m





 
 
 

à
 


1. Self Understanding
2. Learn basic skills in the helping
process
3. Improve interpersonal effectiveness




  
1. Awareness - self awareness
- how to connect / communicate

2. Attitude - the healing power of

unconditional positive regard
(1 Thess 2:7-12)

3. Basic Skills - ability to establish and maintain

good interpersonal
relationships

 





1. Warmth - caring, respect, acceptance
(Romans 15:7)

2. Genuineness - open, sincere, honest, spontaneous,

not phoney or artificial (be real)
(1 John 3:18)

3. Empathy - ability to accurately identify with

another¶s thoughts, feelings, values,
beliefs, actions. Empathy requires
flexibility of thought and generosity of
spirit
Apathy Empathy Sympathy

No emotion Experiencing another¶s Embracing or

Indifference world (perceptions, sharing the feelings
Without feeling feelings) without losing of another person.
one¶s identity or Feeling or
individuality expressing
compassion for
another¶s suffering

 
 

mhoughts
This level (the r
) is what you
are thinking, the intelligence you have,
or ³head´ knowledge.

Feelings
This level (the O r) is the
emotions level: What you are feeling
about all this, what¶s happening inside,
your emotional response.

Actions
This level (the bO  O
) is elicited
as a result of what you¶re thinking and
what you¶re feeling. It is what you are
doing, or what is going on in your life.
m 


1. Self disclosure / assertiveness

2. Attending and listening
3. Reflecting (responding)
4. Exploring
5. Decision-making skills

  









 

1. Problem management
2. Decision-making
3. Crisis management
4. Support, nurture, healing
5. Life skills training
 






1. Confrontation in counselling means to point out another¶s
errors to him and help him see where he is wrong
2. The Bible teaches more of a confrontational model of
counselling than a helping model
3. Depression is a sin
4. Listening as a counselling method is enough for some
types of problems
5. Giving advice is a poor counselling procedure
6. Scripture is our only legitimate source of information
about counselling
7. Every Christian is competent to counsel others
 






8. It is possible for a highly neurotic person to be healed
through prayer and Bible reading without having to go
to a psychologist or psychiatrist
9. A severely disturbed person has come to you for help.
There are psychologists and psychiatrists locally, but
they aren¶t Christians. It would be best for you then to
go ahead and attempt to help this person or refer him
to your pastor
10. Mental illness is caused by a person having engaged
in a sin of some kind
11. If a person¶s emotional life is stable, then his spiritual
life will be stable
 






12. The concept of ³praising God for everything´ teaches
us to deny and suppress true honest feelings
13. If your spiritual gift is ³mercy´, you will find counselling
to be a natural ministry
14. Since God gives different spiritual gifts to His people,
some ministers should not be counselling


    
An interactional process that facilitates an
understanding of self and encourages voluntary
growth and change through the utilization of
one¶s own resources.
mhis process invites individuals to be open to
the role God plays in their lives and to be
receptive to the ways his grace can influence
their relationships.


m   

1. Inclusiveness
Creating a sense of acceptance and
belonging

2. Openness
Creating a safe place

3. mogetherness
Creating a sense of peace and
commitment
m   


gmhe spirit of community once achieved is

not then something forever obtained«it is
repeatedly lost«
A genuine community recognises its ill
health when it occurs and quickly takes
appropriate steps to heal itself´
Scott Peck
The Different Drum, page 66
Arrow books, 1987
   
 
³All praise to the God and Father of our Master,
Jesus the Messiah! Father of all mercy! God of
all healing counsel! He comes alongside us
when we go through hard times, and before you
know it, he brings us alongside someone else
who is going through hard times so that we can
be there for that person just as God was there for
us.
2 Corinthians 1:3,4 TM
   
 
³If you preach, just preach God¶s message, nothing else;
If you help, just help, don¶t take over
If you teach stick to your teaching
If you give encouraging guidance, be careful that you
don¶t get bossy;
If you¶re put in charge, don¶t manipulate
If you¶re called to give aid to people in distress, keep your
eyes open and be quick to respond
If you work with the disadvantaged, don¶t let yourself get
irritated with them or depressed by them. Keep a smile
on your face.
   
