HEALTH COUNSELING IN ADOLESCENTS
There are a number of different forms of counselling, some of which are used in specific circumstances. In all forms of counselling the relationship between counsellor and client is of great importance. Counsellors sometimes work in general practices to treat patients with mental health problems in primary care.
Although the term counselling implies the giving of advice and guidance, in the past much of the counselling available used a client-centred nondirective approach. In this approach the counsellor is passive and tends to rephrase and reflect what the client says. Counselling may be concerned with addressing and resolving specific problems, making decisions, coping with crises, working through conflict, or improving relationships with others. The work of most counsellors in primary care is generalist and is not necessarily linked to any diagnostic categories. In generic counselling, a broad range of techniques is used to help the patient. In specific counselling, a specific model such as psychodynamic counselling or bereavement counselling is used.
MEANING OF HEALTH COUNSELING IN ADOLESCENTS
Health Counselling is a talking treatment that involves a trained therapist listening to you and helping you find ways to deal with emotional issues. Sometimes the term “health counselling” is used to refer to talking therapies in general, but counselling is also a type of treatment in its own right.
Health counselling can help the client cope with:
- a mental health condition, such as depression or anxiety
- being diagnosed with or living with a health condition
- dealing with a difficult life event, such as losing someone you love, a relationship breakdown, financial burden, or work-related stress
- identifying triggers that cause you to follow negative patterns
- difficult emotions – for example, low self-esteem caused by your health condition or feeling angry about your situation.
What is Health?
Health is the level of functional and/or metabolic efficiency of an organism at both the micro (cellular) and macro (social) level. In the medical field, health is commonly defined as an organism’s ability to efficiently respond to challenges (stressors) and effectively restore and sustain a “state of balance,” known as homeostasis.
Another widely accepted definition of health is that of the World Health Organization “WHO”. It states that “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. In more recent years, this statement has been modified to include the ability to lead a “socially and economically productive life.” The WHO definition is not without criticism, as some argue that health cannot be defined as a state at all, but must be seen as a process of continuous adjustment to the changing demands of living and of the changing meanings we give to life.
Definition of counselling
Counseling is an interactional process meant to enhance redefinition of stand for positive adjustment on particular issues of life.
Counselling refers to helping process that uses the safety of a special relationship between the counsellor and the counselee-who together explore the thoughts, feelings and counsellor attitudes of the counselee with the objective of tapping the resources within the counselee to effect healing and change.
It is necessary to assist the student’s teachers to be disciplined and be able to deal with challenges and realities they face in their ever changing environment, understand themselves, their academic social and physical environment, realize their potentials, as well as identify opportunities in a world where chances for further training, employment and advancement continue to dwindle. Learners are counselled to alter any maladjusted behaviour. Since most citizens are involved in education process directly or indirectly, the impact of guidance and counselling is real to them.
TYPES OF HEALTH COUNSELING IN ADOLESCENTS
- This is a structured and systematic approach to resolving problems that are linked to stressful circumstances.
- It is particularly suitable for patients whose life problems are adversely affecting or maintaining a disorder.
- It involves the patient identifying and listing problems and then considering what practical ways exist to solve or alleviate the problem. These solutions are tried and then reviewed.
- This method has been shown to be useful in treating mild mood disorders.
- This is similar to problem-solving approaches but the focus is on the current state of interpersonal relationships in the home, work and elsewhere.
- Problems in relationships can be viewed under the headings of loss, interpersonal disputes, role transitions and interpersonal deficits.
- A problem-solving approach is adopted to encourage the patient to try out alternative ways of coping.
- This has been effectively used for patients with minor mood disorders.
- In this technique there is more emphasis on past experience and unconscious processes as the mainspring of current behaviour.
- The patient’s emotional reactions to the counsellor and situation are an indicator of the nature of problems in other relationships.
- This approach has not been as thoroughly evaluated as those above.
IMPORTANCE OF HEALTH COUNSELING IN ADOLESCENTS
Health Counselling has been used in the following situations:
- Counselling to relieve acute distress:
- In this situation there is emphasis on emotional release and ways of coping with the immediate problem.
- Where the method is nondirective, unstructured and involves the recall of distressing events, it may be inappropriate for those surviving traumatic experience and may lead to worse outcomes than where the patient receives no counselling.
- Cognitive methods may be of some help but timing is important.
- Counselling for late effects of trauma, including post-traumatic stress disorder:
- As above, it is inappropriate to use nondirective and unstructured approaches since they may result in recreating the emotionality of the experience without offering ways to deal with it.
