Saturday, April 26, 2014

Addressing and Disarming Anger

I. Common Reasons for Anger
 A. The client is angry about something the agency has done
  1. Client does not understand the laws and regulations you have to follow
 B. The client is angry about something you have said or done
  1. Clients may misunderstand you
 C. The client is fearful
  1. client can be upset over the turn in their live
 D. The client is exhausted
 E. The client feels overwhelmed
  1. Clients may be overwhelmed with their problems
 F. The client is confused
  1. Client can be confused by policies
 G. The client feels a need for attention

II. Why Disarming Anger is important
 A. Eliminates an obstacle to true understanding
  1. Once the anger is diffused you can understand what the problem is
 B.Shows client you respect their message
  1. Once disarmed it shows you respect problem even if you don't agree with the way it is expressed
 C. Enables you to understand the problem
  1. Once anger is disarmed you can address the problem
 D. Allows you to practice empathy
  1. You can see it the problem as client sees it
 E. Focuses work on solving the problem
  1. Focus on solving the problem not on who to blame

III. Avoiding the Number One Mistake
 A. Don't take the anger personally

IV. Erroneous Expectation for perfect Communication: Another Reality Check
 A. Some Human service workers think their clients will give them no problems, don't fall into this trap

V. The Four Step Process
 A. Be appreciative
  1. Show that you are appreciative to them for bringing the problem to your attention
 B. Ask for more information
  1. To understand the problem you need to know the details
 C. Find something with which you agree
  1. Find a little piece that you agree with
 D. Begin to focus on a solution
  1. Focusing on a solution should include collaboration

VI. What you Do not Want to do
 A. Do not become defensive
  1. Don't fall into a trap of defending yourself
 B. Do not become sarcastic or facetious
 C. Do not act superior
 D. Do not grill the client
  1. You can ask questions just be careful to not ask to many

VII. Look for Useful Information
 A. You can benefit from feedback if you really listen

VIII. Managing An Angry Outburst
 A. An even tone, continued reflective listening, and relaxed movement works best

http://www.psychologytoday.com/blog/happiness-in-world/201311/dealing-anger
This is a article about to help someone deal with their anger. It gives an example of a angry client that is really fearful and what to do.

A question I have is when a client gets so angry and you are fearful of what they may do, what are you supposed to do about it?

Friday, April 18, 2014

Bringing Up Difficult Issues

I. Confrontation
 A. Matter-of-factly bringing up something out to better gain a better understanding and perhaps to make meaningful changes or take important new steps

II.When to Use Confrontation
 A. Discrepancies
  1. Times when a client will communicate two different messages
  2. The client says one thing but does another
  3. The client has one perception of events or circumstances and you have another
  4. The client tells you one thing but the clients body language sends a very different message
  5. The client purports to hold certain values but the clients behavior violates those values
B. Other reasons to use confrontation
  1. The client has unrealistic expectations for you
  2. The client has expectations for him or herself
  3. The client asks for assistance but actions indicate the client in not interested
  4. The clients behavior is contradictory

III. The I-Message in confrontation
 A.The problem is yours so it should include a reference to you
 B. A complete I-message includes 4 parts
  1. Your concern, feeling, observations about the situation
  2.A non blaming description of what you have seen or heard of the behavior
  3. The tangible outcome for you as a result or the possible consequences for the client
  4. An invitation to collaborate on a solution

IV. The rules for confrontation
 A. Be matter of fact
 B. Be tentative
 C. Focus on tangible behavior or communication
 D. Take full responsibility for your observation
 E. Always collaborate
 F. Do not accuse the other person
 G. Do not confront because you are angry
 H. Do not be judgmental
 I. Do not give the client a solution

V. Asking permission to share ideas
 A. Rather than give advice ask if it is ok to share solutions

VI. Advocacy: Confronting collaterals
 A. If someone is interfering with the clients treatment or your ability to help them you need to speak up

VII. On not becoming overbearing
 A. Sometimes a I-message is really about your agenda and is not sensitive to the client and where the client is with the problem at that moment
 B. 5 ways we can make a I-message ineffective
  1. Using the word "but" or "however" reverse what we have just said supporting the clients point of view
  2. Expressing how we see the situation using I correctly but never inviting the client to describe how she sees the situation
  3. Coming across as the way we view the situation is the only way to view the situation
  4. Failing to consider that there are extenuating circumstances that you are not privy to


  This is video that discusses what confrontation is and gives examples of it in couples therapy.