 

Love from the centre of who you are; don¶t fake it.
Don¶t burn out; keep yourself fuelled and aflame.
Laugh with your happy friends when they¶re happy;
Share tears when they¶re down
Make friends with nobodies; don¶t be the great somebody.
Don¶t hit back; discover beauty in everyone.´

Romans 12:8-18 TM
Ýà 
 

 

³Your care for others is the measure of true greatness.´

Luke 9:48 LB

³You became great by accepting, not asserting.

Your spirit, not your size, makes the difference.´

Luke 9:48 TM




What do you learn from the story in Luke

24 (Road to Emmaus) about the way Jesus
related to people
Ý
 




 


   
 

1. Established the relationship

’ Acceptance ± warm, caring. Not aloof or insensitive
’ Empathy ± ³God with us´ (identified with us)

2 Listened / understood individual needs

3. Open, honest communication
’ Spoke clearly, with authority
’ Expressed feelings non-verbally
’ Read body language
Ý
 




 


   
 

4. Gently confronted illogical ideas

’ Confronted dysfunctional behaviour, misunderstanding
’ Cleared up misunderstanding
’ Sort to reshape / refashion thinking

5. Empowered people to take

responsibility for their own behaviour
and growth
’ Gave hope and encouragement
’ Encouraged ownership
    

 

Stage Helper Behaviour Client Behaviour

I Connecting and Attending, listening, Exploring their story

clarifying and understanding or problem

II Goal setting: Promoting new Developing new

based on dynamic perspectives and perspectives and
understanding clarifying options setting goals

III Action: Facilitating action Acting, problem

Designing and management,
implementing achieving goals

Adapted from an Egan (1982, p. 51)

My greatest What brings
Vy greatest
greatest
personal
personal
strength
happiness

How I see How others

myself see me
gI have come that they may have
life, and have it to the full.´
John 10:10
à
  

 

Someone who is comfortable with and

open to the full experience and
expression of all human emotions
(necessary for personal peace and meaningful relationships)

Involves: 1. Way we see ourselves

2. Way we relate to others
3. Way we see / relate to God
ë
 

 



   


1. Awareness of others
’ bserve behaviours
’ Connect with thoughts and feelings
’ How you see others (bias, prejudice, sensitivity)

2. Awareness of self
’ What you think of self (self worth)
’ How you feel about self (affects relationships)
’ How do other people see you?
’ How do you come across to others?
Ýohari Window

 


1. Self disclosure is an invitation to

intimacy
2. mo be able to freely self disclose you
need to accept and appreciate yourself
3. A lack of self disclosure dulls awareness
of your inner experience and decreases
your ability to further disclose

 


4. Why is it so hard to self disclose

’ fear of rejection
’ fear of ridicule, criticism, shame
’ family background
’ lack of trust (no respect or caring)
’ fear of being discounted or ignored
’ never get to be gfully heard´
’ afraid of closeness
 
1. I get angry with myself when
2. I like myself best when
3. I feel ashamed when
4. I trust myself when
5. When I fail, I feel
6. I feel on top of the world when I
7. I get confused about myself when
8. I¶m pleased with myself when
9. I get down on myself when
10. I feel confident when
 
11. When I do things that I feel are wrong, I
12. When I¶m successful, I
13. I¶m most at peace with myself when
14. I get depressed when
15. When I think of what others have told me about
myself, I
16. I get annoyed with myself when
17. When I take a good look at myself, I
18. I think I¶m okay when
19. I think I¶m not okay when
20. When I look at my values, I
  à

