Being a Reflective Counsellor

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“As important as methods may be, the most practical thing we can achieve in any kind of work is insight into what is happening inside us as we do it. The more familiar we are with our inner terrain, the more sure footed our [work] – and living- becomes.”
~ P. J. Palmer

How do you reflect?⁠

Reflective counselling practice is mindful practice. ⁠

Reflective counsellors are aware of their own strengths and limitations. They conduct counselling with purpose and intention. They monitor their own levels of stress and are mindful of personal matters that may interfere with their performance. Reflective counsellors take the time to evaluate and refine their performance after each counselling session and are committed to ongoing personal growth and professional development.⁠

There are many processes that contribute to effective reflective practice. Some of these may include:⁠

1. Evaluating own performance⁠
2. Developing self-awareness⁠
3. Monitoring potential for burnout⁠
4. Ensuring adequate self-care⁠

There are a number of strategies that can be implemented to assist you in monitoring and/or improving the way you conduct your counselling sessions. Here are a few examples:

1. Self evaluation
This is the process of reflecting on your own skills, your professional strengths and limitations. Awareness in these areas will enable you to choose professional development or training activities to fill any identified skill or knowledge gaps. Self-awareness of this nature will also enable you to identify clients that are beyond your scope of expertise and will ensure that you refer responsibly.

2. Client feedback
Providing client with the opportunity to review the counseling process can be tremendously beneficial for both counsellor and client alike. Not only does it acknowledge the client’s opinion as valid and valued, it also provides an opportunity for the counsellor to evaluate his or her current approach and adjust or continue accordingly.

3. Peer review
Peer review enables counsellors to come together and discuss individual cases, ethical dilemmas and brainstorm intervention options. It is a process that can increase counsellor accountability and improve the quality of service offered to clients (please ensure confidentiality policies are appropriately upheld).

4. Professional supervision
Supervision is an integral part of counseling practice. Within supervision, counsellors can enhance their skill and knowledge base, ensure responsible and ethical practice and monitor their self-care and professional competence. Supervision acts as a mechanism to ensure that a counsellor’s approach is aligned with professional standards and reflects the requirements of the industry.

What are your go-to practices and processes?⁠

Read more here –

Skovholt, T. M. (2001). The resilient practitioner: Burnout prevention and self-care strategies for counselors, therapists, teachers and health professionals. Needham Heights, MA: Allyn & Bacon

Schon, D. (1983) The reflective practitioner: How professionals think in action. Avebury Press: Aldershot.

Clinical Guidelines for PTSD

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New Guidelines are Out!

Clinical EFT (Emotional Freedom Techniques) is an evidence-based method that combines acupressure with elements drawn from cognitive and exposure therapies. The approach has been validated in more than 100 clinical trials. Its efficacy for post-traumatic stress disorder (PTSD) has been investigated in a variety of demographic groups including war veterans, victims of sexual violence, the spouses of PTSD sufferers, motor accident survivors, prisoners, hospital patients, adolescents, and survivors of natural and human-caused disasters. ⁠

A new paper recommends guidelines for the use of EFT in treating PTSD derived from the literature and a detailed practitioner survey. It has been reviewed by the major institutions providing training or supporting research in the method. ⁠

The guidelines recommend a stepped-care model, with 5 treatment sessions for subclinical PTSD, 10 sessions for PTSD, and escalation to intensive psychotherapy or psychopharmacology or both for nonresponsive patients and those with developmental trauma. Group therapy, social support, apps, and online and telemedicine methods also contribute to a successful treatment plan.

Please review if you work with patients and clients.⁠

Reference:⁠
Church, D., Stapleton, P., Mollon, P., Feinstein, D., Boath, E., Mackay, D., & Sims, R. (2018). Guidelines for the Treatment of PTSD Using Clinical EFT (Emotional Freedom Techniques). Healthcare (Basel, Switzerland), 6(4), 146. doi:10.3390/healthcare6040146  It is available in full here.

The Setup Statement and Changing the Ending

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Did you know in EFT Tapping you can change the end of the setup statement?

While the traditional version may sound like Even though I have this problem, I deeply and completely love and accept myself, many people don’t feel comfortable saying that. The main thing is to acknowledge what is currently happening, and accept that is how it is right now –  obviously any tapping is then designed to target/change it.