What do you do if you are overbearing with a client? How do you fix it?

Asking Questions

I. When Questions are Important
 A. When you are opening a case on a person and need identifying information
 B.When you are compiling information for assessment and referral purposes and need fact to do that properly
 C. When you are encouraging the client to talk about his situation freely to better understand which aspects of it are important to the client.

II.Closed Questions
 A. A closed question is one that requires a single answer
 B. Used when opening a case or compiling information for an assessment

III. Open Questions
 A.Open questions serve the purpose of giving clients the opportunity to talk about what is important to them.
 B.Open questions put the client at ease

IV. Questions that make the client feel uncomfortable
 A. Avoid the use of "why"
  1. It implies that it should have been handle differently
 B. Don not ask multiple questions
  1. The person can feel interrogated
 C.Do not change the subject
 D.Do not imply there is only one answer to your question
 E. Do not inflict your values on the client
 F. Do not ask questions that make assumptions

V. A formula for asking open questions
 A. Use openers like "Can you" or Could you"
 B. Some tips for asking open ended questions
  1. It takes practice
 C. Be careful to not use a question that is really not open
 D. To open that question try this
  1. "Tell me abut it"
 E. Words that snap questions closed
  1. "How, why, what, when, where

This a video that gives examples of opened ended questions during a therapy session.

I know as a therapist it can be hard to get all the infromation you need to help the client by asking closed needed questions, but can it be harmful to a client if all you ask is closed ended questions?

Saturday, April 12, 2014

Clarifying Who Owns the Problem

I. You need to clarify who owns the problem
 A. It is the person who's needs are not being meet

II.Three reasons to why you should know who owns the problem
 A. You will know who is responsible for solving the problem
   1.You will not accept responsibility for your self
 B.Meddling is disrespectful
   1. It shows you have doubts about the clients ability on how to handle the problem
 C. The client loses opportunities to grow
  1. When you take over it can interfere with a meaningful experience for the client

III. If the client owns the problem
 A.You need to first listen, instead of giving a solution
 B.Give them options, help with resources
 C. Ask them for ideas
 D. It is not uncaring
  1. Don,t feel guilty for not doing more, clients need to work on their own problems
   2. It helps the client grow
 E. It is a strategic decision
  1. Based on your knowledge of the client you decide how much to get involved
  2. Know your clients strengths and weakness then you can tailor your involvement
 F. Be a resource and a collaborator
  1. Bring information to the client to help in making decisions

IV. If you own the problem
 A.It is your responsibility to resolve the problem

V. If you both own the problem
 A. Sort out who owns what part of the problem
 B. You need to negotiate to resolve the problem together


 http://www.une.edu.au/about-une/academic-schools/bcss/study-areas/psychology/research/psychology-community-activities/over-fifty-problem-solving-strategies-explained
This website goes in depth on showing you ways to clarifying problems and strategies on how to come up with solutions for them.


Is there a way to know when you have gotten to involved with helping to find a solution? Are there any signs or clues to show you if you need to back off?






Here is a video from u tube that talks about two types of problems and creativity in solving them.















Saturday, April 5, 2014

Attitudes and Boundries

I. Basic helping attitudes
A. Warmth
1. A worked needs to be friendly, nonjudgmental, and receptive
B. Genuineness
1. Be yourself and not be phony
C. Empathy
1. Put yourself in the person's shoes
2. You must comprehend what the person's needs and feelings are
3.Empathy is not sympathy
D. Don't be judgmental

II. Reality check
A. If a client does not have behavior the way we think they should, that does not give the right to give bad service.

III. How clients are discouraged
A. Don't compare the client to you or someone else
B. Make sure to notice positive changes and strengths
C. Don't try to dominate the client

IV. Understanding boundaries
A.Maintain useful boundaries and refuse to erect those that are not helpful

V.Seeing yourself and the client as completely separate individuals
A.The client reminds you of you
1. Be careful not to push clients into doing things that help us to resolve our problems, it can push the client away
B. The client reflects on you
1. Don't push clients in order to make ourselves look competent.

