Many people who feel unloved deal with past traumas and losses that affect self image. Most cases are irrational thinking that lead to these feelings. Despite this, these feelings are sincere and real enough for the person. In this video, we look at what makes individuals feel unloved and how to feel loved and have a healthier self image.
Please also review AIHCP’s Healthcare Certification Programs.
Written by Marko,
You don’t think about it because that would make you paranoid and crazy, but that sidewalk outside your apartment building might be a lawsuit waiting to happen, and your workplace could end up injuring you even if you work in an office.
Most people assume that these types of places are safe because they should be. Hospitals should follow procedures, your landlord should fix the steps if they’re broken, etc. That should be the deal.
But these places aren’t exempt from serious injuries, and it’s rarely one giant disaster that causes them. It’s a series of little things that are problematic, like the handrail that’s been wobbly for years. Everyone knows about it, yet nobody’s fixing it.
| Falls are the leading cause of all nonfatal injuries in the U.S. – Centers for Disease Control and Prevention (CDC) |
Small things tend to pile up, and once they do, it can easily end with someone seriously injured and a lawyer getting involved in a situation.
Injuries are a big deal, so when you think about how they happen, you naturally think of something dramatic, like someone running a red light.
This makes sense because the issue is simple and obvious, but for the most part, that’s not how real life works. Real-life injuries and everything involving them are messy, and the cause isn’t always as obvious as you’d expect it to be.
| Each year, 44,000+ deaths and millions of injuries in the U.S. are caused by preventable incidents (e.g., falls). – Injury Facts |
So while you’d think that one big bang caused the person to end up in a full-body cast, the reality is that it was a series of little issues nobody paid attention to that were responsible for the injury.
Miscommunication can be enough of a reason for an accident.
| Communication failures are the leading root cause in 60+% of all serious medical errors. – Joint Commission International |
A nurse tells something to the tech, but the tech is already stressed, so they can’t even hear the whole thing properly. They both go on about their day, thinking two different things while at the same time believing they’re in perfect agreement. The information simply got lost somewhere along the way, and they won’t have any idea of it until someone gets in trouble.
Then there’s the “it’s always been fine before” mentality, and this is a big one.
Let’s say you’re a warehouse manager and you skipped the monthly safety check because there’s simply not enough staff for it.
Nothing happens. Goodie!
Next month rolls around, so you decide to skip the safety check yet again. Things are still fine. Fast forward a few months, and you’ve skipped that safety check so many times that you don’t even remember to do it. And then one frayed cable reminds you why you shouldn’t have skipped the first one, let alone every other that followed.
Another big part of this is routine.
People are creatures of habit, and when you do the same thing 100 times, you stop really seeing it. Your brain goes on autopilot because that’s what’s efficient, but this is horrible for safety.
| Habitual behaviors can reduce active attention and situational awareness. – Stanford University |
You can’t catch small issues on autopilot, and if you’re under pressure already, then you can’t even pay attention properly. As a result, you take shortcuts over and over until they start to feel like normal work instead of shortcuts.
It’s important to note that nobody WANTS to hurt someone else; none of this is done intentionally.
But if nothing bad happens right away, then things seem to work the way they are, so why change them? This goes on for a while until the day when all hell breaks loose, and someone ends up in the ER. And that’s when it hits you that it wasn’t that teensy little detail that was the problem, but a bunch of missed steps coupled with stress that caused the disaster to happen.
And do you want to know the really scary part in all of this? It happens everywhere.
When a person gets hurt, it’s only natural to look for who messed up.
One person, one mistake, it’d be great if it were that simple.
But the smarter thing would be to step back and look at the whole system because that’s when you can truly see the whole story. You’ll probably see the same issues repeating over and over, just in different places and involving different people.
That means that it’s not the individual who’s at fault here, but the way the system was built at its core.
| Most errors result from flawed systems and processes rather than individual negligence – Agency for Healthcare Research and Quality |
Here’s a quick example to illustrate:
Most businesses will have certain ‘safety measures’ in place to help prevent harm. And while they are effective, they’re written for ideal conditions. This means full staff, lots of time, no distractions, etc. But we all know that this isn’t how real life works. So what ends up happening is the rules sit on a shelf somewhere while people on the floor make do with what they have.
Training can also be part of the problem because most people learn how things go when everything is normal. But that means that they don’t get to learn how to spot the small warning signs before something goes awry.
So when a problem does arise, it’s not unusual to see lawyers getting involved, especially law firms that specialize in these types of accidents/cases, such as Slip and Fall Injury Lawyers.
Injuries don’t appear out of thin air, and if you take the time to trace them back, you’ll see that things start to go wrong days (or even weeks!) before.
But nobody noticed at the time, so here you are.
We’ve all been there. You tell someone something, you assume they understood, but they heard something completely different, and you found out about that too late. This happens all the time, especially in workplaces.
For instance, a supervisor might ask you to check the back stairwell, but they’ll forget to mention that the tenant complained about the railing being loose, and now you’re in a cast and on painkillers.
And before you ask about maintenance, the guy didn’t see that anything was off, so he figured there was nothing to fix.
Sometimes, the problem is the way people behave.
Other times, the problem is a dumb setup, like a parking lot that has no lights in the corner or a staircase that looks like a joke with all the mismatched step heights. You probably don’t look at any of that and think it’s dangerous, but it is because those spaces have an impact on what you do.
If the entrance has no mat, people track water inside, and the floor stays wet the entire day. When there’s clutter in the hallway, people step around in all kinds of ways to get through.
You might not notice it, but your surroundings almost force you to behave in a risky way, and you have no idea about it.
Sane people don’t plan on doing their jobs wrong, but processes change little by little.
So you skip a step because you have no time for it, and nothing bad happens. You figure, why not skip it again? Less work for you, and everything stays okay. But then skipping steps just becomes the way you work, not because you’re lazy, but because that seems more efficient.
Let’s say you work at a store where the rule is to rope off spills right away.
But you’ve done that 10 times already for tiny spills that get cleaned up in 2 minutes, and it feels like overkill. Next thing you know, you’re not using the rope anymore, and it works until the one time when you get distracted, and someone walks right through it.
There’s only so much you can pay attention to; that’s just the reality of being human.
When there’s not enough staff or you’re behind schedule, the only thing that seems to help is doing more than 2 or 3 things at once. But if you go down this road, you’re bound to forget something here and there. You forget to lock the gate, you miss the wet floor sign, you tell yourself the loose tile can wait until later, etc.
And then later never comes because your brain literally can’t keep track of everything when you’re stretched that thin.
This one’s everywhere because who’s responsible for the crack in the sidewalk in front of the office building or for the leaky ceiling in the entryway? Everyone knows about these problems, and you think someone even mentioned it way back when, but whose job is it to fix these?
Nobody’s, it would seem. So it all stays there, week after week.
The most concerning thing about these injuries is that most of them happen because people haven’t been paying attention to everything that isn’t working.
The truth is, all those inconveniences like cluttered halls and dark corners are accidents waiting to happen. And you can’t say it’s hiding in plain sight because it isn’t actually hiding. It’s all there; everyone can see it.
The fix isn’t rocket science, and it doesn’t need a huge budget.
Just build systems that match how people work, not how you wish they worked. That’s really all there is to it.
Author Bio
Marko is an adamant and eager content writer with a decade of experience in various niches, with healthcare being one of them. With his way of implementing storytelling, comparisons, and examples into hard-to-grasp topics, Marko’s able to make complex things sound interesting and relatable – key ingredients to make something understandable. As a hobby, Marko enjoys offroading, board games, and spending time with his family and his dog Cezar.
From https://aihcp.net/2022/10/18/how-nursing-management-can-help-lower-serious-safety-events/ with anchor prevented and reduced
From https://aihcp.net/2026/03/06/3-signs-a-patients-case-calls-for-extra-vigilance/ with anchor prevent complications and ensure patient safety
Please also review AIHCP’s Legal Nurse Certification program and our CE courses as well, to see if they meet your academic and professional goals. These programs are online and independent study and open to qualified professionals seeking a four year certification
The secular world voices concerns over many types of planning. Financial planning dominates most venues as critical to one’s security and future retirement. Commercials flood the television with various firms that can assure oneself and one’s family’s future through the guidance of financial advisors. One also sees the shift of importance to health and dieting, as well as intense workout plans. Life coaches, personal trainers all help create unique physical and dietary plans to the needs of one’s personal goals and health number parameters. Such concern over health and financial security is important and should be on the top of everyone’s list but in the secular world, seldom does one hear of spiritual planning. If one’s bodily health, or financial security or stability of one’s retirement in the temporal realm is important, where is the more pressing concern of one’s spiritual health, spiritual security or heavenly retirement? In the secular world, as St Teresa of Avila points out, so many exist outside the interior castle of the soul and its inner monologue and relationship with God. The soul is so blinded by the needs of the body that it forgets itself. Instead it ONLY sees the needs of the body, its health, its security and its future at the expense of the soul’s eternal salvation. When imbalance of such exists, then these physical goals and planning become illusions and false idols that detract from one’s final end. This is a very perilous life style.