You could say any of the following:⁠

• Even though I . . . , I accept I have this problem.⁠
• Even though I . . . , I am still a good person.⁠
• Even though I . . . , I am taking charge right now.⁠
• Even though I . . . , I want to change this.⁠
• Even though I . . . , I completely and sincerely accept myself.⁠
• Even though I . . . , I completely love/like and accept myself.⁠
• Even though I . . . , I deeply and completely love and accept myself anyway.⁠
• Even though I . . . , I deeply and completely forgive myself.⁠
• Even though I . . . , I deeply and completely love and accept my feelings.⁠
• Even though I . . . , I choose to love and accept myself.⁠
• Even though I . . . , I choose to be open to this process.⁠
• Even though I . . . , I am okay and open to the process.⁠
• Even though I . . . , right here right now, I am safe.⁠

What is your favourite ending?⁠

Common Tapping Questions Part III

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More Common Tapping Questions!⁠

Also read Part I and Part II as well.

Q: If I’m in a situation where I feel uncomfortable saying the setup and reminder phrases aloud, can I say them to myself?⁠

Yes, this still works. If you find yourself drifting and not staying focused, you may wish to continue at another time when you can say them out loud again.⁠

Q: If I’m in a situation where I feel embarrassed or uncomfortable tapping, what should I do?⁠

You can tap inconspicuously on any points you can and leave the others until you have the opportunity to tap in private. Also, consider tapping on the feeling of being embarrassed or uncomfortable in the situations concerned.⁠

Q: If I don’t have a particular feeling and I say the setup statement and tap with someone who does, will that give me the unwanted feeling?⁠

No, you won’t take on someone else’s discomfort. Tapping with someone else for his or her discomfort can give you an awareness of a similar aspect that you may have. In that way you may get “borrowed benefits” from tapping with them and reduce your own discomfort.⁠

Common Tapping Questions Part II

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You may also like to read Common Tapping Questions Part I here.

Q: How soon can I tap on my own?⁠

You can use the technique on your own as soon as you understand the concepts. However, always know you can seek the assistance and support of professional practitioners too. Remember If you would like to watch a video of me teaching tapping and outlining how it works, see below!

Q: I worry about getting the setup or the tapping wrong. Does EFT have to be done precisely and perfectly?⁠

No, there is no such thing as perfect EFT. For example, people with significant brain injury have reported benefits from doing their version of EFT that differed somewhat from what they were taught . What mattered was that they were able to grasp the EFT concept; and because their unconscious brain understood the intention, they were able to gain benefits from the way they did it. ⁠
If you are really worried about getting it right (and without the help of a professional), tap with the setup statement “Even though I am worried about getting the words wrong, and it might not work, I accept myself anyway” (reminder phrase would be “worried”).⁠

Q: Can I make things worse if I don’t tap exactly as taught?⁠

No, you won’t make anything worse—just stick to the basic steps. If you don’t feel you completed the process because you haven’t reached a SUD of 0 or 1, return to it another time. It is always best to tap until you feel calm, or there may still be aspects to deal with. Seek the support of a certified EFT practitioner if you do need assistance.⁠

The Science Behind Tapping Won an Award!

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Very excited to hear The Science Behind Tapping: A Proven Stress Management Technique for the Mind and Body is the Award Winner in the Self-Help: General category of the 2019 Best Book Awards sponsored by American Book Fest!

If you haven’t checked it out, here is an overview and page to collect your free gifts for purchasing.

This is such a wonderful recognition of a growing field of 4th wave approaches to stress reduction and therapeutic options!

You can view all the categories and the winners/finalists here.

Common Tapping Questions Part I

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Common Tapping Questions!⁠

Q: If I’m in a situation where I feel uncomfortable saying the setup and reminder phrases aloud, can I say them to myself?⁠

Yes, this still works. If you find yourself drifting and not staying focused, you may wish to continue at another time when you can say them out loud again.⁠

Q: If I’m in a situation where I feel embarrassed or uncomfortable tapping, what should I do?⁠

You can tap inconspicuously on any points you can and leave the others until you have the opportunity to tap in private. Also, consider tapping on the feeling of being embarrassed or uncomfortable in the situations concerned.⁠

Q: If I don’t have a particular feeling and I say the setup statement and tap with someone who does, will that give me the unwanted feeling?⁠

No, you won’t take on someone else’s discomfort. Tapping with someone else for his or her discomfort can give you an awareness of a similar aspect that you may have. In that way you may get “borrowed benefits” from tapping with them and reduce your own discomfort.⁠

Table Top and Table Legs in EFT Tapping

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We often use an analogy of a table when discussing how EFT can work quickly. The tabletop in the analogy often represents a global issue in life, and the legs of the table represent the times in life that reinforced that issue. Each of the legs and memories will have its own aspects.⁠

