Counselling & Technology: More Than Just a Gimmick!

Does counselling work? Well, only if there is a client in the room, otherwise its just an awkward silence between me, myself and I.

Engaging with a client is one thing, nurturing and maintaining a therapeutic connection is where the ‘good stuff’ happens. So, it’s agreed, good counselling does work when the client turns up and better still comes back.

This wee post is about points of initial connection (PIC’s). It is not a trick or mind play, for me its simply a reflection of the details I consider to make the space and time as comfortable for the client as possible. My intention and hope is that they quickly shift from going to see the Counsellor, towards the realisation that they are in fact catching up with Tony.

room-new

Now, here is a picture of my office and you’ll notice a few bits and pieces from the Phrenology head to a picture of my son. With a quite intentional variety in between they will quite often acknowledge the thing that connects with them. These can offer a quick conversation where we both get to cautiously , yet confidently find the point of resonance where everybody is relaxed and ready to go.

Anyway, I do digress a bit. If you look again at the picture above you’ll see something that draws attention from every adolescent (and most adults) that step into my room. That is the Star Wars Force Trainer on my bookshelf. The idea of this device is you put a small headset on that measures brain waves (i’m not so sure about this, as I rather think it goes off your pulse), but the outcome is the same. The harder you concentrate, the stronger the fan and therefore the higher the ball floats within the tube. Not to mention you get Yoda in the background cheering you on. As with anything like this, it had to be imported as NZ haven’t quite accessed this field yet. It has been an incredible hit!

I have many examples of how this toy has proven invaluable in supporting positive change for some of my young clients. For example one 7 year old came to see me wyodaith a report of significant behaviour issues, both at home and school. He was very much on his last warning after no real change post a couple of Ed Psych visits. This young man was oozing character, personality and a heap of energy, which I could see wouldn’t make for Mr Popular with his teachers or peers. We had talked-and performed- the relationship between thoughts, feelings and behaviours (CBT). There was a deep narrative behind the status quo. The ‘Yoda’ machine, which he called it, made an appearance to highlight how the relationship between the thoughts and behaviours could be seen tangibly. With ongoing exploration of the feelings, we could monitor and celebrate progress. Now, it is a toy, a great one, but a toy none the less. So was it monitoring progress, not so much, but it was serving as a powerful anchor to maintain momentum with everything else we discussed. 8 Months on he continues to be a popular member of the class and has a better relationship with his teacher. Even if the only thing it could have offered was a genuine understanding of the interrelation between thoughts, feelings and behaviours, then i’ll take it. Better still, he had fun and therefore talked….alot.

It appears particularly powerful with students presenting with significant anger. anger-icebergAgain, it offers a tangible rationale for ‘whats the point?’ but equally an absolute focus and calmness that brings them absolutely into the space we are in, and therefore in a better state to explore the ‘anger iceberg’.

Is it a gimmick? not for me, and certainly not for my clients. It is another example of how technology can be used to facilitate the counselling process with young ones. As with everything in a counsellors toolkit, you introduce and offer it if and when appropriate and purposeful to the session.

 

 

 

 

 

 

The Danger of a Label

Whether its Dr. Google, Social Media, something else or a combination of them all, a growing challenge has emerged. The challenge is the eadocse in which curiosity can become fact. Quite often a label (diagnosis) is imposed by others who really have no place to deliver such judgement or diagnosis. I’m increasingly seeing young adults in particular, enter the room with impressive confidence, and having barely sat down, will state ‘ I have clinical depression and if I could crack on with the first of 6 CBT sessions that would be marvelous’. This has quite an impact coming from young ones as young as 11.

When this is delivered by a health professional a label can take on so much more traction. A recent example I know of was a young man who presented to a GP with a headache. They then conducted a HEADSS assessment (Home, Education, Activities, Drugs, Suicidality and Sex). They then conducted a GAD 7  diagnostic tool for anxiety. The result was then relayed to the teenager that they had Anxiety. The next day after a sleepless night he had 3 panic attacks, couldn’t cope with school and the family had already made an appointment with the mental health team for his anxiety. This young man had taken absolute ownership of the diagnosis, as had the family, due to it coming from a health professional. These symptoms and issues had seemingly appeared overnight causing a significant barrier in his life, both at school and home. The facts and reality were quite different. He did present with a headache. He had stayed up all of the previous night to start and complete an assignment that had been set some time ago and was now due. stressHe was simply tired and stressed, both normal and short-term responses.