In this blog, we will look at Spiritual Planning and how to implement some the most basic elements of it to provide spiritual growth and stability and a closer relationship with God. In this blog, our financial planning is interest in grace not money, growth in virtue not assets, security in God not bonds, and retirement in heaven not Florida. This blog in itself could be a long manuscript on such a broad subject, but will attempt to keep the subject as compact as possible with also consideration to other blogs and concepts, as well as texts, within AIHCP Christian Counseling as well as Spiritual Direction resources that have already touched on similar concepts found in this blog.
Please also review AIHCP’s Spiritual Direction Program, as well as its Christian Counseling Certification.
It is imperative for Christians to remember that salvation is not an accounting book of one’s own good deeds versus bad deeds. One cannot live a sinless life. The fall of Adam has prevented such endeavors and as broken human beings, we need the grace of God, earned through His Son on Calvary for salvation. One’s faith in Christ is essential for salvation, for one cannot find salvation in one’s own works. Pelagius, an early Church heretic, attempted to heretically teach that one’s human nature was not completely corrupted and that one, albeit rare, could imitate Christ and possibly live a sinless life. Pelagius believed works could save oneself. This was condemned by the Church at the Council of Carthage, and equally rebuked by the great saint, St. Augustine. St Paul indeed teaches that it is through Christ and His death and one’s faith in Christ that souls are saved, but it is important to understand that faith is more than a formal assent, but is a cooperation with the graces earned by Christ at Calvary. Christians are not saved by faith “alone” which was never included in the original translation but through faith which encompasses a working nature. Scripture emphasizes a working faith in Christ that balances the assent of faith with its fruits and works, for St James emphasizes the balance of spiritual works in faith. Christ, Himself, commands His followers to keep His commandments.
Hence as Christians believe that one cannot earn heaven by oneself, as if balancing a ledger, but one must completely rely on the grace earned by Christ, at such a high cost for each of us, for one’s salvation. The fruits of the working faith, the cooperation with the grace earned by Christ for one’s salvation, does not belong to oneself but a when connected to Christ, and under the grace of the Holy Spirit, become salvific. Spiritual Directors, as well as Christians who attempt to better themselves in spiritual life, must first come to this ultimate surrender that their salvation is not their own but a gift from Christ and applied through the Holy Spirit. The Blood of Christ cleanses one of sin and pays the price for that Original Sin of Adam as well as the actual sins committed by oneself. Alone, no matter what one does, like the past sacrifices of patriarchs, are insufficient, but when aligned with Christ and His death, where one’s cross becomes tied to Christ’s cross, then they become pleasing to God. Christians are not activators of their salvation, nor are they passive recipients of it, but are cooperators with what was earned at the cross, motivated by grace to the gift of salvation.
The Spiritual Planning strategies in this blog do not replace Christ’s gift of salvation, but are grace motivated gifts of the Holy Spirit to participate in that redemption at a more efficient way. While the soul participates, it is the grace of the Holy Spirit that encourages it, strengthens it and molds it. Unlike physical fitness and planning, where one plays a key role in physical transformation-albeit guided and trained by another, the spiritual transformation of a soul is the work and grace of the Holy Spirit.
It is important then to find humility upon any spiritual transformation-for all virtue and grace come from the Holy Spirit that was earned by Christ at the cross. One must come and apply the Blood of Christ and Grace of the Holy Spirit, but it is not one’s own deeds and actions but the work of God existing within one’s faith that permits such a cooperation. So, like all endeavors, one must be mindful of pride. Like financial planning, or physical training, pride can easily corrupt a healthy self image with vanity. Likewise, in spiritual transformation, pride can create the illusion that one has made oneself holy and that one is more holy than other people. Like the Pharisees, one can have one’s own spirituality become a weapon and tool for one’s own damnation. It is so important as one enters into a deeper relationship with God to be mindful of spiritual pride and to pray daily for continued spiritual humility and complete reliance on the grace of God. Salvation and faith is a gift from God and something earned by Christ. We are merely partakers of this gift and must always give honor and glory to God for any spiritual gifts or insights. With this understanding, the remainder of this blog will look at some helpful techniques in spiritual planning and growth.
Supplied with the grace of the Holy Spirit to transform purely human thoughts and deeds into something more, one can work with those graces to better obey the commandments, submit to God’s will, grow in virtue, and enter into a deeper and more healthy relationship with God. This direction and progression towards God is a life long process with pitfalls, crosses, joys, successes, failures and losses. However, what it needs to be is a progression and a perfecting of oneself in virtue to have a deeper relationship that translates into the next life with God. Padre Pio points out that progression is key. A soul, even one that has sustained growth, that fails to continue in growth or progression becomes stagnant. The soul, like a plant seeking light, must continue to grow in the direction of that light, guided by the light and nurtured through it. The moment the soul stops seeking that light, it ceases to grow in communion with God. One can consider the temporal analogy of financial growth. If one has grown in wealth and has seen continual growth in the one’s accounts with a health market, then suddenly notices a stagnant level of return, there would be great concern. Why not for the soul? If growth has suddenly stopped or become stagnant with relationship with God, this should be a serious concern. For instance, a soul that regularly attends service in Protestant churches or Mass in Catholic churches, but has no spiritual connection despite obligatory attendance has entered into a state of concern. This is why Padre Pio reflected the vital importance of continual growth, despite setbacks, but continued renewal. If a soul falls, does it immediately seek God’s forgiveness? If one fails, does one immediately identify the issue and rectify it? As sinners, we all fail, but what is critical in spiritual planning, is not only the “attempt” to limit failure, but one’s quickness to rectify it. This again stems to one’s insight on humility and pride. If one understands one’s nature as broken, then one who falls, falls in humility but also seeks forgiveness in humility. One in pride who falls, has a far harder time seeking forgiveness.
Spiritual planning must acknowledge the reality of failure, but it almost acknowledge the life long nature of the journey. In life, some look for quick investments without securing a solid foundation. Others in physical training, desire a physique but lack the discipline to attain it. Some who diet, see a diet as a temporary status to attain a particular weight to fit in that dress, instead of a life long purpose of dietary health. Spiritual growth is not fast, it is not temporary, but it is a life style. It not likened to a New Years resolution, or a Lenten journey. Lent, for many Christians, is a spiritual diet. It lasts 40 days and then is suspended after Easter. The spiritual disciplines of Lent should be intensified in unison with the Church and in memory of Christ’s passion, but it should not be a spiritual diet for 40 days. The experience of more prayer, Scripture, introspection, fasting, denial, sacramental experience and spiritual growth in virtue should not be a 40 day experience but should represent the base line of all Christian life. This is not to demean the naive view of Lent by some Christians, for it is far better to sense some need than none at all, but, as Avila points out, these souls represent the utmost basic relationship with God and His grace. They, like a first level mansion, walk in, walk out, may peek inside its windows, but fail to grasp the greater beauty further inside the interior mansions of relationship with God. They become distracted by the lures of the world and progression spirituality ends abruptly until a later existential emergency or spiritual feast day.
Spiritual Planning is a life long journey that is about constant growth, humility in that growth, acknowledgement of failures, and complete trust in the grace of God to allow one’s working faith to manifest fruits and a closer relationship with God; A relationship that manifests in its finality in Heaven with God.
Counseling strategies, life coaching, and physical training plans are quite similar to spiritual training. As Mark Walberg commonly states, “Are you prayed up”. Spiritual Directors are Spiritual Trainers in this sense. They are not just spiritual but also should have a core understanding of counseling techniques based in goal setting and facilitating change. In previous blogs, we discuss the psychology of change and habit. We discuss neuro-pathways and how habit takes time to form. One does not suddenly become a a horrible sinner by one trip nor a great saint by one wonderful moment, but it is a character and progress of that character that defines both virtue and vice. As the ancient philosophers noted, character is a continual presence of a particular excellence in action that is unhindered but natural to the nature. This is natural habit is not something easily gained, or lost. One merely can look at the horrible nature of sin and its addiction itself. One who works to rid oneself of vice must work with the grace of the Holy Spirit to heal, change and transform. God can miraculously change and convert a person, but in most cases, the journey is one of a cross, one where one’s nature learns of the love of God and His continual mercy as change is undertaken and achieved. So, suffice to say, the process of change involves counseling. It involves goal setting. Just like certain financial goals are discussed, set and hoped for, so certain goals spiritually must be discussed and planned. Like exercise, the goals of a certain weight, or certain amount of reps in a particular weight training, concur with a particular habit or virtue that one aspires for. As meticulous journals keep weight training numbers, so one may need to keep track of one’s modified behavior in recollection and examination of conscience. How many times, did I sin today? How many times, did I accept the grace of God and overcome temptation? St Ignatius Loyola in his spiritual exercises in week one, challenges the person to almost scrupulously monitor and track one’s failings. As if tracking calories, St Ignatius asks us to track sin and vice! A working faith demands such accountability to a God who has paid such a high price for us and has made such graces available to the soul for its salvation.
