Addressing Client Anger

Transcription

1 Addressing Client Anger (Working with Client Anger) Cruse Conference July 2013 Warwick University 1

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3 Aim Aim and and Objectives Aim a succinct review of working with client anger (from a BV s perspective) Objectives Reminder of basic skills already learnt Understanding when anger may be present Anger pay offs and costs in client/counsellor relationship Opportunities to share good practice 3

4 The context The context (for Cruse BVs) You are bereavement volunteers Not anger management consultants You operate to Cruse boundaries (extract) It s purpose is only for bereavement work The contents of the work are directly or indirectly a consequence of bereavement. Sharing experiences Chatham House rules 4

5 Concerns Concerns about about angry client clients? anger Post its Possible areas: The client Yourself Knowledge Anything else? 5

6 Anger and Cruse (Some revision) Grief model Complex grief Transference and Counter transference Unresolved grief 6

7 Grief Model Kuebler-Ross Model of Grief ACCEPTANCE ANGER Emotion SHOCK DENIAL DEPRESSION Time You can go through it at a range of times, no one size fits all, you can go backwards 7

8 What What is is anger? anger? Basic human emotion signal we think we are being treated unfairly Different for everyone influenced by emotional make up and circumstances It is okay to feel angry Physical reaction flight or fight anxiety 8

9 Who Who do do client s clients get get angry with? with? Discuss 9

10 Who Who do do client s clients get get angry with? with? Some answers you might have: Medical staff not curing and/or looking after deceased God if He cared He would not have let this happen Family not being more caring/supportive Themselves I didn t do enough Deceased for going away Deceased if suicide, for doing it 10

11 Anger Payoffs Reduces stress but only temporarily Hides emotional pain Gets you attention May be used for punishment and revenge Helps you change / control others Source The Anger Control Workbook Matthew McKay and Peter Rogers 11

12 Anger Anger Payoffs Costs Physiological hypertension, heart disease, increased mortality Work relationships Family/personal relationships Hurting people Health and physical wellbeing Personal impact e.g. reckless driving, fights, legal problems Financially e.g. bad decisions made in anger Source The Anger Control Workbook Matthew McKay and Peter Rogers 12

13 Types of Anger Types of Anger 13

14 Anger Levels Levels of Anger 14

15 Recognise anger anger summary What level of anger is it? What type of anger is it? 15

16 Working Addressing with Client Client Anger Anger This section will cover: De escalation yes or no? Skills that help Ask for help if needed 16

17 De escalation Addressing Client yes Anger or no? Why would you want to de escalate client anger? Discuss 17

18 De escalation yes Strategies or no? Yes: Unsafe for counsellor Bad for client No: This may be the only opportunity for client to explore / express their anger 18

19 De escalation De escalation Strategies Strategies (1) Some of the things to think about: Listen carefully Prevent Predictable Problems Be Respectful Disengag e Don t Take Behaviour Personally Redirect Remain Calm Ask for Help Problem Solve Be Aware of Causes Structure, routine and Predictability Shout Avoid the issue Explain why client is wrong Refuse to see client again 19

20 Communication Skills Communication Strategies DOs DOs Be clear what you CAN and CANNOT do Say if the person s behaviour is intimidating: It s hard for me to help you, when you yell Really listen Use active listening to clarify: Reflect Be sure you understand and are understood 20

21 Communication Strategies DON Ts Skills Communication DON Ts Promise what you can t deliver! Tell the person that they are getting upset Tell the person to calm down Argue and give advice Side with or blame anyone Lie 21

22 Skills Paying attention Discuss 22

23 Skills Paying attention Body Language I hear you expressions Mirroring (paraphrasing) Inquiry ask open ended questions Empathy Listen Reflectively Affirm Summarize Elicit actions and statements for change 23

24 Skills Recognising Barriers Language differences Cultural differences Poor listening skills Making assumptions Being preoccupied or in a hurry Reacting with anger Defensiveness Blaming Our own feelings 24

25 When to Ask for Help You have tried to handle the situation alone and it is getting worse You can can t think objectively A participant in the conflict poses a threat to himself/herself or others 25

26 Practical steps Discuss: Three things you can do for yourself Three things you can get your client to do Three things you can do for your client Three things your supervisor can do 26

27 Things you can do for yourself Keep skills up to date Use your own support network, including your Supervisor Ask for help when you need it 27

28 Things you can do for your client Reassure clients that angry feelings are normal Try to help clients express appropriate anger about current situations Within Cruse remit explore coping strategies e.g. Help client identify and understand anger towards the deceased to bring to conclusion If appropriate to direct anger towards the deceased 28

29 Things you can get your client to do Explore aspects they don t miss about the deceased to identify unacknowledged negative feelings Make a list of negative and positive feelings makes the negative more bearable Verbalise the anger 29

30 Things your supervisor can do Listen and support you Help you put your client in perspective Reflect what you are saying and help you identify ways to help your client Step in when help is needed 30

31 Things to remember Guilt, anger and shame feelings most likely to be repressed Anger not adequately acknowledged can lead to grieving difficulties Anger directed towards deceased may lead to guilt feelings Retroflected anger (turned in on oneself) can lead to depression, guilt and low self esteem at worst can lead to attempted or actual suicide 31

32 What did did your your concerns tell tell us? us? Feedback 32

33 Aim Aim and and Objectives Objectives Review Aim a succinct review of working with client anger (from a BV s perspective) Objectives Reminder of basic skills already learnt Understanding when anger may present Anger pay offs and costs in client/counsellor relationship Opportunities to share good practice 33

34 Any questions? 34