, how would it make you life better?

From the above response to Julie, i use Julie's name to personalise the conversation and by stating that i understand how she feels, i am trying to foster an environment where she feels she is comfortable to discuss her frustrations.i paraphrase what julie is saying to get her to hear what she has said and seek clarification on who 'people' refer to. this is trying to focus julie on the here and now. julie is generalising by saying 'people' and by posing a closed questions, this will clarify who people refers to. i use the silence period to facilitate digestion of what has been said. i use julie's name to show that i am still focused on her and ask her an open question. this is more to try to change the way Julie views the situation. By asking her if situations were different, how would this make it better for julie, i will be able to explore areas that are bothering here here and now. this approach might not work as Julie could say that, well situations are not different but its worth a try. GUS.

-- Anonymous, November 11, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

---------------------------------------------------------------------- ----------

It seems to me that you feel that peolpe on the ward misunderstand you and instead of helping you they give you labels and and then insist that everything you do is indicative of the label they give you. I can understnd that you feel distressed about this situation and that it does not dispell your feeling of self doubt. What I suggest is that I inform my colleagues that their labelling distresses you and hopefully you would feel more at ease when interacting with them or myself . Do you feel that this may be a positive step ?

In choosing this response my aim was to firstly to paraphrase what she is saying to establish if I have got the intended meaning behind what she said.After I established this then I would want to show may empathy for her and at the same time my acknowledgement of her statement that the labelling does not eradicate her feelings of self doubt.My advice serves two purposes: to assure her that her sentiments will not be ignored but that the relevent people will be told of the effects of labelling her and hopefully desist from the practice.secondly the advice was also to show that I was taking her seriously and that hopefully she should feel comfortable and at ease to engage with me on other matters. The final part of the interaction draws upon the principles of partnership in a therapeutic relationship and also principles of user involvement and empowerment. My aim was agian two fold : to ensure that she is actively involved and a partner in her care and to egage further with her from more of a probing and questioning stance to assertain if there were more issues to be dealt with.

-- Anonymous, November 12, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

(....remain quiet for a while to show that I am have given sometime to take in what he has said.) I have to admit that I am really out of words and am trying to think of something clever at this time but I cannot. I don't know what to say mate.... whether to say to you its alright to cry, cos you might believe strongly against it or to say it will be alright, cos I don't know to what extent this has affected you. All the same I would like to commend you for sharing this information with me.

( at this time I pause for a while to give the impression that I am trying to digest what Ismir has said to me.)

Do you want to elaborate further on why you feel ashamed and scared?

-- Simbarashe V. M. Kashiri. (skashapr99@hotmail.com), November 06, 2001.

I tried to enact this scenario taking into consideration the pressures one will be under after recieving such information from a client. I used silence therapeutically to show the client that indeed I was giving some thought to what he had said and simultaneously emphasising the severity of the issue he had brought forward. I then made it clear to him that I wasn't going to give him clear cut answers like " it's O.K. to cry.." because I felt that would be imposing my own beliefs on him. I also highlighted to him my vulnerability as a mental health nurse in saying I didn't know how to respond to him. I also made it clear that I most certainly couldn't sympathise with him but at this time only empathise as nothing that has ever happened in my life can equal what has happened to him. This I did to show that we will have to work together, taking into consideration our beliefs and how they would affect our way of thinking. This in its self was the first step in building a therapeutic relationship with Ismir as the underlying problems are around more severe than whats said in a statement.

-- Anonymous, November 12, 2001



Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Julie, i recognise and appreciate your assertiveness towards contibuting to your care package and the expression of your desire to be heard, and that is good on your part. my aim is to incorpate into your care plan, as much as possible, your views on how best we can improve the current situation. in order to achieve this i will ask you to tell me what recent events have triggered these feelings you have towards the staff and how you have dealt with the situations.

-- Shepherd Pamhidzayi Masango (smasaapr99@hotmail.com), November 06, 2001.