Goal Planning
Goal planning is part of the counseling paradigm. This is especially seen in behavioral therapies where behavioral change is based on how one thinks. Behavior is greatly modified and altered by how one thinks. Cognitive Behavioral Therapy helps individuals think differently so as to feel differently and finally behave differently. Within the behavioral model, desired changes take time but they are planned changes in behavior starting in how we think about things. Spiritual Directors can help individuals think differently about life through the prism of grace, God, and virtue. In doing so, desired behavioral modifications as well as targeted virtual habit can be set in goals.
Again, though, before any planning can be undertaken, unlike temporal planning which relies on the strengths and powers of oneself, spiritual planning must be placed entirely into the grace of God. Goals and noble desires are attained through grace and normal actions are spiritualized and made perfect when united with Christ. Hence no spiritual plan can have any value if placed in pride and self or the belief that one’s own works and deeds have value without the guidance and grace of God. Without God, these works, dreams and aspirations are utterly worthless. This is why any plan, before undertaken, must be placed within the guidance and protection of God. Daily prayer, devotion, and commitment to God’s will is essential. When one rises, all plans, all duties, all vocational assignments, all crosses, and all joys must be given to God. The morning offering gives to God everything one does in a day before the day starts and unites everything to Christ to be offered to the Father as a perfect sacrifice to be guided by the grace of the Holy Spirit. One must then relinquish control and unite one’s will with God. One must acknowledge one’s utter dependence on God and again unite one’s will to Him for transformation. Placing one’s plan under the guidance of God and allowing it to fall under His will is a big differing point between temporal planning and spiritual planning, but for the Christian, why not submit all plans-even temporal- to God’s will!
In counseling, especially behavioral therapies, plans need to be discussed and identified. The goal need identified but also how to attain the particular goal, the challenges to that goal, possible setbacks and time frames. Because of the human nature, the counselor needs to curb enthusiasm so as to prevent burnout when goals become difficult. Great zeal can quickly turn to great despair. The counselor is trained to set intermediate goals for a person. Little goals that track progress can help build confidence and lessen despair upon failure. This can be seen in financial expectations, as well as weight loss expectations, or even behavioral modifications to stop smoking or drinking. An individual with a spiritual plan to evict a vice from one’s habitual orbit, may find despair if one fails on a particular day. Like a person who succumbs to a cigarette or donut late at night, one can succumb to a vice. A good spiritual director can calm the person and identify why and how it occurred but also to remind one that habits take time and goals take time to achieve. One needs to find mercy in God when one fails and not find complete pride or joy in one’s own accomplishments but to reflect all in God.
Pitfalls are part of all plans. Individuals attempted to escape habits, fall, but what God cherishes is the choice to change and the direction. This is why spiritual directors should encourage the soul and point out the importance of gradual change in severity and frequency and the mercy and grace of God. Intermediate goals do not demand perfection but gradual growth. Once intermediate goals are met, one can move forward to the next step. Like weight training, once a certain number of reps are met, or a certain weight is attained, one is able to advance. Like so in spiritual life.
Like all planning, it is crucial to keep the person focused but also humble and also remind one of one’s nature. Many times during change, individuals become obsessed more so with the numbers than the journey and end goal. One can become scrupulous and focus more on avoiding or worry or fretting over the smallest of actions to the point it causes extreme distress, despair and guilt. The devil can be very subtle in derailing a soul working towards God. So it is important that whichever habit, or spiritual goal one has, to not mistaken the goal or new habit as the ultimate end. Unlike the view of the ancient philosophers, virtue itself is not the end goal of our worship. Virtue is a vehicle and intermediate step to the ultimate goal which should be relationship with God. So when one focusses more on numbers, one begins to focus more on self than God. God is the ultimate goal in the entire endeavor of spiritual planning. Unlike physical training, when one only looks at the body and its change, but not the overall health, then derailment can occur to various maladies. Likewise, when virtue is sought for the sake of virtue, instead of its purpose as a vehicle to God, then it can be turned against oneself. In this, one needs to see things that are means as means, and clearly in planning contrast it with one’s end. Counselors help individuals navigate this, as well as spiritual directors.
Spiritual Strategies
With a stronger understanding of the nature of planning, as well as setting goals, and understanding the difference between means and ends, we will quickly review some types of spiritual plans. In my daily life, I believe in planning. Calendars are essential but also journals as well as notes to self, as well as self talk to keep one on track. Life is comprised of professional, academic, family, self, physical and spiritual aspects and we need to balance these in accordance. We need to structure these vocational duties that we owe to God, self and neighbor. First and foremost, they must be prioritized. Certain things on lists are non-negotiable. They are priorities that must be met before others. Obviously physically, diet, grooming, and sleep are among those. Spiritually, prayer, worship and communion with God should top that list. However, in any planning, there are events, assignments, or obligations that are secondary to primary ones. Some may be flexible and able to be moved, while others may be optional. It is important to define these when planning.
Planning wise, like financial plans, I like to plan by the quarterly year. While I have daily duties, weekly duties, bi-weekly duties, and monthly duties, that lead to fulfillment of the quarter, I like to see set goals for that period. Some goals are primary, others may be flexible, but they are listed. The 3 month period serves as a reminder of what needs done in some cases, but also where I would like to be as a measuring stick. Obviously one can see where this can be applied financially, physically but also spiritually.
From a spiritual context, how has one’s daily, weekly and monthly habits gradually changed over the 3 month period? Daily journaling, weekly remarks and monthly checks can keep one on pace with possible goals. If one is stricken with the vice of drunkenness, one can review the number of drinks a week and its gradual reduction from week to month to quarterly period. If the goal is to reduce this habit, then one may discover a new trend that one can find solace in as recorded numbers show reduced intoxication as well drinks per week or month. One can then ascertain if one has met the quarterly goal or not and how to access the next quarter. Remember, this is a life style, it is a marathon, not a race, so gradual is better than nothing. This again takes one to the importance of daily and weekly monitoring, so that data and change of habit can be documented. During this examination of conscience, at the end of each day, or week, or month, or every one quarters, one can see the weaknesses, what one can do better, and most importantly remember on one’s complete reliance in God for any change. The spiritual director can encourage the soul in this progress and also help set new intermediate goals, or re-ascertain certain strategies or time tables to help maintain the confidence of the person in this change and ultimate better relationship with God.
The spiritual director also becomes a spiritual coach in this endeavor. Upon reflection of plans, one’s attainment, progress, or failures, a coach helps develop a person’s skills. This may consist in different prayers or penances, or fasting that help foster a particular virtue or habit. Particular spiritual readings of the saints and their writings, as well as Biblical books or chapters that correspond with one’s troubles can be utilized. Goals within a particular time table may include within a 3 month span to work in charity, or read a certain amount of books, or become more acquainted with a particular book of the Bible that will help one move forward. In may also include if Catholic, more frequent reception of the Eucharist, as well as confession. These things not able help the soul in despair, but also give the soul sources of grace to help transform over the spiritual planning time. Spiritual directors or confessors can become original in their ideas to share with individuals various particular deeds, or readings that meet a person’s needs and direction.
With all planning, one seeks change, and good change agents produce change. This involves within the spiritual planning, promoting healthier communications and removal of vice associated materials. These things that promote sin are referred to as occasions of sin. It can be a person, place or thing. Spiritual directors need to encourage souls to avoid places associated with particular sins. If bars are associated with drinking or lewd conduct, then these places should be removed from a person’s habitual visit. The same holds true for any addict of any vice. In regards to lust, avoiding imagery or situations that promote lust should be removed from one’s life. If a cell phone in close proximity calls one to pornographic imagery, turn off the phone or remove it from one’s reach. Many of the saints practiced far greater mortifications, beyond what I would recommend, but one must, if seeking change, remove the occasions of sin. Like a person a diet who removes donuts and cakes from the cabinet, one must remove occasions associated with the detrimental behavior.
Like wise positive change agents must be introduced into any spiritual plan promoting change. Like in a diet, one supplies their refrigerator with wholesome foods, so the soul must supply the daily routine with wholesome content. Good spiritual reading, better company, prayer, as well as support from other religious persons who share the same ends is crucial. A clean home promotes change, so does a clean spiritual environment. One needs to remove the spiritual filth for the soul to change. Like a dirty body that needs cleaned to become healthy, so does a dirty soul need cleaned to move forward. Christ’s blood and the grace of the Holy Spirit provides the solution. One must wash oneself in these things and provide oneself with healthy reminders of those things that promote new spiritual change within oneself. Healthy and positive change agents replace negative occasions of sin and replace maladaptive coping with healthy spiritual coping founded in prayer and faith in God.
Spiritual planning is a life style change that takes time and is a life change of progress towards God. One cannot earn this change but it is gift from God that we partake in. While the grace of God is a gift, one still must work with that grace. Spiritual change, like any change, or plan in life, is something that one must dedicate oneself to and purposely plan to achieve with commitment and guidance of the Holy Spirit. There are many ways to promote a better relationship with God and when we find time to plan prayer, worship and submission to Him, He will guide us in all our plans to find better communion with Him.
