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Professional Development

Obsessive-compulsive

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Obsessive-compulsive is a mental disorder that is characterized by unreasonable thoughts and fears (obsessions) that lead to compulsive behaviors.OCD often centers on themes such as a fear of germs or the need to arrange objects in a specific manner. Symptoms usually begin gradually and vary throughout life.

A client came in for counseling and presented with the

issue of OCD, which was diagnosed while the client was in primary school. However,

the presenting problem is that the client now feels that due to the onset of

the COVID- 19, the intensity of handwashing is psychologically affecting him

in that any time he touches anything not belonging to him, he feels

uncomfortable and feels he needs to keep washing his hand.

During the counseling session, the first thing will be

exploration with the client on the consequences

he imagines might take place in the absence of hand washing and construct

exposures to those consequences.

The treatment plan will be exposure therapy.

Psychotherapy of choice for the treatment of OCD is exposure and response

prevention (ERP), which is a form of Cognitive Behavioral Therapy. In ERP

therapy, the client will be gradually exposed to his obsession, which is

touching other people’s belonging and asked not to perform the compulsion of

hand washing that will

Ease his anxiety and distress. This will be done at

the client’s pace.

Supervision is defined as a formal, systematic, and a

a continuous process of professional support and learning for health care

providers and anyone who is in essential services. They are assisted in

developing their practice through being engaged in regular discussions with

experienced colleagues and the major aim is to promote improved decision making

skills, learning how to practice self-care and valuing oneself protection

through the reflective process and clinical practice analysis.

The sessions provide an opportunity for the caregivers to

examine and work through job-related vicarious trauma deal with disruptions in

schemas about self and others and symptoms of post-traumatic stress disorders.

Health workers encounter difficulties or discomfort in dealing with clients’

fearful or angry emotions about the incidences encountered and may avoid

discussing the clients’ traumatic experiences with peers or loved ones.

However, supervision is not about being given advice on

what to do or what not to do. It’s also not in black and white that there is a

clear cut on what is expected of the supervisee when it comes to handling

clients.

It is posited that as health care providers increasingly

draw near to vicarious trauma, and they can become distracted in services

production and question abilities to deal with certain cases. They may struggle

to deal with their own emotional reactions to clients’ issues and as a result end

up having feelings of sadness, helplessness, powerlessness, or fear. There can

be a heightened sense of fear in repeatedly hearing about clients’ health

issues and As a result, they begin to consider all of the risks to their own

safety when it comes to matters of health as well as their own children. A good

example is a case handled recently of a patient who had Obsessive-compulsive

disorder and in the process of treating her it was later found out that she

also had autism which poised even a greater challenge to the health care

provider was not used to handling patients with psychological disorders. As a

result it hindered effective production of health care services to the patient

and in return, the health care provider was equally affected psychologically

resulting in seeking clinical supervision.

Supervision has a number of functions, which help the

professionals in their daily practice among them being, helping them improve

clinical practice and reduce the emotional burden of clinical care as it helps to

identify solutions to problems thus improving practice as well as increasing

the understanding of professional issues. However in the recent supervision,

this function was equally met and it has helped in patient care and the health

care provider as well both individually and as a professional group. This has

helped in reduction of burn out among the health care providers as well as the

the self-doubt that mostly accompanies burn out at the workplace.

Supervision enables in improving clients’ morale at the workplace as they feel cared for and their employer is concerned with their

welfare. As an outcome of clinical supervision, the health care providers will

definitely input all their energy at work since they feel that both their

personal and professional needs are well catered for and, therefore, will have no

hindrance to the provision of the services. In return to these, the clients will be

happy and hence gain confidence in the service providers.

Supervision helps gain feedback and guidance in handling

cases.

They get insight on particular cases in that if a health

care provider handled a case, sharing it with colleagues and supervisor during

supervision process, some clients may appear straightforward, but it is always

possible to miss something that supervision

Might appropriately address. One approach is to ensure

that every client psychological

The formulation is reviewed and discussed within supervision.