Referring to julie by name personalizes the interactions and it allows me to use myself therapeutically throughout the process. i have chosen Egan's skilled helper model as the therapeutic use of self and adopted the style of a facilitator. my questioning indentifies with the first stage of the model, that is, hearing the client story,(whats going on),indentification of blind spots (whats really going on) then leverage (focusing/prioritising). in my response i have prompted julie to further describe any recent events and feelings that have contributed to the overall impression of the team, this helps her to tell her story. i have complimented her on her assertiveness to reiterate the fact that i am a competent listener who is not just out to point the negative and this empathic reflection helps her to uncover blind spots or gaps in her perceptions and assessment of the situation. my intension is to then prioritise or focus on the area that she might have energy to move forward on they by move her from stuckness to hope, from her response.

-- Anonymous, November 12, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Percy,

Good advise mate but shoudn't this be part of ICT 2. Peace and love man.Peace and love.

-- Anonymous, November 12, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Percy..i am in uttermost bewilderment and awe of your analysis. the guidelines of ict 3 clearly state that you provide insightful analysis of YOUR RESPONSE .......... maybe iam wrong i dont know.. (pause for a while then shake my head)

-- Anonymous, November 12, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Julie, you must be feeling really bad at the moment and it is not easy being in hospital and having a mental health diagnosis, But it is not your fault that you have an illness and we the nurses are here to help you to accept the illness and to learn to leave with it and possibly find a way to defeat the illness. we are here for you to talk to and I persinally will be willing to spend time with you if you need to talk to someone.

-- Rumbidzai Musodza (rmusoapr99@hotmail.com), November 05, 2001.

---------------------------------------------------------------------- ---------- I responded in this way because iI was trying to act in a therapeutic manner in advising Julie that she could talk to the nurses and that i was willing to spend time with her. I thought i was being empathetic as well in relating to what Julie was saying as well as containing Julie's anxiety about being in hospital.

-- Anonymous, November 12, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Ismir, I don't believe that a man should be ashamed of crying. If it is something that makes you feel better that is what is important. I have myself felt quite relieved after crying sometimes. It usually happens when I am overwhelved. I do think in your case may be you need to cry to relieve yourself of your anxiety and of your fear may be?

-- miniora schmitz (mschmapr99@hotmail.com), November 05, 2001.

With Ismir I used myself as an example, as how relieved I feel sometimes after crying. I wanted to make Ismir understand that it was OK to cry. Human beings are allowed to cry when they can use it as a way to relieve themselves of their grief and sadness. I was trying to get through to him that he is like any of us and it was not a shame to cry. I was trying to reassure and support Ismir in what I said to him.

-- Anonymous, November 12, 2001



Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

It is very normal for people to judge when they do not understand,from my understanding it seems you want to stop these rituals and i suggest that you pay attention towards getting yourself well than focus on other people who will never understand even if you explain.You are not well at the moment hence i would not say you are acting silly because this is beyond your control , i wish you could start looking at it that way.

-- catherine dimbi (dimbi2@hotmail.com), November 06, 2001.

In this reply I used the reassuring and supporting technique and this approach normally shows sympathy and reduces the intensity of a client's feelings.The reply also carries in it some advice ,i.e I told her to focus on her illnes than to concetrate on people judging her because they always will even if she gets well.According to Egan's model of helping where we have ;the current scenario ;prefered scenario and the action, I have advised Nina to move away from her current scenario and focus on where she wants to be i.e prefered scenario which is getting better ,but that can only be achieved if she concetrates on improving her situation.

-- Anonymous, November 12, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Don't feel put down when people laugh because these are ignorant people people who know nothing about your problem.Have you tried other ways to stop the nagging pain that makes you perform your rituals?

-- Thandiwe Matambanadzo (capricon22@hotmail.com), November 06, 2001.

---------------------------------------------------------------------- ----------I used this response because it seemed Nina was really affected by the way people react towards her when she is doing her rituals. To me she appeared distressed and naturally I was trying to reassure her by telling her to ingnore these people. But from the respone she gave me it appears she misunderstood me or the way I came across was agressive. What I was actually trying to say is that Nina should not focus on what these people are doing as they are unaware of her problem as this is what I myself would do in this situation. By doing this I was trying to acknowledge and accept her feelings but in the end,it seemed as being dismissve and not empathetic. When I asked what methods she tried to stop her rituals I was probing for Nina to clarify which methods she had tried and why these didn't work and perharps look at other alternatives she had not tried.By doing this it would guide my discussion with Nina along lines of methods used to help her and other alternatives.