Spiritual planning in itself should be a big part of one’s life. It should take priority over everything else we do because our ultimate end is God. Spiritual planning acknowledges the necessity of Christ’s death and the grace for salvation and how to apply it to our lives so when we stand before God, we will know Him well, as we enter into paradise.
Please also review AIHCP’s Spiritual Direction Program, as well as AIHCP’s Christian Counseling Certification.
Behavioral Therapies: Access here
Behavior and Change. Access here
Theology and Psychology of Moral Actions. Access here
Spiritual Exercises of St Ignatius
Interior Castle-Teresa of Avila
Leontis, A. (2025). “Virtue Ethics: What it is and How it Works”. Philosophos. Access here
“Spiritual Direction”. IgnatianSpirituality.com. Access here
Moore, M. “Goal Setting in Counseling and Therapy”. Mentalyc. Access here
The Creative Grief Cycle
Creation, Communication, and Rediscovery in Grief Writing
Written by Daniel Stern
Grief disrupts the narrative of life. When a profound loss occurs, the future we imagined with that person vanishes, and the past becomes newly charged with memory and absence.
Yet paradoxically, grief is also one of the most powerful generators of creative expression. Poetry, painting, music, and storytelling have historically emerged from loss, giving shape to emotions that are difficult to express.
For many writers, including myself, poetry becomes the place where grief first learns to speak.
I’m not a clinician. What I’m describing comes from my own experience writing poetry about grief. I found that creative expression did more than document loss; it initiated a cycle of emotional processing. My experience aligns with research on expressive writing, poetry therapy, and meaning-making in grief—that creative expression can help people process loss and make sense of it.
From this intersection of lived experience and research, I began to notice a pattern in how grief can move through creative expression. I refer to this pattern as The Creative Grief Cycle.
Together these stages form a self-reinforcing cycle that moves grief from raw emotional experience toward shared understanding and lasting meaning.
Research on expressive writing, meaning reconstruction, and poetry therapy supports key elements of this cycle.
Stage One: Creation — Writing as Emotional Processing
The first stage of The Creative Grief Cycle is the act of creation itself.
When grief is written, it changes form. What was once diffuse emotional pain becomes structured language. Words, metaphors, and images impose order on an experience that initially feels chaotic.
Psychologist James W. Pennebaker, whose research pioneered the study of expressive writing, demonstrated that writing about emotional experiences improves psychological and physical well-being. His studies showed that expressive writing helps individuals organize traumatic memories into coherent narratives, supporting emotional processing that might otherwise remain unresolved (Pennebaker & Chung, 2011).
Scholars in poetry therapy also describe writing as a structured way of processing emotional experience (Mazza, 2017). Neimeyer (2012) has similarly emphasized that grief often involves reconstructing meaning after loss, frequently through narrative and creative expression.
Subsequent studies have found similar benefits. A comprehensive review in Advances in Psychiatric Treatment found that expressive writing can reduce stress, improve mood, and enhance coping with traumatic experiences (Baikie & Wilhelm, 2005).
In grief specifically, expressive writing has been associated with meaning reconstruction, a central process in bereavement. Neimeyer (2001) describes mourning as rebuilding meaning after a loss disrupts one’s life narrative.
These findings mirror my own experience writing poetry after the loss of my son. In one poem I wrote:
“A poem begins in blood.
My son is gone, yet I write—
each word a slice of myself.” The Price of a Poem
Writing did not remove grief. Instead, it transformed grief into something that could be examined and understood.
Researchers studying poetry therapy describe this process as the movement “from silence to speech.” Stepakoff (2009) explains that poetry allows individuals to represent traumatic grief symbolically, making it possible to approach experiences that initially feel unspeakable.
In The Creative Grief Cycle, creation is therefore the first step in transforming grief into meaning.
Stage Two: Communication — The Social Function of Grief Poetry
The second stage of The Creative Grief Cycle occurs when the work is shared with others.
Grief is inherently isolating. Individuals experiencing loss often feel that their emotions cannot be adequately explained to those who have not lived through similar experiences.
Poetry can bridge this gap.
Because poetry communicates through metaphor, rhythm, and imagery, it can convey emotional realities that ordinary explanation cannot. Readers encountering grief poetry can recognize aspects of their own experiences within the work, creating a moment of shared understanding.
Maybe creative expression can help individuals communicate their complex grief experience when traditional conversation is difficult.
Stroebe (2018) highlights that poetic language can complement scientific models by illustrating the lived experience of grief, bringing emotional depth to processes identified in research. Psychological frameworks describe processes of mourning, but poetry can capture the lived texture of grief—its contradictions, memories, and silences.
This communicative dimension is visible in many grief poems. In one of my own poems, I describe writing as a way to keep a voice present in the world:
“I write
because my voice still walks the earth
even when his footsteps do not.” Don’t Live Inside That Silence
The poem becomes more than a personal reflection; it becomes a message others can encounter.
Communication also allows grief to move across generations. In another poem, written about telling stories to my granddaughter after her father’s death, I wrote:
“I give her my son
the only way I still can—
one story at a time.” Tell Me a Daddy Story
In this moment, poetry functions as inheritance. Memory travels through language into the future.
In The Creative Grief Cycle, this is when grief moves from private experience into shared understanding.
Stage Three: Rediscovery — Revisiting the Work
The third stage of The Creative Grief Cycle emerges and can evolve over time.
Unlike spoken conversation, creative works endure. A poem written during an intense period of grief can be reisited months or years later. This creates a powerful reflective process. When the writer returns to the poem, they revisit the emotional state that existed when it was written. The poem becomes a preserved record of grief at a particular moment in time.
Poetry can preserve the emotional complexity of grief in ways that allow both writers and readers to return to the experience with evolving perspectives.
In practical terms, a poem becomes an emotional time capsule. The writer who reads it years later is no longer the same person who wrote it. The grief may have softened, deepened, or transformed.
In one poem, I tried to capture how silence evolves over time:
“Silence becomes a cathedral,
vast and unforgiving,
its arches built of absence.” The Roar of Silence
This rediscovery stage allows grief to evolve from raw emotion into reflection.
In The Creative Grief Cycle, rediscovery completes the cycle by enabling the work to continue generating meaning over time.
The Creative Grief Cycle
Taken together, the three stages form a continuous cycle:
Creation → Communication → Rediscovery
Each stage reinforces the others. Writing enables communication. Communication deepens meaning. Rediscovery inspires further creative expression.
This cycle offers an explanation as to why creative work often continues long after the initial loss. Once grief has been expressed through art, the creative impulse frequently expands into other forms of expression.
In one poem reflecting on transformation through grief, I wrote:
“Grief softens us,
wonder reshapes,
creation strikes sparks
across even the softest anvil.” The Furnace Never Cools
Grief melts what once felt rigid. Creativity reshapes it.
Conclusion
Grief cannot be eliminated. Loss remains one of the defining experiences of human life. But creative expression changes how grief exists in the world.
Through The Creative Grief Cycle, grief moves through a process of creative transformation:
In this way, poetry does not simply document grief.
It allows grief to become something else: connection, reflection, and enduring voice. Loss may silence a person’s presence in the world. But through poetry, the conversation continues.
About the Author
Daniel Stern is a retired engineer turned astronomer and astrophotographer whose poetry explores grief, silence, memory, and renewal. His work lives at the intersection of science and emotion, where observation becomes reflection and language reaches for what cannot be measured. He recently published The Roar of Silence, a collection of 15 poems born from personal loss and the search for meaning in its wake. He also authored Aphelion, a book of poetry fused with his deep-sky astrophotography. In his work as an astronomer, his astrophotography has been recognized numerous times by NASA (APOD). He has discovered planetary nebulae and, in collaboration with others, has been published in peer-reviewed astrophysics journals. Stern lives in Delray Beach, Florida, with his wife, Randie.
Website: www.theroarofsilence.com
Email: dstern@mea-obs.com
References
Baikie, K. A., & Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment, 11(5), 338–346. https://doi.org/10.1192/apt.11.5.338
Mazza, N. (2017). Poetry therapy: Theory and practice (2nd ed.). Routledge.
Neimeyer, R. A. (2001). Meaning reconstruction and the experience of loss. American Psychological Association.
Neimeyer, R. A. (2012). Techniques of grief therapy: Creative practices for counseling the bereaved. Routledge.
Pennebaker, J. W., & Chung, C. K. (2011). Expressive writing: Connections to physical and mental health. In H. S. Friedman (Ed.), The Oxford handbook of health psychology (pp. 417–437). Oxford University Press.
Stepakoff, S. (2009). From destruction to creation, from silence to speech: Poetry therapy principles and practices for working with suicide grief. The Arts in Psychotherapy, 36(2), 105–113. https://doi.org/10.1016/j.aip.2009.01.007
Stroebe, M. (2018). The poetry of grief: Beyond scientific portrayals of mourning. Omega: Journal of Death and Dying, 77(1), 3–16.
