healthcare certifications

Trauma Informed Care: Vicarious Trauma, Compassion Fatigue, Burnout and Regulating Self

Posted on by Mark Moran

It is only natural for many counselors to become sickened, disgusted, angered, or enraged when discussing trauma with a victim.  The stories of abuse against the innocent cry for justice.  As counselors, or safe guarders, in many ways, these emotions are important in helping the counselor or social worker become instilled with the desire to find justice of the victim and legal punishment for the perpetrator.  Hence, it is natural to feel.  Counselors are not robots and as human beings, they can become influenced and effected by the details of the stories of victims.  These effects can appear in forms of vicarious trauma, compassion burnout, or even loss of emotional control in a counseling session.  As healthcare professionals, it is imperative that counselors, social workers and pastoral caregivers are able to monitor themselves in order to be there for the client/victim.   In this article, we look at vicarious trauma, burnout and regulating self and how it is important to identify these things and utilize the skills of regulation in counseling, but also every day life.

Vicarious trauma is indirect trauma that affects the counselor or caregiver. Please also review AIHCP’s Trauma Informed Care program

Please also review AIHCP’s Healthcare Certifications as well as its Trauma Informed Care program, as well as AIHCP’s Grief Counseling and Crisis Intervention programs.

Absorption Vulnerability: What is Vicarious Trauma, Compassion Fatigue and Burnout?

It falls under the umbrella of vulnerability absorption.  Counselors can become affected by their clients and the stories told by them. Within these types of absorption, counselors can face compassion fatigue, vicarious trauma, or burnout.  Within compassion fatigue, the trauma and stories of the victim wear down the counselor emotionally.  It affects their ability to be empathetic and optimistic in the therapeutic relationship.. Vicarious trauma, on the hand has a different type of reaction to trauma.  Vicarious trauma is when a counselor or mental health professional is indirectly affected by the trauma of the client/victim (Compton, 2024, p. 236) but in this type of trauma, the counselor experiences types of post traumatic stress symptoms.  It goes beyond the emotional wear of compassion fatigue but also affects the beliefs and behavior of the counselor.  Burnout on the other hand does not include the trauma of the victim, but has more to do with large caseload, working long hours and inter stress dynamics at work (Compton, 2024, p. 236).  All symptoms of burnout as well as vicarious trauma and compassion fatigue are detrimental to the therapeutic relationship because it weakens the counselor’s ability to actively listen, employ empathy, help the client heal and remain regulated. Some may overlap and also play on each other.

Compton points out that counselors who are more susceptible to vicarious trauma and absorption vulnerability usually have past trauma that is triggered in counseling through the indirect trauma of the client (2024, p. 238).  Hence indirect exposure to horrible stories of abuse, one’s own past trauma history and the triggers associated with it can engage within the counselor various trauma responses.  Like the client, the counselor can experiences challenges to one’s own beliefs and world views and also cause an existential crisis of faith (Compton, 2024, p. 237).  This can later filter into the counselor’s home life causing counselors to either avoid those in need, or to overcompensate with becoming to involved.  Overinvolvement and lack of professional boundary can lead the counselor into seeing the client as oneself and lead to clouded vision as well as trying to do too much beyond one’s skill level in some cases.

Regulating One’s Emotions

When hearing horrific stories of abuse, it can be difficult during a session for a counselor to be able to maintain the needed co-regulation for a client.  A counselor, like a trauma survivor, can enter into states of hyperarousal or hypoarousal.  In other articles, we discussed the nature of hyper and hypoarousal states of the client, but these same states can also affect the counselor in negative ways.  In regards to hyperarousal, a counselor may become more irritated, anxious, or upset, while also feeling an increased heart rate as the sympathetic nervous system is activated.  Likewise, a counselor may become dissociated, numb or lost due to the reaction of the parasympathetic system.  In both cases, the counselor is losing the ability to regulate.

Settling oneself without upsetting the client is key.  In the hyperarousal state, the counselor needs to settle and ground oneself by calming the mind through breathing, grounding, or other cognitive exercises that relax the sympathetic nervous system, while in the hypoarousal state, a counselor needs to activate by stimulating the brain or creating movement.  Many times, it is encouraged in these activation or settling techniques to discreetly include the client who may well also be experiencing tension.  Hence any of deep breathing exercises or cognitive grounding techniques, as well as movement, stretching, or even a cold glass of water can help a counselor and client regain emotional regulation.  Many of these grounding techniques and how to utilize them are mentioned in other AIHCP articles.  Please click here to review grounding and containment strategies.

While counselors track clients emotional and physical reactions, counselors can also scan their own body for hyper or hypoarousal.  Compton recommends scanning one’s own body in intense moments to detect these emotional changes within the body.  In addition, Compton recommends evaluating ones subjective unit of distress on a scale of 1 to 10 via the SUDS scale (2024,. p. 249).  It is  important to understand not only the window of tolerance of one’s client but also oneself.  Again, the window of tolerance refers to the optimal time a person is able to discuss trauma in a rational and calm way without triggers activating a fight, flight or freeze response.   In charts, the window of tolerance is colored as a green zone, while hyperarousal is dictated a red zone, while hypoarousal is regarded as the gray zone.  When in the red zone of hyperarousal, a counselor needs to stop and engage in calming activities, while when in the grey zone of hypoarousal, a counselor needs to activate and arouse the mind and body (Compton, 2024, p. 248-249).