-- Anonymous, November 12, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

hie Ismir. there is no reason for you to be ashamed, crying is a natural human response. I believe its a way of expressing how you feel at that particular time. What made you cry? was it the whole experience or was it the fact that you couldn't say anything?

-- heather shambare (hshamapr99@hotmail.com), November 06, 2001.

in using his name i was trying to personalise the conversation. In my response i am trying to relay to the client that crying does not make him anyless of a man. i am trying to show him that i empathise with him and that crying is a natural human response which we all share. my two questions in the latter part of the interaction are from a probing and questioning perspective. They are open ended and serve two purposes to ensure that Ishmir continues to engage at the same time making sure that he is not cornered but has the option to answer either one of the two questions - thus ensuring continuious dialogue.

-- Anonymous, November 12, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

to those learned students who are questioning alex's response may i suggest you actually get to grips with the concepts that are in the exercise we are undertaking. with no disrespect intended, i hardly think your two weeks of module ten makes you experts who can critique another persons rationale for their choice of response..... just food for thought!!

-- Anonymous, November 12, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

In my response to Julie, I said Julie if I understand you correctly...My intention was to personalise the context of conversation and draw julie's attention in this rspect it was to express my concern about what she was going through. Secondly I said Are you saying your past expriencescould have led you to delop this doubt about the nurse... Although the intention of this statement was to paraphrase and reflect on Julies statement it was very selective didnot reflect on all the inportant aspects of julies concerns about her feelings.

Lastly how has this expience influenced your perception of nurses who are trying to help you. despite the fact that this statement had an intention of questioning and probing it generalised all what julie had said into experiences there didnot funnel down the particular aspects that i had wanted to persue further.

-- Anonymous, November 13, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

hi,julie,i understand how you are feeling,especially, the part of being labelled attention-seeking;we all want to be listened to when we are feeling down.i would like to hear more about what you have been through.

-- sarah makotore (smakaapr99@hotmail.com), November 06, 2001.

---------------------------------------------------------------------- ---------- in my reponse,i was trying to get julie to talk freely about her problem so that i could get a clearer picture of what is going on--in this way i was hoping that she would feel that i was very keen to know more so that i could help her more meanigfully.

-- Anonymous, November 13, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Hi Julie, i can see you are frustrated of being labelled an attention seeker. Also being diagnosed with BPD has left you feeling very angry and let down by everyone around you, you have the right to feel this way. Julie as your key nurse i am here to help you get over this traumatic experience and you are welcome to ventilate your feelings and thoughts to me perharps things will start to improve.

-- suna smythe (ssmytapr99@hotmail.com), November 06, 2001.

I delibrately addressed Julie by her name, because i want to familiarise myself with her. As Julie is feeling very let down by everyone surrounding her, i think i can empathise with her innermost thoughs. I am also implying to Julie, that i am available at anytime if she wants to talk, inorder for us both to build a partnership within a therapeutic relationship and also to apply the principles of users-involvement and empowerment.Julie i hope you are aware that it is your right to have an advocate on your behalf if you feel you need some one neutral to ventilate your anger to.

-- Anonymous, November 14, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Hi Ismir! your experience has touched me, it made me begin to search my 'inner self' for unanswered questions. Congratulations! i am pleased you cried your pain out, did you feel better after you have cried?. Donot be ashamed of yourself it is our culture to feel the way you did.

-- suna smythe (ssmytapr99@hotmail.com), November 06, 2001

Hi Ismir! your experience has touched me, it made me begin to search my 'inner self' for unanswered questions. Congratulations! i am pleased you cried your pain out, did you feel better after you have cried?. Donot be ashamed of yourself it is our culture to feel the way you did.

-- suna smythe (ssmytapr99@hotmail.com), November 06, 2001

With Ismir i can begin to see the concept of counter-transference between us, this is why i said his experience made me want to search my innerself. I am saying to Ismir, he should feel free to cry because it helps rather than bottling things up. I also congratulate him because i cry a lot when am feeling low and it is human to cry. Ismir donot be hard on yourself you have a culture keep to it.

-- Anonymous, November 14, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

crying can be a very powerful way of ventilating your feelings ,you do not have to feel ashamed at all, anyone in your shoes might do the same.