Please also review AIHCP’s Grief Counseling Certification, as well as its Child and Adolescent Grief Counseling Program, Pet Loss Grief Counseling Program, Christian Grief Counseling Program, Grief Diversity Counseling Program, Grief Perinatal Program, Grief Practitioner Program and finally its Grief Support Group Leader Program.
Fear can play a strong role in grieving. Whether anticipatory and fearful of a future event, or fear that cripples one while grieving to express or reach out, or fear that becomes maladaptive with other types of losses, it needs addressed. This video looks at how fear can affect grieving. Please also review AIHCP’s Grief Counseling Certification
Written by Harry Wolf,
According to the CDCP, three in four American adults have at least one chronic health condition. And over half of adults have two or more.
It should not be surprising, therefore, that chronic disease drives the majority of health care spending and hospital utilization nationwide. For clinicians and health systems, the pressure to improve outcomes while reducing avoidable admissions has never been greater.
The good news? Remote patient monitoring, or RPM, has become a core strategy in chronic care delivery…
RPM refers to the use of connected medical devices and digital platforms to collect patient health data outside traditional clinical settings. Data flows directly to clinical teams, thus enabling proactive interventions – rather than reactive treatment.
For example, RPM programs can track blood pressure, pulse oximetry, weight, and symptom scores for high-risk cardiovascular and pulmonary patients.
According to the National Library of Medicine, structured remote monitoring enables earlier identification of clinical deterioration and more timely medication adjustments. Earlier detection means fewer last-minute medication changes and more predictable care trajectories.
What do core RPM programs typically include the following components:
Well-structured RPM programs improve both clinical and utilization metrics. Benefits are especially pronounced in high-risk populations with heart failure, COPD, diabetes, and uncontrolled hypertension.
A 2024 systematic review, published by Springer, found that digital monitoring interventions for COPD were associated with reduced hospitalizations and improved self-management behaviors.
Patients using structured monitoring tools demonstrated better medication adherence and earlier reporting of symptom exacerbations. Of course, improved adherence at scale directly affects readmission metrics and quality-performance benchmarks.
A 2025 multicenter study in the Journal of Medical Internet Research showed that older adults with multiple chronic conditions reported reductions in hospital readmissions and improved care coordination in RPM-supported cohorts.
The findings showed measurable gains in transitional-care stability. For hospitals operating under value-based reimbursement models, even modest reductions in 30-day readmissions produce significant financial – and operational – impact.
When RPM programs are designed with structured protocols, various improvements are commonly observed. Such as? Well:
Clinical teams gain better visibility between visits rather than relying on episodic check-ins. And continuous data streams shift care from reactive to preventive.
Medication adherence and lifestyle compliance remain persistent challenges in chronic disease management, as you may well be aware. RPM platforms create accountability loops that reinforce treatment plans outside the clinic.
A 2025 randomized controlled trial published in JAMIA demonstrated significantly higher monitoring adherence among heart-failure patients enrolled in structured RPM programs with defined engagement strategies.
Patients receiving routine feedback and clinical follow-ups were more likely to consistently submit biometric readings.
Consistent data submission… It allows clinicians to make evidence-based adjustments – rather than relying on retrospective recall. Structured engagement models typically include:
High-performing programs treat engagement as a clinical function – rather than a technical add-on. Human oversight, of course, remains central to sustained participation.
Technology adoption alone does not guarantee clinical transformation. Sustainable RPM implementation requires:
Centers for Medicare & Medicaid Services has expanded reimbursement pathways for remote physiologic monitoring and remote therapeutic monitoring – over recent years, that is.
Policy updates published by Medtronic highlight ongoing refinements in outpatient and physician-fee-schedule structures. Reimbursement clarity directly influences administrative buy-in and long-term program viability.
Health systems evaluating RPM deployment should assess several operational domains:
Fragmented implementation… It can create clinician fatigue and documentation burden. Thankfully, fully-managed models often reduce internal strain by centralizing:
For instance, solutions such as Nsight Health’s remote patient monitoring provide fully-managed services that include patient outreach, enrollment, 24/7 clinical monitoring, FDA-cleared cellular devices, and billing support.
Nsight Health operates with its own clinical team and infrastructure, allowing provider organizations to integrate RPM without building parallel internal departments.
Despite strong outcome data, RPM adoption still encounters barriers related to digital literacy, connectivity, and clinician workload. Rural and underserved populations may face additional infrastructure constraints.
User-friendly device design and cellular-enabled connectivity are essential for reducing disparities. Findings summarized by arXiv in 2024 highlight that simplified onboarding and automated data transmission improve participation among older adults.
Device simplicity matters – when patients manage multiple comorbidities and complex medication regimens, that is. Programs seeking equitable implementation should prioritize:
Equity-focused design increases the likelihood that RPM benefits extend beyond digitally-savvy populations. Broader adoption strengthens community-level chronic-disease management.
Continuous data collection… It only delivers value when it informs actionable clinical decisions. Remote patient monitoring programs that integrate directly into electronic health records create a unified view of longitudinal patient data, reducing fragmentation across care settings.
RPM-supported care models improve care-coordination efficiency when biometric data is embedded within shared clinical dashboards. Integrated-data workflows allow clinicians to identify high-risk patients earlier – as well as prioritize outreach based on stratified risk scores.
For busy care teams, risk-based prioritization prevents alert overload. And it supports focused intervention – where it matters most.
Clinical decision-support systems within RPM platforms typically apply threshold-based alerts, trend-analysis algorithms, and protocol-driven escalation pathways. Structured review processes help transform raw data into meaningful treatment adjustments.
Effective integration strategies often include:
Clinical leaders should also evaluate interoperability standards when selecting RPM vendors. Such as? HL7 and FHIR.
Seamless data exchange… It reduces manual entry, lowers documentation burden, and improves coding accuracy for reimbursement.
Data governance plays an equally critical role in maintaining trust and compliance. Secure transmission protocols, HIPAA-aligned storage, and role-based access controls protect sensitive health information – while enabling cross-disciplinary collaboration, that is.
When RPM data is operationalized within structured clinical pathways, decision-making becomes proactive rather than episodic. Providers move beyond snapshot-based assessments toward dynamic, data-informed management plans.
Chronic disease management increasingly operates within value-based reimbursement models where outcomes, not volume, determine financial sustainability. Remote patient monitoring supports this transition by aligning real-time clinical oversight with measurable quality metrics.
For example? Well, a 2025 analysis reported by Medical Economics highlighted a Michigan Medicine RPM initiative that reduced hospitalizations among high-risk patients by nearly 60 percent.
Patients enrolled in structured at-home monitoring experience significantly fewer acute-care episodes, compared to matched controls, that is.
For health systems participating in shared-savings programs, reduced admissions directly influence both penalty avoidance and incentive eligibility.
Beyond utilization metrics, RPM programs contribute to improved performance of:
Continuous biometric tracking supports more accurate documentation of disease severity and clinical interventions.
Financial impact areas typically include:
CMS reimbursement pathways for remote physiologic monitoring and remote therapeutic monitoring continue to evolve.
With ongoing refinements to outpatient and physician-fee-schedule policies, regulatory clarity strengthens the business case for sustained RPM investment.
Operational discipline… It remains essential to financial success! Programs must ensure accurate time tracking, compliant documentation, and consistent patient engagement to meet billing thresholds.
When clinical outcomes improve alongside reimbursement optimization, RPM becomes more than a digital add-on. Yes indeed, it functions as a strategic infrastructure component supporting long-term value-based performance.
Workforce shortages continue to strain areas like primary care, cardiology, pulmonology, and endocrinology practices. Remote patient monitoring offers a structured way to redistribute clinical workload – while maintaining high-touch chronic-disease oversight, that is.
Centralized monitoring models reduce the burden on in-clinic providers. How? By shifting routine data review to trained remote teams.
Programs that incorporate dedicated monitoring staff improve response times and reduce clinician burnout associated with unmanaged alert volumes. For organizations already facing staffing constraints, centralized monitoring protects provider bandwidth.
Care-team redesign in RPM-supported environments typically clarifies roles across physicians, advanced-practice providers, nurses, and care coordinators. Defined escalation pathways prevent ambiguity when biometric thresholds are exceeded.
High-functioning RPM workforce models often include:
Redistribution of responsibilities also supports advanced-practice providers working at the top of their license. Physicians retain oversight for complex decision-making – while routine monitoring and patient engagement occur through structured workflows.
Fully-managed RPM programs can further streamline operations. How? By externalizing:
Workforce optimization through remote patient monitoring ultimately strengthens both patient access and clinician sustainability. Structured team-based models transform chronic-care delivery into a coordinated, data-driven system – that is: rather than a sequence of disconnected visits.
Remote patient monitoring has transformed healthcare. In particular, it has matured into a clinically validated and financially aligned strategy for advancing chronic disease management.
Evidence across cardiovascular, pulmonary, and multi-morbidity populations demonstrates measurable reductions in hospitalizations, stronger adherence, and more stable care transitions – when programs are structured around proactive oversight.
Sustainable success depends on more than device distribution, though. Integrated data workflows, risk-stratified dashboards, reimbursement compliance, and clearly defined team roles determine whether remote patient monitoring delivers lasting value.
