Teaching session worksheet
>click here for printable version<Introduction
Counselling is a basic skill that underpins almost every consultation in general practice. When we are listening to a patient tell us about their illness experience, when we are talking to a patient about quitting smoking, or helping them deal with their anxiety; in all of these situations we are using counselling skills. They are ubiquitous!
At a basic level these skills might include active listening, empathising, validating the patient’s experience or assessing their readiness to make change. More challenging aspects of counselling might include breaking bad news or working with patients with chronic pain or extremely stressful life experiences.
There are different levels at which GPs can be involved in counselling; some may want to undertake further training in order to provide focused psychological strategies for their patients, such as cognitive behavioural therapy.
The following areas for discussion cover a broad range of points about counselling in the general practice setting.
As part of their Mental Health Education Program, Block Releases are held for Basic, Advanced and Subsequent term Registrars that cover aspects of this topic. This tutorial is an opportunity to consolidate and build on some of this learning in a local setting. It would be useful to ask your Registrar if they have attended the Block Release and discuss any pertinent aspects or issues.
Full details of the Block Releases including useful resources are available here. Some of the learning objectives from the block releases that may be relevant to this session are listed below.
Objectives:
- Be able to implement ‘watchful waiting’.
- Be confident with psycho-education using consumer friendly resources.
- Have a greater understanding of management strategies.
- Be confident with several brief evidence-based psychotherapeutic interventions.
- Have greater knowledge of mental health services in the community and referral pathways.
- Be familiar with a list of useful resources, including consumer self-help resources.
Activity
Your Registrar will be asked to review a consultation and undertake a reflection activity based on their consultation.
There is one set of activities for Basic term Registrars and one for Advanced. Both require a review of a consultation video and reflection activity. Advanced term Registrars will also be asked to reflect back on previous learning in this topic area.
Once the Registrar has completed the activity they will bring their materials and the video-recording of the consultation back for review with the Supervisor.
Use the review of the consultation and the Registrar’s notes to discuss various aspects of counselling. The key questions below should be addressed in your discussions.
Key questions
- What do we mean by counselling skills? Are they the same as therapy?
- In what situations do we use counselling? Every day? Less frequently?
- How do we achieve and maintain a therapeutic alliance?
- What do you do if one strategy fails?
- There are different levels at which GPs can be involved in counselling? What level do you want to be involved? How might you get there?
- What resources are there within the practice? Outside the practice? Locally and more distant?