1. TRAUMA Bringing Hope and Healing

2. HOSPIVISION Registered Sec. 21 Company Public Benefit Organization Recognized by National Dept. of Health as counseling service provider Pastoral Services: More than 50 years! Specialized training in Clinical Pastoral Care and Counseling

3. The medical environment Clinical and goal directed The role of personality A Holistic approach?

4. The patient’s expectation The doctor is “God” “What does the doctor say?” “What is happening?” / “What is happening to me?” “What are they hiding from me?” “What must I do?”

5. Breaking it gently “Telling it like it is”. “Not telling it like it is” Communication by accident: Missing the moment Communication by design: Sensitivity Clear digestible information “But I have told you ….”

6. The road to recovery Caring and clarity A sense of control Avoid misunderstanding An understandable prognosis Realistic expectation The cost of caring: Sharing the burden

7. DEBRIEFING AND COPINGSKILLS What is debriefing? – systematic process of education, emotional expression, cognitive reorganization – group support : makes use of natural occurring groups- because of shared experience – Can also be one on one. – Father of debriefing: S.L.A. Marshall (AMERICAN PSYCHIATRIC ASSOSIATION)

8. PROCESS OF DEBRIEFING Being present to each other Confronting S.O.L.E.R – technique: establishes trust so that patient share his story (Carl Rogers)

9. PROCESS OF DEBRIEFING REFLECT - What happened? How did you handle it? Which coping mechanisms is already present (Narrative Therapy)

10. PROCESS OF DEBRIEFING LISTENING SKILLS – empathy Open and closed questions Clarify- Am I the only support system? What is being said? (Carl Rogers)

11. PROCESS OF DEBRIEFING VIDEO- establish baseline Eject thinking, feeling (Narrative Therapy) INTERPRETATION – Acknowledgements Coping skills Cognitive reorganization (Carl Rogers)

12. RISK GROUPS Patients moving in and out of consciousness Alcohol and drug abuse Overdose patients Rather do Traumatic Incident Reduction

13. HIV Pre-Test Counseling Introduction Explanation: Dr’s rely on different blood test to investigate the illness… You need to take blood to test for HIV What does the patient know about HIV? Explain basics if necessary (what it is and how it is transmitted) HIV test required written permission The results will be kept confidential Results will be given during post test counseling Any questions?

14. HIV Post-Test Counseling Introduction Did the patient receive pre-test counseling You have results of the test “Unfortunately you tested positive for HIV” Wait for reaction Acknowledge and validate emotions and concerns What does the person know about HIV? Review basic information (what it is, how it is transmitted, which steps to take) Ask if they would like follow up counseling/support