Was this article helpful? If so, take a look at our other informative content.
Author bio: Harry Wolf is a freelance writer. For almost a decade, he has written on topics ranging from healthcare to business leadership for multiple high-profile websites and online magazines.
References:
Unathored, 2025, About Chronic Diseases, Centers for Disease Control and Prevention.
https://www.cdc.gov/chronic-disease/about/index.html
Po, Hui-Wen, Chu, Ying-Chien, Tsai, Hui-Chen, Lin, Chen-Liang, Chen, Chung-Yu, Ma, Matthew Huei-Ming, 2024, Efficacy of Remote Health Monitoring in Reducing Hospital Readmissions Among High-Risk Postdischarge Patients: Prospective Cohort Study, National Library of Medicine.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11437225/
Mishra, Vineet, Stuckler, David, McNamara, Courtney L., 2024, Digital Interventions to reduce hospitalization and hospital readmission for chronic obstructive pulmonary disease (COPD) patient: systematic review, Springer Nature.
https://link.springer.com/article/10.1186/s44247-024-00103-x
Testa, Damien, Iborra, Vincent, Dutech, Mireille, Sanchez, Manuel, Raynaud-Simon, Agathe, Cabanes, Elise, Chansiaux-Bucalo, Christine, 2025, Impact of a Home-Based Remote Patient Monitoring System on Hospitalizations and Emergency Department Visits of Older Adults With Polypathology: Multicenter Retrospective Observational Study, Journal of Medical Internet Research.
https://www.jmir.org/2025/1/e64989/
Mohapatra, Sukanya, Issa, Mirna, Ivezic, Vedrana, Doherty, Rose, Marks, Stephanie, Lan, Esther, Chen, Shawn, Rozett, Keith, Cullen, Lauren, Reynolds, Wren, Rocchio, Rose, Fonarow, Gregg C., Ong, Michael K., Speier, William F., Arnold, Corey W., 2025, Increasing adherence and collecting symptom-specific biometric signals in remote monitoring of heart failure patients: a randomized controlled trial, Journal of the American Medical Informatics Association.
https://academic.oup.com/jamia/article/32/1/181/7738853?guestAccessKey=
Unauthored, 2026, 2026 updates and changes to Medicare hospital inpatient (IPPS), outpatient (OPPS), ambulatory surgical center (ASC), and physician (MPFS) fee schedules, Medtronic.
Littrell, Austin, 2025, At-home monitoring cuts hospital admissions by nearly 60%, study finds, Medical Economics.
Jat, Avnish Singh, Grønli, Tor-Morten, 2024,Harnessing the Digital Revolution: A Comprehensive Review of mHealth Applications for Remote Monitoring in Transforming Healthcare Delivery, arXiv.
https://arxiv.org/abs/2408.14190
Please also review AIHCP’s Case Management Certification program and Case Management Courses see if it meets your academic and professional goals. These programs are online and independent study and open to qualified professionals seeking a four year certification
Behavioral Psychology is a branch of counseling and techniques that emphasize the direct role social experiences and learning play a role in behavior. Cognitive Behavioral Therapy is an offshoot from it. Behavior Therapy focuses on how current behaviors are affected through previous learning experiences and how they shaped the current behavior. Behavior Therapy is concerned less with the subconscious and how it played a role in one’s current behavior but more so how past experiences, learning, and how classical and operant conditioning formed one’s individual behavior. Like many schools of thought, it adheres to a strict conceptual model for its approach but for many therapists, it is integrated with other schools of thought to meet the needs of the client. Among the many psychological schools, Behavior Therapy is the most empirically based approaches despite its limitations if used as the only lens to examine human behavior. It perspective is a critical piece of understanding individuals and helping them find productive change and healing. For that reason, it and many of its techniques are widely applied with other Psychoanalytic and Rogerian therapies.
Please also review AIHCP’s Behavioral Health Certifications, including Grief Counseling, Crisis Counseling, Trauma Informed Care, Anger Management, Stress Management, as well as Spiritual Counseling and Christian Counseling.
Behavioral Therapy emerged in the Mid 20th Century and continues to adapt and add key components from the original thought. Key pioneers and founders of Behavioral Therapy include Joseph Wolpe, Hans Eysenck, B.F. Skinner, Arnold Lazarus, Albert Bandura and David Meichenbaum (Tan, 2022). Traditional Behavior Therapy is based on behavior being conditioned by one’s learning and social environment. Classical conditioning as well as operant conditioning play large roles in how behavior evolves within a person.
Classical conditioning is based off IvanPavlov and his studies on canine responses to stimuli. In classical conditioning, the dog salivates in response to the treat or food. The salivation is referred to the unconditioned response or natural response to the food or unconditioned stimuli. The UCR to the UCS is a natural response to something that occurs subconsciously within any living creature. Pavlov however incorporated a conditioned stimuli next to the unconditioned stimuli to help provoke a conditioned response. He added the ringing of a bell during dinner time for the dogs. The dogs continued to salivate and eat due to the food, but later when the food was removed, the ringing of the bell still conditioned a response of salivating. A CR emerged due to the CS. This illustrated that living things can be conditioned and behavior changed at neural level over time.
Operant conditioning also played a role for Wolpe, Skinner and other early behavioral therapists. Operant conditioning looks to alter behavior through consequences. Behaviors that are reinforced with pleasant stimuli or reward, or even the absence of negative stimuli constitute positive/negative reinforcement of it. These consequences look to maintain or increase a certain behavior. Behaviors that are met with punishment and negative stimuli look to eliminate or reduce a certain behavior (Tan, 2022).
Behavior modification became a key component in changing a person way of thinking and acting. Skinner even took this a step farther than most and indicated that all behavioral events and modifications determine what a person will or shall do, even to the extent of denying free will (Tan, 2022). Obviously, this was an extreme outlook and narrows human behavior only to present stimuli and events without considering the numerous other things at play. Nonetheless, one cannot deny the profound effect environment and stimuli plays within the role of behavior and decision making.
As the school of thought developed, cognitive and other elements would become important tenets in Behavior Therapy.
Behavioral Therapy employs a broad range of techniques and therapies. First and foremost, the therapist is more so in control than in Rogerian therapies and other Person-Centered Therapies. The therapist takes a central role. The client proposes the “what” while the therapist presents the “how”. Hence, there is far less concern with the therapist-client relationship. Although not disregarded, especially when integrated, the emphasis of healing and change is more so in the techniques and the now instead of focusing on a relationship or probing into the past.
To help understand the client, behavioral assessment is the first and key stage in helping the client. This involves targeting the “what” of the problem and identifying symptoms and problems of the client (Tan, 2022). Counselors propose operant conditioning as a key element of change. They utilize positive and negative forms of reinforcement to help the client change. Some cases involve complete extinction of any positive or negative. If dealing with a child’s temper tantrum, extinction would be utilized as a way to completely to ignore the outburst and when the child is again calm to implement positive reinforcement. Punishment or aversive control can also be utilized to produce change. Positive punishment adds an adverse stimulus, while negative punishment removes something positive. A child may be forced to do a choir or with positive punishment associated with undesired behavior, while negative may involve grounding a child or taking away a privilege. In some cases though, punishment and extinction can also cause unwanted desires in anger and aggression. Because of this, positive reinforcement is seen as the best psychological tool in promoting healthy change (Tan, 2022).
Another technique utilized in Behavior Therapy is Token Economies. This technique is a positive reinforcing strategy based on reward of token which has a symbolic value for something that can earned through good behavior. This is a common technique used in schools which keep track of desired performance and behavior with recognition and reward.
Modeling represents another utilized strategy to help foster change. In modeling, the client observes another person’s behavior and the consequences surrounding it. Bandura listed certain ways modeling can be utilized in changing behavior. He first emphasized teaching which includes simple observation and application of the model. Second, in therapy, prompting involves the client performing a certain behavior that was observed. Motivating a client through modeling involves focus on the reward of the other person and hence motivating the client to replicate the behavior. Reducing anxiety involves watching the model perform an anxious deed to be replicated by the client. Maybe this involves the model dealing with something that is a phobia for the client. Finally, live modeling involves replicating the behavior or acting it out in therapy under the guidance of the counselor (Tan, 2022).
In addition, Behavior therapies also look to incorporate certain social skill and assertiveness training. In this, the therapist helps the client understand their current behavior and why he or she responds in certain situations and how to respond differently, utilizing a variety of modeling and rehearsal techniques. In this way, Behavior Therapy works closely with a variety of management techniques to work on behaviors that need changed, included areas of anger, assertiveness, as well as stress management. In addition, the counselor looks to help the client meet goals and self directed change. Bandura believed strongly in the self efficacy of a client to successfully implement change in one’s life (Tan, 2022). In meeting goals, self talk and other cognitive ways to help someone through a situation is encouraged. Meichenbaum employed stress inoculation training, as a type of exposure therapy to stress itself and how one responds to stress. This CBM (Cognitive Behavior Modification) was also utilized by the military to help soldiers in stressful situations (Tan, 2022).