Let’s consider a common pattern of behavior: procrastination. Imagine someone who just does this all the time. Even when they try to be organized and efficient, they slip into a pattern of procrastinating.⁠

In this example the tabletop is procrastination. It is the big global issue, and tapping just on “procrastination” may not change the behavior. The legs of the table are the events, memories, and times in that person’s life where they did procrastinate; and some of these will be more significant that others (e.g., if there was a negative consequence from procrastinating, it may have been more impactful).⁠

Tapping on all those specific events with all the aspects will be important. However, you may not have to tap on every single time in your life you ever procrastinated. (You may sigh in relief here!) It only appears important to tap on the really significant memories you recall about the topic. The procrastination table here will collapse when the largest legs are removed. The table will fall over even when several legs remain.⁠

The image here offers a visual example of a tabletop of someone who believes they aren’t good enough. You can see the legs of the table include examples of specific times in their life where they haven’t measured up (and each of these can have its own legs too). The idea is to tap on these individual memories (legs) as you become aware of them, and over time the belief of “I am not good enough” will change, and you will have a different reality. Chances are, you won’t have to tap on every single memory.⁠

So keep this in mind next time you tap, and keep a running list of the legs!

An example of a Support Group Format

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Following on from the blog on 12-11-19 about how to run a successful support group – here is an example of one of my eating disorder groups from a while ago. You can see how structured they are as a guide, but with flexibility built in in case you need it.

A Support Group Example – Topic: Overcoming the Numb Zone

Opening
1. Distribute name tags
2. Enquire as to how everyone’s week went – allow 5-10 minutes “diffusing time”
3. Brief overview of this week’s workshop

Materials Required
1. Handouts provided

Exercise
1. Ask participants to describe in one word how they feel right now

Discussion of the following points:

Common feelings in sufferers of eating disorders tend to be the more negative mood states (depression). Depression is a particular problem in its own right, but is often precipitated in eating disorders sufferers because of electrolyte imbalances (due to periods of starvation and/or bingeing and purging behaviours). There are different ways of dealing with negative mood states.

Step 1 Dealing with and changing your thinking (last week’s session) – become aware of self-defeating thought patterns and challenge yourself with more rationale ones

Step 2 Awareness – recognising your feelings.

Discuss the following in some depth:

• Paying attention to your mood states and changes – when you start to feel sad, gloomy, angry, bored, lonely, tune into what’s happening and how you’re feeling

• Own your feelings – starting to talk about your feelings will help you to own them

• Be alert to your body – this is a clue to your emotions!

• Label your avoidance – keep a lookout for the places, people, activities you used to do but avoid now. Forget about WHY you avoid them – think about WHEN you avoid them

• Think about the times when your confidence disappears – certain times and places?

Homework / Closing

1. Provide participants with the sheet on identifying feelings and instruct them to look at the dictionary meaning of the word listed over the next few weeks
2. Finish with a motivational story

I used to design 12 at a time and have them available to choose from as I went (all groups are different so work out what is important for yours)! Enjoy the journey supporting others and remember you can always ask for supervision from a mentor if you need it.

How to Run a Successful Support Group

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If you have ever had the idea to start a support group in your local area or community, these tips might help the process.

I personally ran weekly support groups in the area of eating disorders, for sufferers and their families, for a period of 8 years.  Those groups and the people who attended taught me a wealth of information, which I want to share with you here today.

Questions to ponder:

1. The first step is to Think About what you want to Accomplish. What are your reasons, visions and purposes behind the group.

2. Do you want the group to be closed (limited numbers) or open (anyone can attend whenever it suits). Will it be a limited series of dates (e.g. 12 week program) or run throughout the year on the same day of the week/month and the same time?

3. What type of leader do you want to be? Are you skilled as an expert in something, and that is what you are offering? Or are you a consumer who wants to facilitate the gathering but not lead it in any way?

My reason was to support people in the larger community who suffered an eating disorder, who might not have been able to attend individual therapy or wanted a group as an adjunct to standard care.

My role was as an expert – the support group I ran was open – anyone could attend, whenever they want. The topic was always set by myself every time we met (which was often weekly, although was fortnightly sometimes over the 8 years), and there was always some type of loose structure to follow. This might have been a topic to talk about (and we went wherever that flowed) or an exercise to engage in.

  1. How will you let people know about the group? Can you access potential people through social media? A Meet-Up forum? Do you want to target specific groups only? Or the general community?
  2. Finally, where will the venue be? Do you need to consider any fees for rental? Or insurance such as public liability (in case someone injures themselves at the venue). Will you charge a nominal fee for attendance, or will it be free? Would refreshments be necessary or expected? How will you handle this?