Levels of Love Ýoy Strength Sadness
Intensity

Strong Adore Ecstatic Dynamic Desolate

Cherish Ýubilant Powerful Anguished

Vild Affection Happy Strong Blue

Desirable Cheerful Confident Sad

Weak mrusted Glad Capable Displeased

Accepted Satisfied Competent Dissatisfied
  

Levels of Anger Fear Confusion Weakness
Intensity

Strong Enraged merrified Bewildered Crushed

Seething Horrified Vuddled Helpless

Vild Vad Scared Vixed-up Powerless

Frustrated Apprehensive Baffled Vulnerable

Weak Irritated Worried Undecided Weak

Annoyed mimid Vague Feeble

 
 

Level 1 Anger, blame, resentment

Level 2 Hurt, sadness, disappointment
Level 3 Fear, insecurity
Level 4 Regret, remorse, guilt
Level 5 Love, understanding
Ability to forgive

„ou can heal what you can feel

„ou can¶t heal what you haven¶t felt
   

Belonging Worth
’ Sense of security and ’ Being affirmed as a
identity with others person of value (outside
(outside support) support)
’ Giving myself ’ Respecting my own
support thoughts, and feelings
(inner support) Self (inner support)
Esteem

Competence
’ Gaining a sense of
achievement (outside
support)
’ Recognising my
achievements
(inner support)

 à

   


’ Communication is a learned skill

’ It is impossible not to communicate
’ Communication takes 3 forms
a. verbal
b. non-verbal
c. written

’ All communication occurs at 3 levels

a. content ± what is being shared
b. feelings ± how you feel about the content
c. meaning ± intention or message behind the words
Æ  
  


   

 


u ord
7%

on rb
mon o o
ommun on
8%
%
m




 
  

1. Different backgrounds
(cultural, language, values, status, education,
previous experiences)

2. Different perceptions
(see things differently)

3. Preoccupation / distracted
4. Filtering ± hearing what we want to
hear
(bias, prejudice, suspicion, distrust)
m




 
  


5. Vessage overload
6. Ambiguity
(what is presented as a problem is not always the
real problem)

. Ýumping to conclusions
. Vaking assumptions
m




 
  


•. Deliberate use of groad blocks´

a. judging the other person
(threatening, moralising)
b. sending solutions to the other person
(lecture, judge, blame, give advice)
c. avoiding the other person¶s concern
(question, divert attention, humour)

10. Blind to the emotion


  
Closed
No personal involvement
in communication
- generalizations
- intellecturizing
Feelings are excluded
as irrelevant,
inappropriate and irrational
Open
Personal involvement
sharing of perceptions
inner feelings, thoughts,
values, beliefs
Feelings are shared and
discussed
 
  

Closed Open
Show little concern for the Is interactive and
topic or issue being concerned about the topic
discussed or issue

Speaks and lives in the Speaks and lives in the

past tense gthere & then´ present tense ghere &
now´
 


 
 
Submissive Assertive Aggressive
’ I allow the other to take Both the other and I I take total responsibility
responsibility for the take responsibility for the relationship.
Relationship for the relationship
’ I don¶t express my own I directly, honestly, I express my own
feelings, needs and openly, express my feelings, needs, ideas
ideas. Feelings, needs and at the expense of the
ideas. other¶s.
’ I ignore my own rights I express my rights in I stand up for my own
or feel I have none. a way that doesn¶t rights but ignore the
violate the rights of rights of the other.
the other.
’ I let the other be more I make myself equally I make myself more
important than I am in important to the other. important than the
the relationship. other.
 

 
 
Submissive
’ I let the other do the
choosing in the main
life decisions.
’ I let the other infringe on
my personal space ± by
not taking any myself,
or allowing the other
to take too much.
’ I feel anxious,
disappointed in myself
and later often angry and
resentful or depressed.
Assertive Aggressive
We make our choices I do the choosing for
together. myself and the other.
We have mutual respect I infringe on the other¶s
and no infringement of personal space ±
each other¶s personal by either taking too
space. much myself, or by
not letting the other
have enough.
I feel good about I feel angry, self
myself, more self righteous and later
confident and more guilty.
free.