Behavior Therapy also focuses heavily on relation strategies which serve to relax the central nervous system and the reactions to stress and distress. They employ a wide variety of exercises involving breathing, guided meditation and progressive muscle relation to face and deal with stress, emotions and trauma (Tan, 2022). Mindfulness is also employed in a variety of stress management strategies.
Another key tool used in Behavior Therapy involves systematic desensitization. Wolpe believed that exposures to phobias or traumas can help an individual modify current behavioral reactions and recircuit reactions to them. Utilizing the SUD scale (Subjective Units of Discomfort), the therapist gradually exposes the client to a phobia or issue. For example, a person who fears a spider will be begin to be introduced to issues surrounding the spider with the therapist documenting the SUD scale input between 1 to 100 with 100 being the most anxious. Minimal dosing with the word, moves forward to a picture, then it progresses to dead specimens to alive specimens to eventual complete exposure and touching (Tan, 2022). Wolpe referred to this as counterconditioning a certain behavioral response with a new and healthy response. Other forms are more intense. Flooding involves exposure without the feared stimuli or its consequences but at a higher maximum level. One modern utilization of this is EMDR (Eye Movement Desensitization Reprocessing). This technique has gained popularity in therapies facing trauma and has proved to be effective way for many clients to face trauma and phobias itself (Tan, 2022).
Behavior Therapy has evolved to include many multi-dimensional aspects, included mindfulness as well as cognitive therapies. It is a very successful type of therapy but like all therapies when utilized singularly, it can miss important aspects of healing regarding the past, or unresolved memories. Yet despite this, it still possesses a comprehensive approach to multiple issues. It helps the person gain autonomy and confidence through goals and freedom to reset one’s mindset to produce new desired behaviors.
Please also review AIHCP’s Healthcare Certification Programs and see if they meet your academic and professional goals.
Patient Centered Therapy: Access here
Existential Therapy: Access here
Tan, S-Y. (2022). Counseling and psychology: A Christian perspective (2nd Edition). Baker Academic.
Cherry, K. (2025). “How Behavioral Therapy Works”. Very Well Mind. Access here
Gillette, H. (2025). “Your Guide to Understanding Behavioral Therapy”. PsychCentral. Access here
“Joseph Wolpe’s Contributions to Psychology: Pioneering Behavioral Therapy” (2024). Neurolaunch. Access here
Written by Harry Wolf,
Depression, anxiety, and cognitive fatigue… Such conditions are not shaped by psychosocial stressors alone. Indoor environmental conditions measurably influence neurobiology, emotional regulation, and treatment response in both clinical and residential settings.
For professionals working in health care delivery and education, environmental quality has become a clinical variable – rather than a background detail.
Indoor air quality can affect cognitive clarity, mood stability, and overall psychiatric vulnerability. Indeed, fine particulate matter and elevated carbon dioxide concentrations are increasingly associated with measurable declines in executive function and increased depressive symptoms.
According to findings by Spain’s Instituto de Postgrado, cognitive performance is improved when indoor particle concentrations are reduced under double-blind conditions.
For clinicians and administrators, those results suggest that untreated air-quality deficiencies may quietly undermine therapeutic engagement and cognitive resilience.
Diminished cognitive flexibility can translate into impaired engagement in psychotherapy, reduced medication adherence, and increased frustration tolerance issues. In home settings, especially among older adults, subtle declines in air quality may erode cognitive reserve.
Common contributors to compromised indoor air quality? They include:
In larger homes and clinical settings, uneven airflow is more than just a comfort issue. When certain rooms receive less ventilation, air can become stale, temperatures fluctuate, and particles start to build up over time. Over time, these imbalances can start to affect how people feel, think, and respond especially in spaces meant for recovery, focus, or therapy
This becomes harder to manage when each room serves a different purpose. A therapy room, for example, may need a steady, quiet environment, while offices or living areas have different requirements. Relying on a single system often leads to some areas being overcooled while others are left inconsistent.
In situations like this, solutions such as Five-Zone Ductless Systems make a noticeable difference. They allow each room to be controlled independently while still running on one outdoor unit, making it easier to maintain stable air quality and temperature across the entire space without overcorrecting in certain areas.
Light exposure… As you probably know, it regulates circadian rhythms, melatonin secretion, and mood stability. Inadequate daylight or excessive artificial light at night alters neuroendocrine function in ways strongly associated with depressive symptoms.
A 2024 systematic review published by PubMed found that exposure to artificial light at night was associated with increased odds of depression, with risk rising incrementally per lux increase.
Controlled indoor light modifications could improve depressive symptoms.
For shift-working nurses, inpatients under constant illumination, or residents in poorly daylit homes, light exposure patterns can directly influence sleep architecture. It can affect emotional regulation, as well.
Circadian disruption may therefore complicate pharmacologic management and behavioral interventions.
Key lighting-related risk factors include:
Design responses extend beyond aesthetics. Tunable white lighting, access to natural daylight, and scheduled dimming protocols… They all help synchronize circadian rhythms.
Environmental services teams and clinical leadership benefit from viewing lighting plans as behavioral health interventions. Illumination levels, spectral composition, and timing form part of the therapeutic milieu.
Environmental noise acts as a chronic stressor – with measurable neurobiological consequences. Activation of the hypothalamic-pituitary-adrenal axis under persistent noise exposure contributes to anxiety, irritability, and sleep fragmentation.
Studies show there are reported associations between long-term environmental noise exposure and increased risk of depression, anxiety, and suicidal behavior.
A 2025 study in Frontiers in Public Health found that higher ward noise exposure was associated with increased perioperative anxiety among hospitalized surgical patients.
For individuals already experiencing medical uncertainty, acoustic overload compounds psychological burden. And it prolongs stress activation.
Health care workers are similarly affected. Noise exposure can potentially cause elevated stress, insomnia, and anxiety symptoms among staff. Burnout risk, clinical error potential, and reduced empathic capacity may follow sustained exposure.
Common indoor noise sources include:
Acoustic mitigation strategies require interdisciplinary coordination. Sound-absorbing ceiling tiles, alarm management protocols, and zoning of mechanical systems reduce unnecessary exposure.
Residential environments supporting recovery from psychiatric hospitalization similarly benefit from quiet zones and sound-dampening materials.
Mental health treatment does not occur in isolation. Auditory load shapes emotional tone, concentration, and sleep continuity – in both institutional and domestic contexts.
Thermal stress… It has increasingly been linked to mental and behavioral health outcomes. Elevated indoor temperatures and high humidity levels can exacerbate irritability, aggression, and depressive symptoms.
Findings by Nature show that humid-heat exposure may substantially increase the global burden of mental and behavioral disorders – under high-emission scenarios, that is.
Additional 2025 findings using WHO-SAGE data demonstrated stronger associations between depression risk and wet-bulb temperature. For clinicians practicing in regions with rising heat indices, environmental monitoring may therefore become part of psychiatric risk mitigation.
Thermal discomfort disrupts sleep, impairs cognitive flexibility, and increases physiologic stress load. Patients with severe mental illness may be particularly vulnerable – due to medication-related thermoregulatory effects.
Thermal risk factors often include:
Precision temperature control reduces physiologic strain. Zoned HVAC solutions, humidity regulation, and building envelope improvements allow clinicians and facility operators to maintain stable indoor conditions.
Residential settings caring for older adults or individuals on psychotropic medications benefit from proactive climate management – rather than reactive adjustment.
Visual clutter and excessive environmental stimuli can heighten cognitive load and anxiety. Overstimulating indoor environments challenge attentional filtering mechanisms – particularly among individuals with autism spectrum conditions or acute psychiatric symptoms.
In clinical environments, chaotic visual fields can similarly increase perceived lack of control and attentional strain.
Common contributors to sensory overload? They include:
Environmental simplification enhances perceived safety and predictability. Streamlined visual design, concealed storage solutions, and consistent spatial layouts reduce cognitive burden and may improve therapeutic engagement.
Behavioral health units in particular benefit from calm visual fields that support emotional regulation.
Attention to visual order does not require sterile minimalism. Intentional organization and reduced sensory noise collectively support psychological stability in both institutional and residential settings.
Navigation within health care environments is rarely neutral. Complex layouts, inconsistent signage, and visually ambiguous corridors… They all increase cognitive load and can heighten stress responses – in both patients and staff.
Disorientation may rapidly escalate into agitation – for individuals already experiencing anxiety, cognitive impairment, or acute psychiatric symptoms, that is. Poorly organized spatial layouts increase mental effort, elevate physiologic stress markers, and reduce perceived control.
In places like large hospital campuses and multi-wing outpatient centers, wayfinding demands often compete with clinical stressors. Therefore, it compounds emotional strain – during already vulnerable moments.
Cognitively vulnerable populations are particularly sensitive to navigational complexity. Individuals with mild cognitive impairment, dementia, traumatic brain injury, or severe mood disorders may struggle to construct reliable mental maps of confusing environments.
Heightened uncertainty activates vigilance systems – which can worsen anxiety. And it can reduce cooperation with care processes among patients.