VI. Erecting detrimental boundaries
A. False attributions
1. People who look like me act like me and think like me
2. People who do not look like me are not like me at all, but are different
3. Neither of these are true
4. When you view people with these assumptions you no longer see the individual
B. False power
1. Don't intimidate the client by displaying authority, competence, or power

VII. Transference and counter transference
A. Transference
1. You can remind the client of someone in their past, a collection of feelings and attitudes the clients holds about you
2. It can be positive and negative
3. Accept it when it exists
B. Counter transference
1. You can project onto the client certain emotions and attitudes because they remind you of someone in your past
2. You have accept yourself and your feelings
3. Don't let these feelings interfere with services

Here is a link to a website that talks about boundaries in psychotherapy and counseling
http://www.zurinstitute.com/boundaries_clinicalupdate.html
This article is valuable because it discuss touch and gift giving which is something that a counselor will come across as they begin helping people. The article talks about it not being bad to use touch or to accept gifts, in the reading I have been doing it says touch is bad. So now I have a question could touch be ok in the right circumstances?



Resource Notbook

Resource Notebook

1. Substance Abuse:
AGAPE
428 East Scott Avenue
Knoxville, TN 37917
(865) 525-1661 (Office)
(865) 546-7577 (Admissions)
(865) 525-0596 (Service/Intake Program)
This is a residential therapeutic community for women in recovery from chemical
addiction. Must have 72 hours sobriety, be at least 18 and ambulatory.
Preference to pregnant IV drug users, but also others if space is available.

ALANON/ALATEEN
(865) 525-9040
Alanon provides support and information to families and friends coping with the alcoholic. Alateen provides support and information for children 10 to 20 years of age whose lives are affected by the drinking of relatives or friends.

NARCOTICS ANONYMOUS
1-800-249-0012
(865) 583-3536 (Helpline)
Support group for those who are addicted to drugs. A Helpline is answered close to meeting times in our local area. Local meetings are held throughout the area.

ALCOHOLICS ANONYMOUS
601 W. Main St.
Morristown, TN. 37814
(423) 586-9866
To support individuals with drinking problems.

CHEROKEE HEALTH SYSTEMS
6350 West AJ Highway
Talbot, TN. 37877
(423) 586-5031
Outpatient therapy for marital and groups, alcohol and drug
addiction, education, child development, day treatment, case management, evaluation and assessment for courts, etc.

CHILD AND TEEN ENRICHMENT CENTER
(423) 318-6982
Individual and group counseling, anger management, and drug counseling for
adolescents.

FOCUS ON RECOVERY
1-800-333-2294

NEW HOPE RECOVERY
233 West Main St.
Morristown,TN. 37814
(423) 581-2411
Intensive outpatient treatment for substance abuse




2. Housing

AMERICAN RED CROSS
(423) 586-2442

CEASE
(423) 581-2220
address not given
Shelter for domestic violence.

HABITAT FOR HUMANITY
(423) 587-2884

HAMBLEN 2-1-1
Dial 2-1-1 from any landline phone
865-692-5258
Provides information and referral to virtually any service needed in the Hamblen county area.

MATS
(423) 587-6287
324 North Hill St.
Morristown, TN. 37816
Ministerial Association Temporary Shelter.

MORRISTOWN HOUSING AUTHORITY
(423) 586-5115
Public housing, rental assistance for low-income, disabled, handicapped, and elderly.

KNOXVILLE UNION RESCUE MISSION/ NEW LIFE INN
418 Broadway
Knoxville, TN 37917
(865) 673-6540
Serves all areas. Shelter for homeless, counseling and referral, case management. Offers emergency shelter, meals, recovery services.

KNOX AREA RESCUE MINISTRIES
Serenity Shelter
Location unpublished
(865) 971-HOPE
Serves all areas. Offers 24 hr. crisis line. Serves Battered and emotionally abused
women. Provides lodging, clothing and meals, appropriate programs, recovery, referral service.

RURAL DEVELOPMENT—USDA
4730 New Harvest Lane, Suite 300
Knoxville, TN 37918
(865) 523-3338
Provides loans for low-income families to purchase a home.