 





1. Ability to listen to others in an understanding way

Not at all able 1 2 3 4 5 6 7 8 9 completely able

2. Willingness to discuss feelings with others

Completely unwilling 1 2 3 4 5 6 7 8 9 completely willing

3. Awareness of the feelings of others

Completely unaware 1 2 3 4 5 6 7 8 9 completely aware

4. Understanding why I do what I do

Not understanding 1 2 3 4 5 6 7 8 9 complete understanding

5. molerance of conflict and antagonism

Not tolerant 1 2 3 4 5 6 7 8 9 tolerant

 




6. Acceptance of expressions of affection and warmth
among others
—ncomfortably 1 2 3 4 5 6 7 8 9 Readily

. Acceptance of comments about my behaviour from

others
Rejecting 1 2 3 4 5 6 7 8 9 welcoming

. Willingness to trust others

Completely suspicious 1 2 3 4 5 6 7 8 9 completely trusting

•. Ability to influence others

Completely unable 1 2 3 4 5 6 7 8 9 completely able

10.Relationship with peers

Wholly competitive 1 2 3 4 5 6 7 8 9 wholly cooperative


  


1. Eye contact
2. Posture of involvement
3. Appropriate body language
4. Non-distracting environment


  


5. Notice vocal qualities (they communicate feeling)

(discomfort, tone of voice, pitch, volume, rate of
speech, emphasis on key words, phrases,
themes)

6. Stay on track with their story by

using
- door openers
- sub-verbalizations (minimal encouragers)
- infrequent questions
- attentive silence
- don¶t supply words
m  
  
 

1. Reflecting content (paraphrase)

2. Reflecting feelings (mirroring)
3. Reflecting meaning (tying feelings to
content)
4. Summarising the main themes and
feelings

  

’ gIt takes two to speak the truth - one to speak,

another to listen.´
Henry Thoreau

’ Listening (what you hear) is more important

that what is said (receiving is more important
than sending)
Benjamin Disraeli

  
gmhe wise man learns by listening.´
Proverbs 21.11 (TLB)

gHe who gives an answer before listening,

it is folly and shame to him.´
Proverbs 18:13 (NASB)

gEveryone should be quick to listen,

slow to speak and slow to become angry.´
James 1:19 (NIV)


  

  
’ Listening is important because:
’ It¶s the way we receive information about others,
self, world, relationships
’ It shows that you are interested and want to
understand the other person
’ It enables you to connect with another¶s
perspective and validate how they feel
’ It affirms the other person and helps them feel
lovable, acceptable and worthwhile
’ It shapes our character and makes us feel secure
’ It bridges the space that divides and separates us
from each other
à
 




Barriers that prevent us from hearing accurately
’ Inattention - fatigue
(listening requires energy and effort)
- in a hurry
’ Preoccupied
’ Distracted - by external noise or activity
- by inner dialogue (lacunae)
’ Bias/Prejudice
’ Boredom
’ Information Overload
à
 




’ Ýumping to conclusions (don¶t hear all the message)
’ Vaking assumptions or snap judgements
’ Failure to connect with the feelings/emotions
’ Self Consciousness (low self esteem)
’ Use of tactics to block communication
’ Words have different meanings to other people
’ mhe presenting problem is not always the real concern


  
gWhy Don¶t People Listen?´ by Hugh
H Vackay

1. Receiving the message before we react to it

2. Resisting the temptation to be distracted by ³trigger

words´ which may send you off at a tangent so that you
lose the thread of your partner¶s message

3. mhinking ³how can I use this information?´ Looking for

ways to make the message relevant to your situation

4. Working hard at listening, if necessary by asking the

other person to give you smaller chunks of information
to absorb


  

5. Giving full attention to the total message and keeping

distractions at bay

6. Empathising with the other person¶s feeling and intention

. Reflecting on what you have heard

- giving ³playback´ before ³feedback´

  

 

1. Always interrupting (impatient)
2. Ýumps to conclusions / makes
assumptions
3. Is inattentive ± wandering eyes, daydreaming
4. Changes the subject
5. Finishes the other person¶s sentences

  

 