-- veronika chagonda (vchagsapr99@hotmail.com), November 12, 2001.

i choose to respond to ismir in this way because for me it would be the most human thing to respond to anyone if they come to you with such a concern.i felt that ismir needed reassuarence about his fears of being ashamed.this response to him i feel that it showed congruence, which is showing genuine concern to somebody`s problems .interacting in this way i felt it would have the impact on ismir of wanting to continue in conversation with me as i am showing great interest hence both parties might benefit from such.

---------------------------------------------------------------------- ----------

-- Anonymous, November 14, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

I choose to use Julie's name to personalise my interaction with her. This I felt was necessary to begin establishing a therapeutic relationship that we both could work on. I did paraphase Julie and asked her if I had understood her correctly but I'm yet to get her reply.

-- Anonymous, November 15, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

I used Julie's name to draw her attention to the fact that I was touched by her perdicament. As an exixtential therapist, my intention was not to prescribe a cure or even to try to explain the problem using any framework. I am only interested in exploring and clarifing so that she will understand the paradoxes of life and come to term with her situation.

-- Anonymous, November 16, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Julie, Iunderstand your disappointment that professionals cannot understand your distress.It is sad.

-- Anonymous, November 16, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

hi, Ismir, Why should you be ashamed of crying. Crying is an important factor which help to express fear, excitement, anxiety, anger, etc. It is a natural human response.

As a result of PTSD, it is important that you don't suppress your emotions and you should share your feelings e.g crying, laughing, etc. Your feeling should be keep to yourself.

-- Anonymous, November 16, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

hi, Ismir, Please don't feel ashamed of crying. Crying is an important factor which help to express fear, excitement, anxiety, anger, etc. It is a natural human response.

As a result of PTSD, it is important that you don't suppress your emotions and you should share your feelings e.g crying, laughing, etc. Your feeling should be keep to yourself.

-- Anonymous, November 16, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

hi Ismir, i am sorry to say that 'your feelings should be kept to yourself' instead your feelings of crying, laughing, etc, should not be kept to yourself.

-- Anonymous, November 16, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

hi Ismir, i am sorry to say that 'your feelings should be kept to yourself' instead your feelings of crying, laughing, etc, should not be kept to yourself.

-- Anonymous, November 16, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Julie, you feel people are not appreciative of your perception and that you are not happy about their attitude towards you. [fbrobapr99@HOTMAIL.COM]

I intentionally mentioned her name to narrow the therapeutic space between me and her. She appears disillusion regarding others view on her.hence, I intended to be empathetic to her emotion through the use of reflective skills.I should haved explore and expand the issues further.

-- Anonymous, November 16, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Ismair, I believe you must have felt distress about the incidence.This reminds me of a friend who cheated on me,I was really upset but with time and help from others I managed to cope wiht it. I believe you too can overcome your problem as you are in the right place for assessment and help[fbrobapr99@HOTMAIL.COM].

I mentioned his name with the intention of familiarise our self.I Paraphrased his feeling with the intention of communicating understanding and empathy to him. The rationale behind that was to encourage him to talk freely and own his feelings.I used self disclosure skills with intention of reassuring him

-- Anonymous, November 16, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Julie, I appreciate your worries and concern not only about your diagnosis but also about people arround you who are supposed to be appreciative of what you have been through. You however sound resentful and I can tell you, peoples feeling towards you are not exactly as you described it, we are very much concerned too and we are all here to help in what ever way we can. So please feel free to approach any member of staff to discus your concern. I am sure they will be more than willing to help.

By acknoledge and validating Julie's worries I was trying to ease her pain At the same time hammering home the fact that those feelings are not particularly or necessarily true, as well as reassuring her, by saying staff are also concerned about her and we are here to help She was also encouraged to come foreward to ventilate her feelings.

-- adesoji kolawole (skolaapr99@hotmail.com), November 06, 2001.

-- Anonymous, November 19, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

yea, i also adressed julie by her name because i felt that in that respect, it would help me to have a more personal interaction and allow me to familiarise myself with her.I tried to reassure her by adopting an unconditional +regards towards her feelings about the other staffs.However, at the same time, i also tried to change her automatic negative thoughts, that she probably might have, into a more positive way.