SALVATION ARMY
Men’s Shelter
409 North Broadway
Knoxville, TN 37917
(865) 525-0434
Serves all areas. Shelter for homeless; must be sober, have valid ID, and be able to work.


TENNESSEE VALLEY COALITION TO END HOMELESSNESS
1-877-488-8234
Funds and assistance to pay rent or mortgage to stabilize living situation, when eviction is imminent. Must have some type of sustainable monthly income.


TNHOUSINGRESOURCE.ORG
1-866-973-3147 or www.tnhousingresoruce.org
One-stop shopping for housing and apartments in all counties in Tennessee.


 WOMEN’S SHELTER—JOY BAKER CENTER
409 N. Broadway
Knoxville, TN 37917
(865) 522-4673
Serves battered and emotionally abused women in all areas. Provides shelter, clothing, meals, appropriate programs, recovery, referral service.

VOLUNTEERS OF AMERICA
1501 East Fifth Avenue
Knoxville, TN 37917
(865) 525-7136

Serves all areas. Offers shelter for homeless, case management services focused on increasing self-sufficiency skills, 3 meals a day, advocacy and referrals to community resources. Must be homeless and either a single woman or family (one or two parent) with children.


CENTRAL SERVICES
(423) 586-9431
2450 S. Cumberland Street
Morristown, TN. 37816
Provides emergency assistance.

DOUGLAS-CHEROKEE ECONOMIC AUTHORITY
(423) 587-4500
534 E. First North St.
Morristown, TN.
Emergency assistance to low income clients in the form of vouchers for food, rent, mortgage, utilities. Donated household items, case management, job search assistance, commodities distribution.

EAST TENNESSEE HUMAN RESOURCE AGENCY (ETHRA)
(423) 587-6511
Rental assistance, transportation, weatherization.

HAMBLEN 2-1-1
Dial 2-1-1 from any landline phone
865-692-5258
Provides information and referral to virtually any service needed in the Hamblen county area.

TENNESSEE VALLEY COALITION TO END HOMELESSNESS
1-877-488-8234
Funds and assistance to pay rent or mortgage to stabilize living situation, when eviction is imminent. Must have some type of sustainable monthly income.


3. Employment
Child and Family Tennessee- Firm Foundations for Self-Sufficiency
            901 E. Summitt Hill Drive
            Knoxville, TN 37915
            (865) 524-7483
Employment, education, housing, transportation needs, other issues leading to self-sufficiency.

CredAbility (Formerly Consumer Credit Counseling of America)
Knoxville, TN
(865) 380-0129
Budget and credit counseling, debt management plans, housing counseling and bankruptcy counseling. Comprehensive curriculum of educational programs, including budgeting and debt elimination strategies.

FIVE RIVERS REGIONAL CAREER CENTER
6057 West A.J. Hwy
Morristown, TN 37877
(423) 317-1060
Provides employment and career development skills.

HAMBLEN 2-1-1
Dial 2-1-1 from any landline phone
865-692-5258

Hamblen County Public Library
417 West main street
Morristown, TN 37814
Phone: (423) 586-6410
Offers free educational learning resources, free computer use, job search help and budgeting 
information.


4. Education:

 HAMBLEN COUNTY BOARD OF EDUCATION
(423) 586-7700
210 E. Morris Blvd.
Morristown, TN. 37813
Provides public education to all Hamblen county children grades K-12.
DOUGLAS CHEROKEE HEAD START
P.O. Box 1218
MorristownTN 37816
(423) 587-4500 ext. 35
Center based and home based opportunities for children 3-5 years old and comprehensive services for the families. Call for applications and information.
WIA YOUTH DEVELOPMENT
(423) 587-4500

U.T. EXTENSION SERVICE
MorristownTN 37804
(865) 974-7342
Serves Hamblen County. Information and continuing education programs on nutrition, health, finances/money management and family life issues such as grandparenting and caregiving. Also instruction on food preservation and on cooking for the diabetic. Open to all ages.

5. Legal help:


LEGAL SERVICES OF UPPER EAST TENNESSEE
(423) 587-4850
1001 West Second North St.
Morristown, TN. 37814
Provides a wide range of civil matters-based on income and assets.