6. Doesn¶t give any response
. Distracts, fidgets
. Fakes attention (and ends up completely lost)

  

 

1. Vaintains good eye contact (alert, focused,
shows interest)

2. Isn¶t in a hurry! ± goes at speaker¶s pace

3. Doesn¶t interrupt
4. Shows concern by:
- asking appropriate questions
- giving good feedback
- clarifying meaning

  

 

5. Is poised and emotionally controlled

(patient, non-anxious presence)

6. Stays on the subject ± listens till the other is

finished disclosing

 
 
  
1. CONNECm WImH FEELINGS
Not only hearing the words of the speaker,
but hearing the feelings behind the words as well

2. EVPAmH„
Empathising with the speaker (i.e. feeling his feelings
and seeing the world through his eyes)

3. SUSPEND ÝUDGEVENm
Suspending your own value judgements
so that you can understand the speaker¶s
thoughts and feelings as he/she experiences them

 


1. Questioning

2. Confronting

  
 
1. Gather information

2. Clarify personal concerns and feelings

3. Establish goals for future action

4. Discourage unprofitable rambling

5. Clarify what is not being said


   

Closed Open

mhe open/closed continuum

Common starting mhe opening word used to frame an

words to closed open question can determine the
questions focus of the answer
Is/Are What « facts
Have/Has How « feelings, processes
Do/Did/Does Why « reasons
Can When « time
Where « location
Would/Could « open focus decisions

   




1. An invitation to self examination

2. Gently holding out inconsistencies in

thoughts, feelings and behaviours

3. An opportunity to explore another

viewpoint or less destructive
behaviour

   



RULES

1. Don¶t confront unless you intend to

stay involved in the relationship
2. Assess the person¶s ability to accept
the confrontation
3. Confrontation needs to be empathic,
authentic, well-timed, concisely stated
4. Don¶t confront with non-verbal hints
 BELIEFS AND VALUES
Frustration, hurt, fear,
threat to self esteem,
injustice,
physical harm or injury

ANGER
a Secondary Emotion

BELIEF S„SmEV
About anger as an acceptable emotion

ANGER ANGER ANGER

Expressed Expressed —nexpressed
Constructively Destructively and Stored
 ANGER ANGER ANGER
Expressed Expressed —nexpressed
Constructively Destructively and Stored

’ Hurt and fear ’ —nresolved feelings ’ —nresolved feelings

acknowledged internalised internalised
’ Anger ’ Direct hostility ’ Withdrawal
expressed and - aggressiveness - compliance
resolved - violence, abuse - submission
’ No negative ’ Displaced hostility ’ Depression, guilt,
feelings left over - controlling suicide
- critical/judgemental
’ Forgiveness ’ Physical/psychologi
- prejudiced
cal reactions
- addictive behaviours
’ Passive-aggressive
’ Apathy
behaviour
- avoidance
- non-participatory ’ Substance abuse
- non-cooperative
’ Boredom
’ Free-floating hostility
- easily revoked

 
 
’ The client displaces on to the counsellor feelings, attitudes and attributes
that really belong to a relationship that the client has previously had with
someone else in their life.
The client responds to those feelings as though the counsellor was that
significant person in their past.

’ The tendency to transfer on to any current relationship those feelings

and emotions that properly belong to a previous relationship.

mransference Patterns
’ Idealising the counsellor
agreeing, complimenting, imitating, dreaming
’ Attributing supernatural powers to the counsellor
expert, godlike, awe
’ Regarding the counsellor as provider
being helpless, dependent, indecisive, asking for advice or touch
’ Regarding the counsellor as unimportant
never listens, changes subject, dismissive, unwilling to explore
 





 
 
’ Feelings that arise from the counsellor¶s own
unconscious needs, wishes or conflicts, that are
evoked by the client and brought into the
counselling relationship. These feelings that the
counsellor transfers onto the client would be
more appropriately directed at another person,
either in the present or the past. They affect the
counsellors neutrality and influence objectivity,
judgement and reason
 





 
 