-- Anonymous, November 20, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

l feel that by using her name you managed to use the "therapeutic use of self"

-- Anonymous, November 20, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

In choosing to use her name, my aim was to enable Julie to feel at ease with me so as to enable myself to get clear picture of what is going on with with as she expressed that she is not being understood.

-- Anonymous, November 20, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Julie, you are very disappointed that professionals like myself and my colleagues could be so prejudiced that we miss out on understanding you as a person who is distressed.

-- Alex Chew (achewoct97@hotmail.com), May 14, 2001.

I feel by focussing on Julie by name this enables the development of a therapeutic relationship between Julie and the nurse that foster trust and empathy.This initial stage (Therapeutic self) must be established before any challenging of Julie's beliefs can be attempted. She is currently very suspicious of professionals and the need to explore where these beliefs are founded is crucial to her trusting again and necessary to her healing. The lost of her friend who was 'more than a friend'needs to be explored. I feel Julie feels angry with grief, rejected and alone at the loss of her friend and and this sense of loss seems to be a reoccurring feature in her life. Lifeline events. She has lost her innocence in her childhood. (Who abused her?) her ability to perform(possible weight gain), her self esteem, her image, her identity, her inablity to work (stressed by her job), her independence,her therapist and finally herlover . All these 'losses' have been projected into her dissapointment of the professions that she once recognised as good, but now recognise her as bad. Now she is in denial and need their help and support.Her negative feelings from her childhood need to be dismantled piece by piece(Freudian Theory),identified and addressed accordingly. Julie needs to feel she belongs as outlined in Maslows Hierachy of Needs (1970)as her conscious self is at odds with her unconscious self.

-- Anonymous, November 20, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Dear Julie, Childhood plays an important role in a persons life.There are therapies that can help you coping with these problems ,CBT would be effective for you.

-- Meghnavaswani (avaswapr99@hotmail.com), November 16, 2001.

---------------------------------------------------------------------- ---------- The use of Julie's name was important. However, I felt that this comment avoided any responsibility for the nurse by prescribing a therapy the nurse thought would be appropriate.

-- Anonymous, November 21, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Dear Julie'

By choosing to use her name Itried to persolised as"therapeutic use of self.I encouraged her to be more assertive in future so she will gain more confidence in her outlook.

-- Anonymous, November 21, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

A person's name to them is the sweetest and most important sound that can be expressed in any language.Personalising the interaction is definiely a plus to enhance the therapeutic interaction.This is a typical example of the therapeutic use of the self

-- Anonymous, November 21, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Julie, I can see that you feel let down by professionals by the way they have labelled you "attention seeker" and you feel let down by everyone around you.

By calling Julie by her name, I am trying to make this conversation personal and make her feel at ease around me to be able to bring out all her emotions. In line with therapeutic use of self, I am trying to develop a sesne of self-integration to be able to work effectively with her. I need to have insight of my ownself so that I will not be threatened by Julie's expression of "real self".

-- Anonymous, November 21, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments” hi,julie,i understand how you are feeling,especially, the part of being labelled attention-seeking;we all want to be listened to when we are feeling down.i would like to hear more about what you have been through. -- sarah makotore (smakaapr99@hotmail.com), November 06, 2001.

---------------------------------------------------------------------- ---------- in my reponse,i was trying to get julie to talk freely about her problem so that i could get a clearer picture of what is going on--in this way i was hoping that she would feel that i was very keen to know more so that i could help her more meanigfully.

-- sarah makotore (smakaapr99@hotmail.com), November 13, 2001.

-- Anonymous, November 22, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

In paraphrasing, the idea was to gain more understanding of what she really meant. When that is established, then I would know how to engage with Julie i.e. showing her empathy, without being judgemental, being attentive and the use of validation skills (therapeutic use of self). And when I said to Julie I would be there when she wanted to talk is because I wanted her to know that she should not feel any pressure to talk to me when she is not ready (empowering her - giving her a choice so that she would not feel Iam using my authority as a nurse). Remember, this relationship is a partnership.

-- Anonymous, November 23, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

In my interaction with Julie, I was trying to demonstrate understanding for her feelings, and also when I used the phrase we will find a way for you to help yourself I was trying to give her some kind of empowerment, including herself in the care.