My groups were all free at attend and no refreshments were provided (although we did have a Christmas breakup every December where everyone bought a plate to share). I approached a local community hall for the venue and they provided it free of charge as the support group was not an income generator.

Rationale for Group Work

Group work enables participants to come together to support one another and create a counterculture where diversity is accepted and competition is challenged. Group situations create a safe forum for the exploration of issues or themes, for some participants perhaps for the first time.

Group situations create an opportunity for participants to develop networks, share common experiences and identify with one another whilst developing strategies for coping.

Support groups may provide a very necessary and unique therapeutic intervention to address isolation, increase knowledge, encourage self-responsibility, enhance confidence, identify feelings and place their concerns within the wider context of life experiences.

The global purposes of any support group may include:

• continued development and documentation of support group
• to co-ordinate and facilitate the skills being taught, in a group setting
• to develop an effective and efficient system for reaching many people

The objectives a support group might be:

• to enhance the understanding of the underlying issues that bring people to the group
• to decrease the experience of isolation, shame and misinformation relating to the group theme
• to enhance participant’s sense of self-esteem and sense of control in their lives
• to enhance participants’ ability to seek support (including individual) that will assist them in their journey

What might your purpose and objectives be?

Practical Steps on the Day

For the very first group (and anytime there are new members), discuss the group rules. You may brainstorm these the first time you start, and take a written note of these rules to draw up and present at each session (e.g. as a poster)

Some Ideas:

• Everyone has the right to speak

• Everyone has the right to pass if they just want to listen

• No one person should dominate the conversation at any given time (facilitator/s excluded)

• When someone is speaking or sharing an experience, they have the right to the rest of the groups’ quiet and respect

• Whilst ideas and behaviours may be critically evaluated, at no time should a participant be personally attacked

• Attendance at groups – is promptness important?

1. Will you sit in a circle? Groups tend to function better this way, rather than classroom style (although an education night might be better as lecture layout)
2. Distribute name tags if needed
3. Make introductions of yourself and any other leaders
4. Discuss the nature of confidentiality if it is appropriate – what are the guidelines around this for your group? Often support groups respect confidentiality, and discussions of personal situations must not be disclosed to others outside the group.
5. Enquire as to how everyone’s week went – allow 5-10 minutes “diffusing time”
6. Give a brief overview of the week’s group topic of choice, if that is the structure
7. Manage the time of the group in case people attending are relying on it finishing on time

Other Ideas for the Support Group

1. Guest speakers are always welcomed – especially with regular groups. It adds variety
2. Does the group need a charter, non-profit status, constitution, governing bylaws? Do you need to seek advice on this?
3. Funding? There are community organizations who offer support groups funding for one off events, or things such as printing costs for handouts
4. Your contact number – if the group requires a contact email address to be monitored or a landline/mobile number to be answered – who will do this?
5. Do you need a referral list of skilled, expert people to hand out if the needs of someone are beyond your expertise? Have that ready to go in case people want to take it
6. Will your group keep a record of attendees details (e.g. demographic information or email addresses?) – this information might be useful if you apply for any type of funding. It could be anonymously completed.
7. Will your group also have a monthly newsletter or online support aspect (e.g. Facebook secret group)

Good luck and be sure to check out our next blog that gives you an example of one of my support groups!

EFT Tapping for Chronic Pain

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“As a clinician who works with people suffering persistent pain, I have had excellent results with EFT for our patients. I have used it for opioid reduction and it has certainly supported my patients through it comfortably with much less withdrawals then a patient not using EFT.  The reduction of pain and anxiety through this modality has certainly given them a fantastic self- management tool as often when they need help it is not often when they can see their clinician.  It has also enabled patients to gain confidence in themselves and to find who they are again beyond their pain.  A most valuable tool to have in one’s treatment toolkit!!”

This comment was left by a health professional at an EFT training – and reminds me of how tapping has been explored many times for pain.

Pain is a very real thing, although medicine still finds it difficult to objectively measure it. Any of us can suggest how strong a pain is in our body, but there doesn’t yet exist a scientific or medical test where a third party could accurately tell us the level of pain we are feeling (e.g. by looking at the brain).

This tells us that pain also has an emotional element, and it influences the impact and severity of what we feel. Did you know that 80% of chronic pain is considered to have psychologically factors involved?

Chronic pain is often associated with a range of physical, psychological, and social risk factors, and is usually described after 3 to 6 months. With an acute injury or similar, the body usually heals within 3 months, so any significant pain after that might highlight something else is happening for the person. After years of pain, the pain tends not to be a signal of damage anymore. And so health professionals look at the emotional factors in the situation.

