communication for health professionals

 

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communication for health professionals

SCENARIO 1/2
You are a counsellor and you have recently started seeing a client, Katherine, who was
referred to you from a medical GP in the area. The client, Katherine is a 25 year old
Indigenous woman, single with no children. Katherine has always considered herself a
slightly nervous person who seems to scare easily. Last year, one of Katherine’s friends
experienced a fire in their kitchen, and Katherine has spent a lot of time recently listening to
her friend’s experience. About a month ago, Katherine arrived at her fiancé’s apartment
while he was cooking a special dinner. The entire time at her fiancé’s place, Katherine was
afraid that something would catch fire on the stove. After he finished cooking, Katherine
delayed the start of dinner while she rigorously cleaned the stove and made sure that all the
burners were turned off. Throughout dinner, she was distracted by the stove and was
constantly looking at it, to the point of completely ignoring her fiancé. After a short
argument, she left halfway through dinner and went home. After they made up, she again
went over to her fiancé’s apartment, only to find that he had placed a sheet over the stove
so that she “wouldn’t be distracted by it”. Upon seeing this, Katherine became hysterical
and started screaming about fire. She ran into the kitchen, ripped the sheet away, and
began checking the knobs and burners to make sure they were turned off. When her fiancé
attempted to calm her down, she pushed him to the floor and kept yelling. Eventually, he
kicked her out and threatened to call the police. Afterwards, her fiancé told her friends what
happened, and they have been wary of Katherine and avoiding her ever since.
Whenever Katherine sees a stove, she immediately imagines flames bursting out of it,
setting the kitchen ablaze. She becomes preoccupied with thoughts of fire and has great
difficulty shifting her attention. In response, she has developed a few rituals to calm herself
down. Often, she will turn the burners on all the way and slowly count backward from 10 as
she turns each one off. If it doesn’t turn off right as she reaches zero, she repeats the
process. Furthermore, the knobs on the stove must be absolutely clean, as Katherine is
convinced that drips and residue can interfere with turning the stove completely off. It’s not
unusual for Katherine to call in sick to work and spend hours cleaning and checking the stove.
Last year, she used all of her sick days by mid-August. To get extra sick days, Katherine
recently went to her local General Practitioner (she does not have a regular GP). Her General
Practitioner thought Katherine might also benefit from speaking to a counsellor, and
referred Katherine to you.
SCENARIO 2/2
You are a counsellor who has been seeing a new client, Nicos, for just over a month (2
sessions). Nicos is a 65 year old retired farmer of Australian/Greek heritage. He sold his farm
just over a year ago and moved with his wife, Barbara (Babs), closer to the city where their
son and daughter-in-law live. He decided to sell up after Babs said they were getting too old
to run a working farm. They are now about a 40 minute drive from where their son,
daughter-in-law and their 2 children, a boy aged 12 and a girl aged 5, live. Nicos and Babs
have not seen much of their children previously as the journey from the farm took over 6
hours.
Since the house move, Nicos’s activity levels have dropped enormously. Without the farm, it
is hard for Nicos to find things to keep him active and entertained; his whole life, his identity,
was built around the farm. He spends most of his day sitting in front of the television and
goes for the occasional walk to the corner shop to buy a newspaper. His sedentary lifestyle is
worrying Babs, who says it is like he has just “stopped”. He has gone from doing extreme
labour to being lost about what to do with himself. Babs keeps herself busy by doing
housework, going for walks, visiting the grandchildren and she’s started going to a yoga class
at the local Seniors’ Community Health Centre twice a week. Nicos says he is feeling more
isolated than he did on the farm. With the depression taking over, Nicos doesn’t want the
grandchildren to remember their grandad as being miserable and worthless so he avoids
seeing them as much as possible. This situation has created tension between Nicos and his
daughter-in-law, who thinks he’s just being aloof. Nicos would desperately like to be
involved in his family’s lives and also to feel less isolated in his marriage. Nicos was not
referred to you by a GP, and feels a bit awkward about, as he says, “the whole counselling
thing”. His wife attended the first session with him, and stated he needed to talk to someone
because he seems ‘depressed’. Nicos does not see medication as an option, and is
uncomfortable even talking about antidepressants.

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