CASA, A Child’s Voice in Court, Inc.
Cherokee Place Plaza Building, Suite C104
2200 Sutherland Avenue
Knoxville, TN 37919
(865) 329-3399
(865) 329-3388
(865) 329-3377
CASA is a court appointed special advocate program for children who have been abused or neglected. CASA explores the history of each child assigned by juvenile court and makes recommendations to the judge regarding the best of the child/children.

HAMBLEN COUNTY JUVENILE COURT
P.O. Box 1006
Morristown, TN 37816
(423) 581-9422

KNOXVILLE LAWYER INFORMATION AND REFERRAL SERVICE

(865) 522-7501
6. Transportation:

TENNCARE TRANSPORTATION
1-800-671-4018
Transportation to medical appointments for TennCare enrollees is available through the individual’s managed care organization (MCO). Call your managed care organization or the transportation number listed on your TennCare card to find out how transportation is arranged. Must have social security number when calling.

EAST TENNESSEE HUMAN RESOURCE AGENCY (ETHRA)
(423) 587-6511
Rental assistance, transportation, weatherization

DIAL-A-RIDE

(423) 587-6511

7. Healthcare:

HAMBLEN COUNTY HEALTH DEPARTMENT
(423) 586-6431
331 West Main ST.
Morristown, TN. 37814
Immunizations, vital statistics, WIC, communicable disease program, family planning program, child healthcare program, nutritional counseling, environmental services, TennCare revivification/enrollment.

HULSE MOBILE DENTAL SERVICES
Maryville, TN
(865) 804-2465
Serves several counties by traveling to provide dental services on a sliding scale fee for insured and uninsured children and adults.

MORRISTOWN -HAMBLEN HEALTHCARE SYSTEM
(423) 586-4231
American Diabetes Association, cancer support group, childbirth classes,
education/community outreach, infant care, rehabilitation services, senior class, social services, medical care, behavioral health

REMOTE AREA MEDICAL
1834 Beech St.
Knoxville, TN 37920
(865) 579-1530

Free vision care provided during weekend clinics staffed by volunteer providers. Clinics may be requested by county health departments and other social service agencies. Unemployed, uninsured and low-income people are served. No charge for services.


8. Food and clothing:

ANGEL FOOD MINISTRIES
Provides grocery relief and financial support. Groceries are sold in a quantity that can fit into a medium-sized box at $25 per unit. Feeds a family of four for about one week. Accepts Food Stamps.
Host sites:
New Beginning Church of God
(865) 484-0055
Mt. Vale Church of God
(865) 475-0851

CENTRAL SERVICES
2450 S. Cumberland Street
Morristown, TN. 37816
(423) 586-9431
Provides emergency assistance.

DAILY BREAD COMMUNITY KITCHEN
(423) 581-7733
Food pantry for families in need.

DOUGLAS-CHEROKEE ECONOMIC AUTHORITY
(423) 587-4500
534 E. First North St.
Morristown, TN.
Emergency assistance to low income clients in the form of vouchers for food, rent, mortgage, utilities.
DEPARTMENT OF HUMAN SERVICES-FOOD STAMP PROGRAM
(423) 585-1444
2416 West AJ Highway
Morristown TN. 37814
Families First Program, Food Stamps, TNCARE.

HAMBLEN COUNTY 2-1-1
          Dial 2-1-1 or www.211tn.org
Or 1-866-588-4211. Teleinterpreter and Spanish speaking staff available. One-stop referral and assistance for financial, utility, and many other needs.

HAMBLEN COUNTY HEALTH DEPARTMENT-WIC PROGRAM
(423) 586-6431
331 West Main ST.
Morristown, TN. 37814

Immunizations, vital statistics, WIC, communicable disease program, family planning program, child healthcare program, nutritional counseling, environmental services, TennCare revivification/enrollment.

CENTRAL SERVICES
(423) 586-9431
2450 S. Cumberland Street
Morristown, TN. 37816
Provides emergency assistance.

GOODWILL INDUSTRIES
2818 West A.J. Hwy
Morristown, TN 37814
(423) 587-9763
New and used clothing, furniture and household items