Supervision also addresses issues therapeutic

competencies. Among them are the professional, ethical standards when it comes

to handling clients among them Clients’ confidentiality which is a factor that

ought to be put into consideration even as the health care provider shares the

a case for insight with colleagues, clients confidentiality ought to be upheld.

This factor was well achieved in the recent supervision since was able to share

about the case that was recently handled of a client who had autism and OCD.

Some of the insights included using alternative therapeutic methods in

handling such a client, such as using drawing or writing for communication with

the client, allowing the client to use the skill that they enjoy using such as

some autistic children prefer hands-on as their mode of communication, they

also prefer being more artistic for the expression other than verbal.

Supervision helps the service provider become organized

in terms of once they are supervised,

Supervision helps improve the health care provider’s

performance, as well as professional development. In that, the supervisee learns

how to handle work in a more professional manner, is reminded by others what

may have skipped their minds matters handling clients, they get more input on

handling clients, they as well learn new skills from colleagues. Which in

return helps improve their work?

One of the major challenges hindering the development of

clinical supervision has been poor conceptualization in both theory and

empirical studies: Clarifying what supervision is and how it works. Supervision

theories have historically been derived from applying models of therapy, from

extrapolating models from other fields, and from clinical experience.

However, there is evidence base for supervision

(Bradshaw et al. 2007)There is limited evidence of improved quality of care

provided by professionals to individual clients. This is as a result of the use of

the same old techniques in the field of psychology; hence there is a need for new

research to be done and implemented when it comes to matters handling clients.

  • (Watkins 2011) Studies are unable to demonstrate direct

and significant benefits to patients. This is so because, the supervision

processes are mostly based on assumptions that the feedback and guidance given

to the supervisee during supervision is assumed that it will work for the

client without putting into consideration the client’s perspective of the

inputs as well. This then makes supervision not client-oriented.

(Evan & Marcroft, 2015) there is a Widespread

consensus over the merits of Clinical Supervision, despite the lack of clarity

over what Clinical Supervision is and little agreement about what constitutes a

‘good’ model of Clinical Supervision. This is as a result of the psychology

researchers not having come to a consensus on the best model for supervision.

Hence it’s difficult to even for the supervisor to decide on the best model and in

most cases, end up combining a number of models and as a result, some sort of

confusion crops up.

(Pollock et al., 2017) a Systematic review was done

in 2017 and found that the evidence relating to clinical supervision is of poor

quality, confounded by the absence of definitions and descriptions of Clinical

Supervision. Thus making it difficult or rather making the supervision less

effective, bearing in mind that there is absolutely no one conclusive

description of supervision.

When it comes to supervision, there are a number of

theories that are applicable inclusive but not limited to Kold’s experiential

learning theory, which will be expounded a bit in this essay. There is also

Erik Ericson psychosocial theory of development which explains about various

psychosocial developmental stages and what a person terms from each particular stage

right from birth to adulthood. There are also Honey and Mumford styles/stages

and the corresponding Kolb learning styles which they defined as, Activist,

reflector, theorist and pragmatist which all corresponds to Kolb’s stages of

learning.

According to Kolb, different people naturally prefer a

certain single different learning style. Of which various factors influence a

person’s preferred style. In his experiential learning theory model (ELT) he

defined three stages of a person’s development and suggested that our

propensity to reconcile and successfully integrate the four different learning

styles improves as we mature through our development stages. He states that the

developmental stages included, Acquisition which is the earning that happens

from birth to adolescence and it’s basically the development of basic abilities

and ‘cognitive structures’. The second developmental stage he defined as

Specialization which is the schooling age it’s inclusive of early work and

personal experiences of adulthood the development of a particular ‘specialized

learning style’ shaped by ‘social, educational, and organizational

socialization’. The final learning stage he termed it as Integration which

onset from mid-career through to later life it’s an expression of non-dominant

learning style in work and personal life.

These people are able to look at things from different perspectives

that are Divergent points. They are sensitive. They prefer to watch rather than

do, they to gather information and use imagination to solve problems. They are

best at viewing concrete situations in several different viewpoints. Kolb called

this style ‘Diverging’ because these people perform better in situations that

require ideas-generation, for example, brainstorming. People with a Diverging learning

style have broad cultural interests and like to gather information. They are

interested in people, tend to be imaginative and emotional, and tend to be

strong in the arts. People with the Diverging style prefer to work in groups,

to listen with an open mind and to receive personal feedback.