 

What prompted me to put ‘pen to paper’ on this topic was a student that presented to me recently and for the first time. This young woman had been managing her bipolar for the last 5 years. This was confirmed on the young woman’s school medical records as well as known and being managed by her parents. The young woman who was sat in front of me was not like any client I have seen previously with diagnosed bipolar. After exploring the bipolar it was the specificity of the time line that quickly directed our conversation. The response was quite staggering. 5 years earlier she was sat in class doing her work as usual. She was then continuously distracted by a peer who continued to take her pencil, tap it on his desk over and over before throwing it on the ground. She would then pick it up and place it on her desk, where shortly after he would continue with his routine. The young woman had by this point had enough, and snapped at the young man to ‘stop it’. His response, ‘stop being so bipolar’. And that was it. It was later confirmed with her parents that they had never sought medical advice or challenged the young girls ownership of the label. There had been no symptoms or concerns of any nature before this point. She had carried this label which had continued to limit the incredible potential this young woman had. It didn’t take long before she made significant gains through an initial approach combining narrative therapy with a strong thread of strengths based exploration.
pencilNow, it is not the label that is the issue. Depression, Anxiety, Bipolar, ADHD and lots of other acronyms all exist, are very real and can all be addressed. It is being aware of who and where the label is coming from and whether they are equipped and able to deliver such a diagnosis. As a parent, be aware of a false diagnosis, and question and demand the right person with the right answers. It’s not to say they are wrong, you just deserve more than an educated guess.

Everybody’s experience is completely unique and one word doesn’t and won’t do justice to your own needs and reflections. The more authentic and original your discussion, the more productive and effective the time and therefore outcome.

Unpack the experience towards a way though, reclaiming power and control from the label back to the person, you. Just have a quick go at saying the below and take the time to reflect on how you feel for each, and then decide for yourself which platform you want to work from.

I am depressed or I feel depressed

I have Anxiety or I feel anxious.

words

Technology & Counselling (Virtual Reality)

This is a short intro into what I am up to in counsellor land. I have often felt that professionals in the field of mental health in NZ are a private pedigree and less than confident or willing to share ideas. I say ideas not best practice because its okay to have ideas, give them a go and embrace if they work and file away if not. Not to mention what works for one person may not work for another. I hope to share my experience and feedback of incorporating technology into my practice in the hope it raises questions, which can only be a good thing.

Firstly why? why not just do what I do and sit back on the masses of evidence that tells folk it works and makes a difference (counselling that is). Also, technology costs money and I want to reduce overheads for maximum profit margin. As the head of a large counselling department we can barely buy refill let alone a VR headset. I will certainly in future posts on this topic return to addressing and discussing challenges such as these.

Why? I want to access and engage with clients that wouldn’t ordinarily access counselling. I want to make it more interesting and challenging for my client and yes for me too. I want to fill my tool box with as many strategies and resources as possible that can support me in my work and my clients in their process. Technology is here and now and I would like my work as a counsellor to keep up with the needs, expectations and opportunities that come with innovation. Most importantly I want to continue to ask questions of myself and how I work so I continue to evolve, whether this means technology is a welcome addition, or whether it is an unhelpful gimmick. I want to make that decision from the coal face rather than being directed by those that may have their own agenda or insecurities about such change or ideas.

663275 Google Expeditions_03

To begin with I’d like to introduce:

Virtual Reality (Samsung VR Gear $199 NZD)

good vr

This device works with a Samsung S6 upwards and I use it with my S7. You upload the Oculus app via the app store and once done you connect your phone behind the front protective fascia and adjust so its nice and tight to your head. It takes only a few minutes to get used to it and how you select something from the menu, focus, volume and the ‘go back’ button. Pretty straight forward.

samsung vr

Context: I have used these in two roles. In my private practice with adults around social anxiety, anger and stress. Also in my role as a school counsellor (Age group 11-18 years). You will certainly see students requesting appointments that you may not have previously seen.

How do I use it?

Mindfulness. There are a couple of free apps that are ‘OK’, but the graphics aren’t as good as they could or should be. What you can do is take your pulse pre and post session to monitor its effectiveness using the phone as a senser. I have found it works and my clients, adults, adolescents and children love it.