’ Possible indications of Counter-Transference
(may be either over-identification or disidentification)
1. Being preoccupied with certain clients
2. Developing fantasies or dreaming about certain clients
3. Altering the length of sessions or forgetting sessions
with certain clients
4. Emotional withdrawal from the client ± cool / aloof;
distance
5. Feeling uneasy during or following sessions
6. Needing the approval of certain clients
7. Not wanting a client to terminate
8. Promising unrealistic rescue
9. Not willing to explore certain issues
10. Collusion with the client ± allows them to blame others
  
m


’ The injurious effects of stress

’ Emotional exhaustion ± associated with
relationships that require a high level of empathy
and concentration
’ Burnout results in physical or psychological
withdrawal and results from situations where you
are exposed to prolonged periods of conflict with
no resolution. It is characterised by:
’ Chronic low levels of energy
’ Defensive behaviour
’ Distancing emotionally from people
  
m


’ Burnout, counter-transference and work

dissatsifaction may be a mask for ³Compassion
Fatigue´ (C Figley, 1982)

Compassion fatigue (secondary traumatic

stress) is associated with the ³cost of caring´ for
others in emotional pain

³an individual observing another person,

experiences emotional responses parallel to that
person¶s actual or anticipated emotions.´
    

 

Stage Helper Behaviour Client Behaviour

I Connecting and Attending, listening, Exploring their story

clarifying and understanding or problem

II Goal setting: Promoting new Developing new

based on dynamic perspectives and perspectives and
understanding clarifying options setting goals

III Action: Facilitating action Acting, problem

Designing and management,
implementing achieving goals

Adapted from an Egan (1982, p. 51)

à


’ Obstacle to life goals
’ Usual coping methods don¶t work
’ Followed by period of upset or
disorganisation
’ No solutions work
à



  

1. A hazardous event / situation
2. Feeling vulnerable
3. Precipitating factor or incident
4. Acute crisis state
a. Symptoms of distress
b. Attitude of panic or defeat
c. Frantic search for relief
d. A time of lowered efficiency
 




 
Premature birth
Role change (unemployed, move, sacked)
Accident / illness
Death / Loss (grieving process)
Suicide
Divorce / Separation
Change of religion
Depression
—nresolved marital conflict (vicious
cycle)
 


ë   

Family lifecycle
Stages of marriage
Family problems
 m


Stages of disillusionment:
Enthusiasm
Stagnation
Frustration
Apathy
Hopelessness
  

IVPACm PHASE CLOUDED REVImALISAmION
’ Rise in tension PHASE PHASE
’ Emotional response ’ Everything looks ’ New perception of the event
black
’ Shock, numbness ’ Develop network of support
and fear dominate ’ Can¶t face reality from people and available
resources
’ Beliefs, values, goals ’ Distorted view
are threatened ’ —tilise and develop adequate
’ Severity depends on
coping mechanisms
’ Feel inadequate as the difficulties
usual problem- experienced or the
solving techniques importance of the
fail event

’ Feelings of
discomfort dur to lack
CRISIS
of success in coping

RESISmANCE DESmRUCmIVE
PHASE PHASE
 RESISmANCE
PHASE
’ Increased tension ±
results in increased
activity
DESmRUCmIVE
PHASE
’ Disorganisation
occurs as tension ’ Fatigue sets in
rises
’ System shuts down
’ Mobilisation of
’ Frustration, helplessness and
internal and external
regression
resources
’ Anger and
aggression,
withdrawal, fear and
helplessness
 







1. Connect with the person in crisis
2. Diagnosis of the problem
a. What is the precipitating event?
- situational or developmental
- how is the event perceived
b. Present level of functioning
- sleeping, eating
- suspect drug dependency
- amount of distress
- amount of behaviour change
- amount of mood / expressiveness
- amount of body pain
- amount of stress level
- amount of fear / ideation
 







c. Coping Skills
- what strengths used to cope?
- past methods of coping

d. Life Support System

- people and resources

e. Assess Risk (actual or potential)