When people feel emotional pain, the same areas of the brain get activated as when people feel physical pain too. So there seems to be a link between pain and emotions.

When you think about it, the brain is very connected with the rest of the body: there are direct connections from the brain stem and spinal cord to the circulatory and lymphatic systems. Every cell in our body is linked the nervous system and so when there is a physical pain and someone has a feeling about it (e.g. anger or distress), neuro hormones get released to match the feeling.
Research shows that being a negative mood makes pain sensations in the body magnified. And the opposite is true: in healthy volunteers, feeling positive is associated with reduced pain.

So what the take home point? If you experience pain in any shape, and for any reason, then taking note of your feelings will be important. Emotions can magnify or reduce the actual sensation of pain. So changing your feelings may be part of the recovery process.
Make some notes now about your own pain if you have any: where you feel it, when it started, what else was happening in your life at that time, and how you feel about it now. Here are some questions to get you started:

• When did the pain start?
• What was going on in my life at that time?
• Did something specific happen?
• Who was I with at that time?
• Did anyone say or do something that made me really mad?
• What was I feeling at the time?
• Is the pain trying to tell me something? Is there a message I hadn’t seen before?
• Who would you be without this pain? Does that scare you?
• What’s the upside of holding onto this pain? Is the pain serving you, helping you in any way? (Maybe you don’t have to go to the job you hate, or visit your in-laws…)
• What’s the downside of holding onto this pain?

2 Ways to use Tapping for Pain Issues

1. You can tap on the physical sensations of pain for relief (intensity and severity) just introduce some relief. You can simply tap and breathe (tap on each point but just say the words ‘breathe’ or ‘relax’ as you tap – this is to just introduce a physiological calm, rather than address any problem). You can describe the pain in terms of colour (red), feeling (angry), texture (hard), temperature (hot), and density/weight (heavy). So it might look like “this red, angry hard slab in my neck”. After tapping down the intensity, you may then be in a position to start tapping on what is actually happening to cause this pain.
2. Use tapping to explore WHY you have this pain. Have a think about WHEN it started (e.g. there may have been an injury). If there was no injury, think about what was happening in your life at the time the pain started (and even think 6-months prior). You can tap on memories with the Movie Technique in EFT or Matrix Reimprinting.

Always seek the support of a professional and skilled EFT practitioner if you need support with this.

If you want to see where the current research is at and what it means – have a watch here.

New EFT Tapping Research Using Neurofeedback

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New EFT Tapping research is investigating the use of neurofeedback in session, using a comfortable EEG headband called FocusBand. Electroencephalography (EEG) is the measurement of electrical activity produced by the brain.  Neurofeedback trains your brain to function more efficiently, improving mental functioning and emotional stability.

Much like physical training, we use brainwave training to strengthen specific brainwave patterns. The more you practice activating a specific area the stronger and more capable that area becomes.

Brainwaves in proper function run like an orchestra. Nothing too loud, nothing too quiet, with a harmonic beat. Restoring this natural symphony is what we do.

EFT Tapping is one way we can quieten the brain and using this wearable sensory device, get real time feedback on how it is working.

FocusBand is not just an EEG sensing device for measuring your brainwaves. It is a complete Neuro-Performance System for business, sports, wellness and gaming.

1. It is the only brain training system that uses an intuitive Avatar.

2. Proven performance in multiple applications.

3. It offers a complete training blueprint that has been validated on the US PGA Tour.

4. The first to use woven sensors

5. It is the only headset which you can wear while asleep in your bed

6 .It has a video option which syncs to the Avatar in real-time

7. The headset while soft and comfortable is still rugged, so you can run and jump without causing erroneous readings.

8. It is the only system that does not need a cumbersome ear-clip.

So we have partnered with FocusBand to use in our 2020 clinical trials using EFT. Have a watch of the video to see how tapping has an impact on the brain as I demonstrate using it.

You can read more here – this is a tool I believe every health professional could use in their work!

Access Chapter 4 from The Science Behind Tapping here free

EFT researcher and author Peta Stapleton, Ph.D., brings together the history and cutting-edge research of tapping. She also shows how tapping can be used for a whole host of ailments, including anxiety, weight issues, depression, trauma, and more. Dr. Stapleton’s own groundbreaking study involving food cravings in overweight adults helped establish EFT as an effective, valid form of therapy.

Access Chapter 4 below - EFT Tapping for Post Traumatic Stress Disorder.

Thank you! Here is your free chapter.