- Cognitive and psychodynamic approaches may be more useful.
- Counselling for relationship problems:
- It may be helpful for a counsellor to encourage couples to talk constructively about their relationship so that they come to appreciate their thoughts and feelings for each other.
- Risk counselling:
- It may be helpful for those who may be facing the risk of developing an hereditary disease or acquiring a sexually transmitted disease to discuss with a counsellor the nature of the risks and the possible responses to the various outcomes.
- Bereavement counselling:
- Counselling in this situation focuses on giving information about the normal stages of grieving, working through the normal stages of grief and giving advice on coping without the deceased.
- Mild-to-moderate depression:
- The National Institute for Health and Care Excellence (NICE) questions the efficacy of this compared with other therapies and has downgraded it to second-line treatment in its latest guidance.
- Generalised anxiety and panic disorder.
- Obsessive-compulsive disorder.
- Psychosomatic conditions – chronic pain, chronic fatigue, and gastrointestinal disorders such as irritable bowel.Also, some gynaecological syndromes such as premenstrual syndrome and chronic pelvic pain.
- Health promotion:
- Counselling can also play an important role in health promotion for some patients, including smoking cessation.
- Chronic or terminal disease:
- Counselling may help some patients to come to terms with chronic or terminal disease. One study advocated the use of group psychotreatment for this indication.
TECHNIQUES USE IN HEALTH COUNSELING IN ADOLESCENTS
Counsellors focus on client choices in their life circumstances as a basis for their work. Counselling can involve a variety of different methods and techniques, including psychodynamic counselling and cognitive behavioural counselling. However, most are influenced by humanistic, process-experiential and psychodynamic principles. Examples of treatment approaches include:
- Nondirective counselling:
- Encourages the patient to share his or her problems with the counsellor.
- Through listening, the counsellor affirms the patient’s worth and allows him or her to take the time to express his or her thoughts.
- Problem-solving treatment :
- Systematically teaches generic skills in active problem-solving, helping individuals to clarify and formulate their life difficulties and apply principles of problem-solving to reduce stress and enhance self-efficacy.
- Cognitive techniques (such as challenging negative automatic thoughts) and behavioural techniques (such as activity scheduling and behavioural experiments):
- Are used to relieve symptoms by changing maladaptive thoughts and beliefs.
- Behavioural treatment :
- Seeks to solve problems and relieve symptoms by changing behaviour and the environmental factors which control behaviour.
- Graded exposure to feared situations is one of the most common behavioural treatment methods and is used in a range of anxiety disorders.
- Cognitive behavioural treatment :
- Is a combination of the two techniques of cognitive and behavioural treatment .
- It looks at how a person’s self-perception can influence his or her behaviour.
- It addresses some of the underlying issues and how these can give rise to destructive or damaging behaviour.
- Can be useful in treating depression, anxiety and substance abuse. One study found it was beneficial in the management of elderly patients with depressive disorder.
- Access has always been the issue in primary care but one study found that online real time treatment delivered by a counsellor over the internet was effective.
- NICE has reviewed the use of and access to cognitive behavioural treatment in general practice and has recommended:
- Beating the Blues – an internet-based cognitive behavioural treatment programme for the treatment of mild-to-moderate depression.
- FearFighter – a similar programme available for the treatment of panic and phobic anxiety.
- Interpersonal treatment :
- Structured, supportive treatment linking recent interpersonal events to mood or other problems, paying systematic attention to current personal relationships, life transitions, role conflicts and losses.
- Psychodynamic counselling:
- Based on the view that past and unresolved conflicts and events result in current emotional distress, a variety of methods is used to help the client make sense of repressed or forgotten experiences, allowing the client to move forward and resolve the conflict or troubling behaviour.
Health counselling involves talking with an impartial listener in a confidential, non-judgmental, supportive and respectful environment. The counsellor will encourage you work through issues with increased awareness and understanding. It can help you develop greater self-acceptance, personal insight, and make positive life changes and decisions. Health counselling helps in a range of areas including:
- New or recent HIV diagnosis or other health issues
- Living with HIV
- HIV and relationships
- HIV positive friends, family members or partners
- Anxiety and depression
- Relationship issues
- Gender identity
- Grief and loss
- Emotional, physical or sexual abuse
- Safer sex
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Federal Ministry of Education (2004); National Policy on Education, Lagos. Health Counseling in Adolescents
Heart, P. W. (2011). The counsellors strength. Port-Harcourt: Double Diamond Publications.