The Assimilating learning preference is for a

concise, logical approach. Ideas and concepts are more important than people.

These people require a good clear explanation rather than a practical opportunity.

They excel at understanding wide-ranging information and organizing it in a clear,

logical format. People with an Assimilating learning style are less focused on

people and more interested in ideas and abstract concepts. People with this

style are more attracted to logically sound theories than approaches based on

practical value. This learning style of people is important for effectiveness

in information and science careers. In formal learning situations, people with

this style prefer readings, lectures, exploring analytical models, and having

time to think things through.

People with a Converging learning style can solve

problems and will use their learning to find solutions to practical issues.

They prefer technical tasks and are less concerned with people and interpersonal

aspects. People with a Converging learning style are best at finding practical

uses for ideas and theories. They can solve problems and make decisions by

finding solutions to questions and problems. People with a Converging learning

style are more attracted to technical tasks and problems than social or

interpersonal issues. A Converging learning style enables specialist and

technology abilities. People with a Converging style like to experiment with

new ideas, to simulate, and to work with practical applications.

The Accommodating learning style is ‘hands-on’ and

relies on intuition rather than logic. These people use other people’s

analysis and prefer to take a practical, experiential approach. They are

attracted to new challenges and experiences, and to carrying out plans. They

commonly act on ‘gut’ instinct rather than logical analysis. People with an

Accommodating learning style will tend to rely on others for information than

carry out their own analysis. This learning style is prevalent and useful in

roles requiring action and initiative. People with an Accommodating learning

style prefer to work in teams to complete tasks. They set targets and actively

work in the field, trying different ways to achieve an objective.

He however argues that whatever influences the choice of

style, the learning style preference itself is actually the product of two

pairs of variables, or two separate ‘choices’ that we make, which Kolb

presented as lines of the axis, each with ‘conflicting’ modes at either end:

Knowing owns

Learning style enables learning to be orientated

according to the preferred method. This means that everyone responds to and

needs the stimulus of all types of learning styles to one extent or another.

Therefore it’s a matter of using emphasis that fits best with the given

situation and a person’s learning style preferences.

When it comes to clinical supervision, people’s learning

styles are, in most cases, determined by their mode and speed of adaptation. For instance, those who prefer to learn through converging will definitely find it

difficult to adapt to assimilation. Assimilation works best for a counselor

when it comes to supervision as the health care provider is able to get ideas

and concepts that will be highly effective when it comes to the implementation of

the skills to the clients. However, just as Kolb puts it that some people may combine

more than one learning style at a go, it’s possible to find one person learning

with two or more methods during supervision. Even though there is definitely the

more dominant one than the other.

As for my case, when it comes to learning am good at

assimilation more than any other style. In that, it’s easy for me to sit, listen

and get insight from others and implementation is very easy for me hence it’s

my most preferred mode of learning.

In conclusion, it is not advisable to apply any

methodology blindly and unquestioningly. Therefore one should review and assess

the effectiveness of methods used. However, one should also not ban or denigrate

ideas simply because the evidence does not exist for their effectiveness, or

because in certain applications, the methods are found to be ineffective.

Supervision should engage the supervisees in Sharing and

being expressive about their stress levels, which

Are normally high due to work-related pressure. They

ought also to be taken through quick debriefing sessions, learning new ways of

coping such as watching videos on stress management, art and music therapy to

help the supervisees relax and express where their stress points are. Meditation

sessions are also encouraged to discuss self-care, explore their levels of

self-awareness on how they care for themselves.

During the sessions, the supervisees ought also to share

Their experiences particularly with recent traumatic

events in the world that is the covid-19 menace which has made it

Difficult in handling cases encountered. Hence, as a

result, more support ought to be given and ways of coping discussed by the

supervisor and supervisees. A mediation session ought also to be incorporated.

 

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