-- Anonymous, November 23, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Hi, Julie, it's Mary. I understand your feelings of anger and I also appreciated the point you make when said people like you are already full of self doubt and also being labelled as attention seeking is not good at all . Julie, I would like to continue to interact with you more and I am sure that working together we will be able to find a way for you to help yourself and feel valued. God Bless Mary

-- Mary Meneghetti (mmeneapr99@hotmail.com), November 08, 2001.

---------------------------------------------------------------------- ---------- This is related to my previous response to Julie.

-- Anonymous, November 23, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

In assisting Julie i tried not to be an outsider but someone who is there to help and is also available and non judgemental.I presented to Julie that this was our problem and we were in it together.

-- Anonymous, November 23, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Hi julie i know you are depressed because you are been diagnosed with BPD, as your key Nurse i am here to work and suppot you as long as you are ready to engage with me

-- foley adebayo cole (fadeapr99@hot.mail.com), November 08, 2001.

I want you to engega me so that we can both bulid a good relationship and iwant you to know that you are not alone i am here to listing to you.

-- Anonymous, November 23, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

By reassuring 'Ismir' that it is only human to cry and it certainly will not make him less of a man I tried to sympathise with him using a therapeutic approach to interact.

-- Anonymous, November 23, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

By reassuring'Ismir'that it is only human to cry and it certainly will not make him less of a man I tried to sympathise with him using a therapeutic approach to interact.

-- Anonymous, November 23, 2001

Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Julie darling, I really understand how you feel about your diagnosis (BPD). I can see you do not trust and have faith in people around you, but as your named nurse, I want to reassure you that we as individuals have different attitudes and attributes.

Julie, I do trust you. Please give me a chance to build a very good relationship with you and from there, you can know if the perception you hold about people in general applies to every individual.

-- Anonymous, November 23, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

HI ishmir I am going to be your key nurse i understand your feeling dont be ashamed as some men do cry in some circumstances. I am ready to work with you as long as you are ready to engega with me.

Ishmir i think your culture allowed men to cry in some situation dont be affriad and ashamed stay off the boys and dont get yourself in promble.

-- Anonymous, November 23, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

what do you think would happen if you didn't respond to these thoughts? I know its not easy, but you need to focus less on how others react, and more on your own methods on responding more effectively to your problems. You shouldn't berate yourself, instead we will work with you to find more effective ways of coping.

-- hazel ryan (hryanapr99@hotmail.com), November 08, 2001.

An open question was used to elicit a more thoughtful response from the client. I have shown an empathetic understanding to the clients situation which I hope will encourage the development of a therapeutic relationship. I have tried to centralise my response, focussing on the client themselves. Nevertheless I feel that I tended to advise my client more than I attempted to facilitate a more thoughtful response on the clients part.

-- Anonymous, November 23, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Hi, Julie, it's Mary. I understand your feelings of anger and I also appreciated the point you make when said people like you are already full of self doubt and also being labelled as attention seeking is not good at all . Julie, I would like to continue to interact with you more and I am sure that working together we will be able to find a way for you to help yourself and feel valued. God Bless Mary

In my interaction with Julie, I was trying to demonstrate understanding for her feelings, and also when I used the phrase we will find a way for you to help yourself I was trying to give her some kind of empowerment, including herself in the care.

-------------------------------------------------------

-- Anonymous, December 14, 2001


Response to “AN ANALSIS OF THE INTENTION, RATIONALE AND SKILLS UTILISED – Click here to post your comments”

Ismir your traumatic experience has touched me. l had a traumatic experience in my childhood which l never acknowledge or cried over because l felt ashamed. l blamed only myself saying l should have known better, but do you know what, after l cried over the whole incident l felt relieved l began to see the incident in different light that made me realise that it was not my fault and l have never been ashamed since.

-- mongameli (mmafuapr99@hotmail.com), November 05, 2001. in this reponse l choose the wounded healer approach. l felt that l need to make Ismir realise that there was something common that we shared in this case our experiences.Ismir l believe had tended to feel no sense of connection with other people and him being in foreign country with different language and culture, l thought that using this approach would make Ismir realise that inspite of these difference we all hurt and that there are things we blame ourselves for which are not really our fault.

-- Anonymous, February 09, 2002


Moderation questions? read the FAQ