Here are some common wayfinding-related stressors:
Disorientation does not merely inconvenience patients. Staff members navigating inefficient layouts can also potentially experience cumulative cognitive fatigue – particularly in high-acuity settings where rapid response is critical.
Design strategies that improve environmental legibility can mitigate these risks. Clear sightlines, color-coded zones, intuitive floor numbering systems, and distinct architectural landmarks reduce cognitive burden.
Memory care units often employ simplified circulation loops and recognizable visual anchors to support orientation – demonstrating how design can function as a cognitive support tool.
Predictability and clarity within built environments reinforce psychological safety. When individuals can reliably anticipate spatial outcomes, autonomic stress activation decreases.
For health care systems focused on trauma-informed design, wayfinding coherence represents a measurable and modifiable determinant of mental health stability.
Indoor environmental conditions intersect with neurobiology, behavior, and treatment response – in measurable ways. Things like air quality, lighting, acoustics, and thermal stability… They all influence mood regulation, cognitive performance, and anxiety expression across care settings.
Environmental optimization should be viewed as a systems-level intervention. Meaning? Multidisciplinary collaboration among personnel like clinicians, facility managers, architects, and mechanical engineers.
Priority actions include:
Environmental assessment tools can be incorporated into quality improvement frameworks alongside infection control and patient safety benchmarks.
Graduate programs in health care administration and clinical education increasingly address built-environment impacts as part of systems-based practice.
Mental health outcomes reflect both psychosocial and physical context. Proactive environmental design reduces preventable stressors – while reinforcing therapeutic interventions already in place.
As we have seen, indoor environmental conditions measurably influence depression risk, anxiety levels, sleep quality, and cognitive performance. So, designing environments that support optimal mental health outcomes is of the utmost importance!
Health care leaders who are evaluating facility upgrades or residential care transitions should incorporate environmental audits. Attention to ventilation, lighting schedules, acoustic control, and thermal zoning will strengthen overall mental health outcomes.
Engaging environmental upgrades as part of comprehensive care planning positions organizations to support both physiological and psychological resilience – among both patients and staff. So look at which solutions you could incorporate in relevant environments.
Was this article helpful? If so, take a look at our other informative content.
Author bio: Harry Wolf is a freelance writer. For almost a decade, he has written on topics ranging from healthcare to business leadership for multiple high-profile websites and online magazines.
References:
https://www.icns.es/en/news/air_quality_improves_cognitive_performance
https://www.nature.com/articles/s44220-025-00548-7
https://pubmed.ncbi.nlm.nih.gov/39721676/
https://www.sciencedirect.com/science/article/pii/S2950362024000122
https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1652514/full
https://pmc.ncbi.nlm.nih.gov/articles/PMC12459723/?utm_source=openai
https://arxiv.org/abs/2503.08761
https://ifstudies.org/blog/a-cluttered-home-causes-more-stress-for-women-than-men
https://pmc.ncbi.nlm.nih.gov/articles/PMC10965811/
Please also review AIHCP’s Certification program and CE Courses see if it meets your academic and professional goals. These programs are online and independent study and open to qualified professionals seeking a four year certification
The pain of a breakup and divorce has many levels of loss and secondary losses. While each can be horrible for a person, different individuals have different experiences for a variety of reasons. This video takes a closer look at the multiple factors in relationship loss and grief.
Please also review AIHCP’s Grief Counseling Certification
Written by Deepika,
In times past, the term rehabilitation had a rather simplistic meaning. You hurt, you rest, and you feel better. That sounds easy, right? Well, the same cannot be said today, as the idea of rehabilitation has evolved from basic recovery to a dynamic process.
It is still about healing the body, but also includes care tailored to patients’ unique goals and challenges. Metropolitan areas like Denver, with a 713,000+ population, comprise a mix of patients recovering from joint replacement or healing from work-related injuries.
Physical rehab in Denver must go beyond cookie-cutter methods to ensure meaningful patient progress. Now, growth often brings with it certain barriers. Likewise, healthcare is still striving to identify the different hurdles to patient progress for timely intervention.
Are you aware of such barriers, particularly the most common ones? This article will focus on three main roadblocks to rehabilitation. Care teams can use the insights shared to keep the patient at the center of every step.
Across industrial verticals, what has helped bring about the revolution of adding value to customers? The simpler answer is personalization. Healthcare, being a largely people-oriented industry, cannot afford to neglect personalization either.
This is crucial in light of how the definition of rehabilitation covers a holistic approach. In other words, healthcare providers must move from a disease-centered approach to a wellness-focused one. Care that is not tailored to a patient’s needs can thwart recovery and frustrate patients.
A 2025 review of patients in exercise rehabilitation found that 27 items of evidence were identified in the form of expert recommendations and randomized controlled trials. Shockingly, none of the evidence was implemented in clinical practice. This was especially true of areas like prescription and personalized assessment tools.
The authors of the study concluded that this lack of tailored assessment led to suboptimal patient outcomes. It only shows that the definition of rehabilitation has evolved, but only in paper, not in practice. Individualized care is a must, which may include adjusting the intensity of therapy or setting realistic recovery goals.
In many urban areas, the needs of patients coming for rehabilitation are wide and varied. Rehabs in such settings would have to go beyond standard protocols and offer reconditioning therapy. It is an approach aimed at restoring the strength and mobility required after deconditioning.
Total Physical Therapy shares that deconditioning happens when your body loses function in certain areas due to inactivity. What does diversity of needs have to do with this? Patients who arrive after periods of illness, hospitalization, or inactivity will not respond to generic therapy.
So, how do healthcare professionals make treatment plans fit the individual in question? It may be done in the following ways:
It doesn’t take long for someone in the healthcare field to understand how real the conflict between a patient and their specialist can be. Traditionally, the medical profession has worn a badge of honor that almost deifies those involved in it.
However, discords are not uncommon, and they may range from minor disagreements to downright cases of violence. From the perspective of rehabilitation, a lack of patient cooperation acts as a major hurdle. It can not only delay the recovery process but also increase the risk of complications.
Now, how does non-cooperation arise in the first place? It could take various forms, depending on factors mentioned below:
We have some real-world examples to support this. As per a 2025 qualitative study, physiotherapists testified to a major lack of patient adherence. From the healthcare provider’s viewpoint, the main reasons were a lack of motivation and communication gaps. As for patients, many reported psychological factors, physical limitations, and second thoughts about rehabilitation.
This makes for a dual approach wherein we understand how cooperation issues may emerge from both patient experience and provider interaction. So, what can be done about this? Healthcare professionals should conduct frequent reviews to detect this barrier.
Moreover, simple and thorough instructions should be provided to patients. Just ensure the dialogue is supportive, leaning more toward patient concerns.
Communication, be it with patients or fellow team members, is the cornerstone of high-quality care. This is not something new, but an important part of care that has been known since the time of Florence Nightingale.
You may wonder how communication just breaks down, especially since healthcare teams are so closely knit these days. Well, the process is more of a slide than a leap. In other words, it happens so subtly and gradually that discrepancies may see the light of day only when things go haywire.
Let’s say a patient needs to be handed over by a hospital to an outpatient rehab team. During the transition, important patient information, such as recent progress or new complications, is not conveyed. Since the new team will be clueless as to the latest health stats, their treatment may not work, or worse, negate the progress already made.
A similar scenario occurs when different healthcare providers give instructions that contradict each other. An example would be a physical therapist who wants the patient on advanced exercises, whereas the nurse instructs them to rest due to swelling. One can only imagine how disastrous the consequences of such miscommunication can be.
Since we are at it, let’s walk through some other communication gaps that usually take place:
Research suggests that over 70% of adverse events in healthcare originate from communication failures. When do most of these failures happen? Not so surprisingly, at the time of handovers or transfer from one unit to another. This means nobody can say that they didn’t see an adverse event coming, at least in the majority of cases.
Now, nurses usually act as the central link in the care team. This means they are in a solid position to remove this particular barrier. For instance, nurses can ensure that the transitioning team receives complete and accurate patient information.
They can also clarify unclear or conflicting instructions before they affect patient care. Only when gaps are addressed at the earliest can patients experience faster recovery.
Based on what was just discussed, how immune would you consider your facility to be? Indeed, immunity against poor rehabilitation care is a matter of constant vigilance. If you observe that communication between care teams is falling apart or audit a care plan only to find that patient progress is stalled, take action.
The future of rehab is dependent on turning every possible obstacle into an opportunity for growth. Your patients are looking for meaningful recovery, something which takes time and intention.
The journey counts, which means every small victory is important. So, which barriers could be hiding in plain sight, and how can your team pull them down for better outcomes?
Author’s Bio:
Deepika is a budding content creator who enjoys exploring various niches, be it lifestyle or healthcare. With a knack for breaking down complex topics, she strives to make information relatable and accessible to everyone. During her leisure, Deepika enjoys reading novels and practicing fine arts to keep her creativity alive.
Please also review AIHCP’s Nursing Management Certification program and Nurse Manager Courses see if it meets your academic and professional goals. These programs are online and independent study and open to qualified professionals seeking a four year certification