Apps: Both would get a 7/10, however the future scenes for Guided Meditation VR would take it to an 8/10 and make it the better of the two.

guided med vr                                exvreience

 

Anxiety. There are again a few apps for public speaking, fear of flying etc. Really not many right now but they are coming through quite quickly. The main distinction is previously VR has meant a programmed virtual reality, so quite grainy computer generated simulation. The cameras now however mean the content is using real images and footage and in HD. This is far better. Again, I have used it for students with a fear of public speaking at my school. I simply recorded our hall with no spectators, 10 spectators, 20 and then 35. Time was limited and students so I plan to sepnd a bit of time on this concept building towards a full assembly. This is great for both students and staff. I turn the sound down and through desensitization we gradually build the scene up with the student reading their presentation. Again we look at anchors in the room and capture the sensations of a successful delivery.

heights

Sports Counselling. Visualisation can be anchored in real-time and specific to the individual and their sport and needs. For example in Rugby, a kicker would be recorded completing a successful kick. This recording is then utilised to replay and rehearse the conditions and enable you both to explore anchors whether on the field, physically or verbally. This principle is used in most golf shops nowadays to improve your swing without having to wade through rivers or apologise to the next green to retrieve your ball.

How do I intend to use it?

Behaviour Modification. I hope to simply record scenarios that cover the gambit of student challenges. Conflict resolution and bullying for example. Recording scenarios that we can use to explore the A B C’s of behaviours and also the opportunity to apply what we discuss in a safe but realistic environment -role play.

I hope to utilise a specific camera to increase the quality and availability of footage and content that is specific to my client base, community and presenting issues, so NZ rather than courtesy of The States. The fly 360 (below) seems like the best ‘normal folk’ or no commercial grade device retailing at about $950 NZD. However there are others in your local store such as the Samsung Gear 360 ($650 NZD). However, if you want to keep it even more low-budget then use your 360 option on most of the newer phones.

fly360

It’s very new and specific reviews of apps and uses will grow in time through future blogs. Early signs are extremely positive, my clients love it and it can really fit in nicely as part of a wider session making a great additional resource to work with clients.

For more info etc. check out:

http://www.vrs.org.uk/virtual-reality-healthcare/therapies.html

Virtual Reality Therapy: Treating The Global Mental Health Crisis

http://www.apa.org/research/action/speaking-of-psychology/virtual-reality.aspx

http://www.wsj.com/articles/virtual-reality-as-a-therapy-tool-1443260202

(These articles offer further reading, they are not necessarily my thoughts and opinions)

 

 

The Starfish Story

When I left PE teaching to take up my first counsellor position I was given a gift by a friend and colleague. This gift still sits pride of place in my office as a bit of a nudge and visual pep talk and reminder. It was a starfish in a small flax bag, that also contained a short story. That short story is one about a child on a beach making a difference, one star fish at a time. This is an adapted version of the original by Loren Eiseley.

The Starfish Story 2

This story can be interpreted to put across many different messages. For many daunting tasks and ‘to do’s’ can be put to one side due to procrastination or fear. This simple story illustrates the need and importance to break the seemingly insurmountable down into manageable pieces, and move forward one step at a time.

In counsellor land this may be that such a safe and supportive environment is provided that a client is able to deconstruct the big picture thinking and expectations, into bite size pieces that can be explored without the clutter of the ‘static noise’. This brings clarity which can bring positive movement, as if we get lost in the static noise and own the confusion that it brings we tend to stay put.

What may seem small and insignificant to you can be monumental to others. What may seem too huge and impossible to you, becomes possible if you concentrate on putting just one foot in front of the other, rather than getting caught up in how far away the destination is.

When it comes to the value of reaching out and helping someone, that really depends on the motivation that drives it. I have had the absolute honour of coming into contact with the most passionate and generous ‘helpers’ I can imagine as possible. It is not what or even how much they give and do, but the genuineness behind the action. When we do something because it’s good and we want to, with the only intended benefit being for the people we do it for, then it becomes a real gift with a heck of an impact. Yes, if it then makes you feel good as a byproduct then that can only be mother natures way of saying ‘top job’. Perhaps not so much if you are doing it to make yourself feel good and helping others is a byproduct. I believe this is the difference between presenting a connection, to engaging in an authentic and positive connection with others. You sure as heck can feel the difference, and you can be pretty sure they do to.