- suicide
- abuse
- homicidal
- incest
- depressive
- dependent
 







3. Intervention
Goals
- return person to usual level of functioning
- decrease anxiety and apprehension

Strategies
a. help the individual to understand intellectually
what the CRISIS is all about
b. help the individual to bring into the open their
present feelings
- stop denial, blaming and suppression of feelings
- deal with feelings of guilt and failure
 







c. Explore the individual¶s coping mechanism
- explore options and alternatives
d. reopen them to their social world
e. negotiate the possibilities of further growth

4. Resolution
a. reinforce self-esteem
b. instil hope
c. Rehearse and reinforce coping mechanism



A common mood disturbance

evidenced by feelings of sadness,
disappointment, grief and loneliness
Æ  

 


1. Low Feelings
- feel sad and dejected
- irritable mood
- low self-esteem
- Withdrawn, isolated
- Feel helpless, hopeless, miserable
- Prone to frequent bouts of weeping
Æ  

 


2. Negative mhinking
- think negative about almost everything
- ruminate over past mistakes, about death
- self critical
- trivial problems seem monumental

3. Poor Votivation
- lack of interest or pleasure in most activities
- lack of self confidence ± indecisive
- bored, daydreaming
- want to run away and escape
Æ  

 


4. Change in Physical Health
- sleeping and eating patterns changed
- real or imagine change in physical health
- hypochondriasis
- slow down in physical activity

5. Vasked Reactions (Behaviour)

- aggressiveness ± anger outbursts
- hyperactivity
- over achieve / under achieve
- impulsiveness ± gambling, sex, violence, drinking
compulsiveness ± work harder, overeat, watch mV
- neglect appearance
- sarcasm / cynicism
 

1. Heredity
- a family predisposition
- childhood experiences
- high expectations, lack of love / rejection

2. Biochemical Imbalance
- associated with a chemical imbalance in the
brain
- organic causes such as:
drugs and poisons
metabolic disturbances
infectious diseases
cancer
 

3. Stress
- a reaction to loss following a personal
tragedy or disaster
- often associated with childbirth, menopause
or retirement
4. Personality
- certain personality types are prone to
depression (e.g. perfectionists, dependant
personalities
5. Learned Helplessness
- someone exposed to repeated losses or
stresses may lose optimism and feel helpless
and depressed
 
 
 
1. Reactive Depression
- mild to severe reaction to a distressing life
situation (e.g. loss of job, loss of close
relationship)
2. Post Natal Depression
gBaby Blues´
- occurs in 10 of mothers after childbirth
- severe post natal depression with manic or
depressive symptoms



3. Endogenous or Vajor Depression

- a severe type of depression associated with a
chemical imbalance in the brain
- may lead to suicide, self harm, psychosis or
delusional thinking

4. Bipolar Disorder (Vanic Depression)

- periods of endogenous depression
alternating with periods of mania
  



1. Be Empathetic, Non-judgemental
- listen to the emotions (anger, guilt)
- stay present ± show you care (actions speak
louder than words)
- avoid being non-directive (lower anxiety and
pessimism)
- don¶t reinforce feelings of worthlessness
- avoid confrontation (don¶t probe or demand
action)
  


2. Assess the Severity of the Depression
- how long has the person felt this way?
Discuss the current life situation to evaluate
causes (note losses, failure, rejection)
- are they on drugs or medication?
- ask if they have thought of harming themselves
- consider a referral

3. Build a Network of Support

- involve family (without violating confidentiality)
- provide encouragement / support is very
important
- utilise faith resources
  



4. If Necessary, make Emergency Action

- with depression, the risk of suicide is high
- if suicide seems possible, intervene
immediately

5. Beware of Vanipulation
- depression breed dependence and demands your
attention
- connect individuals to other support systems
  



6. Stimulate Realistic mhinking

- put events into perspective
- stop ruminating and brooding
- challenge negative self-talk

. Refer for Professional Counselling

. Remember, Recovery is a Process
- when dealing with pain there is no quick way to
closure


  




1. Social Isolation
living alone, single, widowed, divorced, weak ties
to relatives and friends

2. Recent Interpersonal Loss

Death of loved one, end of an important
relationship

3. Sudden Economic Downturn

—nemployment, bankruptcy


  




4. Ill Health or Chronic Illness
5. Psychiatric Condition
Schizophrenia, depression, personality disorder,
alcoholism or other drug abuse

6. Sense of Hopelessness
. Anxiety Related Symptoms
excessive worrying, severe insomnia, panic attack, lack
of concentration


  




ô. Impaired problem-solving
tunnel vision, inflexible thinking

•. Previous Suicide Attempt

10. Communication of a Wish to Die
11. Family History of Suicide or
Attempted Suicide


1. Do they have a plan?
2. Do they have access to weapons?
3. Have they attempted suicide before?
4. Are they currently seeing a therapist?
(get their name, address, phone number. Ask if
you can call their therapist)

5. Stay with them until help arrives

If they leave or run away, use the information
obtained to help the police find them



6. Remember you can only do what you

can do
You have no power to stop someone killing themselves
if they want to do it
You are only a support
 
 

 
1. Emotional Reactions
sadness euphoria
anger shock
guilt fear
disbelief loneliness
emptiness confusion
helplessness lethargy
hopelessness despair
panic anxiety
scanning regret
 
 

 
2. Physical Reactions
fatigue
insomnia
loss of memory
poor concentration
reduced salivary flow
sighing
pressure in the chest
tightness in the throat
trembling inside
nausea
 
 

 
3. Behavioural Reactions
withdrawal
clinging
super philanthropy
displaced anger
agitation
avoidance of reminders
obsessiveness with reminders
engaged in many distracting activities
  


 

1. Acknowledge the Loss

- accept the reality of the loss
communicate your understanding of the pain
and sadness the other is experiencing
- don¶t run away from the pain

2. Listen
- without judging or offering advice
- give the person permission to grieve

3. Communicate on the Feeling Level

- it¶s okay to release feelings and experience the
pain
  


 

4. Remember that Integration and

Acceptance Will make mime
- people¶s moods vary

5. Encourage the person to get support

from close friends and relatives
6. Remind the person that you care and
will continue to be supportive in the
months ahead
  


 
. Utilise the Faith Resources of the
Individual
- encourage them to look for spiritual support

ô. Give Permission to the Grieving

Person to Stop Grieving
- treasure memories (don¶t avoid them)
- fading memories doesn¶t show a lack of love
and respect
- life goes on and its okay and normal to enjoy
its riches to the full
- reinvest in new activities and relationships





 

1. Predictable Cycles
- The same problem keeps recurring with no
agreement or resolution

2. Anger
- You can¶t discuss the problem or issue without
one or both you getting angry

3. Abuse
- Either physical or emotion abuse occurs during
the argument





 

4. Sexual Apathy
- Your sex life is continually unsatisfactory
(for either spouse)

5. Voney or Children
- Money or children have become a divisive factor in
your relationship

6. Poor Communication
- You can find nothing positive to say to each other





 

. Devitalized
- There is no excitement, passion or romance in
your relationship

ô. Decision Vaking
- All the decisions for the family are made by one
spouse

•. Family Distress
- Your disagreements are beginning to distress your
children





 

10. Depression
- Either partner is severely depressed or
threatening suicide

11. An Affair
- Either spouse is involved in an affair

12. Vask
- Your relationship presents a different face in
publish to the one seen in private
  à 




Refer
at the first sign of emotional, marital or family distress.
Delay can compound the problem

Provide
them with the names of several qualified marriage and
family counsellors

Suggest
that they call and request information regarding the
counsellor¶s training, experience and fees
  à 




Discuss
a marriage and family counsellor¶s special areas of
expertise with the person/s you are referring

Refer
couples and / or families for counselling together

Ask
the family to use your name as the one referring when
they make their initial call to the marriage and family
counsellor
  à 




Follow Up
With both the person and the marriage and family
counsellor