Intense emotions of clients can cause vulnerability absorption in counselors. Counselors need a others-orientated empathy to properly help clients heal

Key regulation, a counselor needs to identify triggers that can cause these reactions.  As human beings counselors too have triggers that can cause various reactions to a story or person.  Past trauma, one’s own biases,  and one’s own way of handling things can cause internal division with the client and it is important to identify these triggers.  These triggers can cause issues with providing unconditional positive regard and empathy to the client.  In displaying empathy, sometimes, according to Compton, can fall into two categories- self-orientated empathy and others-orientated empathy.  In regards to self-orientated empathy, one feels the pain of others but it affects the person directly and impacts their ability to help, while others-orientated empathy allows one to feel but gives the necessary space and distance to help others in suffering (2024, p. 254). To review AIHCP’s previous article on unconditional positive regard and empathy, please click here.

Counselors when they do feel emotions should not dismiss the feeling as bad or good.  Emotions, according to Compton, are not dangerous in themselves but a counselor simply needs to allow and notice them but constrain them for the benefit of the client (2024, p. 256-57).  In addition, certain stories may also lead rumination or the inability to shake a certain thought or memory that has invaded the mind during counseling.  Compton suggest focusing such worries and thoughts to goal solving thoughts (2024, p. 258).   Again, emotions and thoughts are natural, but as professionals, one needs to identify them and properly regulate them in counseling.

Self Care

Counselors, like any caregivers or safe guarders, experience many terrible thing through the stories they hear.  The ability to absorb but yet to effectively care is a thin line from falling victim to vicarious traumas.  Hence it is so important for counselors to be skilled in self-regulating, but also skilled in understanding professional and emotional boundaries.  Counselors need to ensure that their brain and body is able to find the necessary time to heal and rest.  Self care is in many ways stewardship of self.  It involves understanding that one is not the ultimate solver of all problems and understanding the value of time and how to utilize it for the greatest good.   Sometimes, it is the mind that needs the most rest.  Allowing the mind freedom from unnecessary trauma or images when away can allow one to find peace at home.  Instead images or stories or movies that may invoke triggers should be avoided. Hence according to Compton, it is important to be a steward of one’s mind, body, time and relationships with others.  This involves boundaries as well as enjoying the good in life.  It can be very difficult to avoid the fog and darkness of abuse and the counselor needs to have balance.  Spirituality, hobbies, time off, boundaries, as well as utilization of grounding techniques and the mastery of them is key.  Deep breathing, relaxation, meditation, and digesting good and wholesome content is important for counselors to be able to continue to give quality care to each hurt soul

Conclusion

Please also review AIHCP’s Trauma Informed Care program as well as its Healthcare certification programs

Counseling and safe guarding victims of trauma takes a toll on healthy minds.  Positive energy and coregulation of the counselor in the therapeutic relationship can be weakened through vicarious trauma, compassion fatigue or burnout.  Hence it is critical to understand one’s own triggers, as well as the ability to regulate one’s emotional responses.  Self care is essential to maintain a healthy balance to keep counselors up to the large task of helping victims heal.

Please also review AIHCP’s Trauma Informed Care program, as well as its other Mental and Behavioral Health Certifications.

Resource

Compton, L & Patterson, T (2024). “Skills for Safeguarding: A Guide to Preventing Abuse and Fostering Healing in the Church” Intervarsity Press.

Additional Resources

Compton, L., & Patterson, T. (2024, March 14). Absorption Vulnerability: A New Look at Compassion Fatigue. Traumatology. Advance online publication.  Click here
Vicarious Trauma: “What To Do When Others’ Distress Impacts Your Well-Being”. (2024). Cleveland Clinic: Health Essentials. Access here

Matejko, S. (2022). “What Is Vicarious Trauma?”. PsychCentral. Access here

Luster, R. (2022). “Vicarious Trauma: A Trauma Shared”. Psychology Today. Access here

 

Signs of Trauma and Abuse Video Blog

Posted on by Mark Moran

It is imperative within trauma informed care to be aware of and looking for signs of trauma or abuse in clients.  This video looks at some signs of abuse and trauma.  Please also review AIHCP’s Trauma Informed Care program, as well as its Crisis Intervention program and Grief Counseling program.  AIHCP offers a variety of healthcare certification programs. Please click here

Emotional Healing Process in Counseling

Posted on by Mark Moran

Emotional Healing Process in Counseling

I. Introduction

The emotional healing process in counseling is a multifaceted journey that necessitates an understanding of both psychological and therapeutic frameworks. Integral to this process is the recognition of how various therapeutic modalities can facilitate the expression of complex emotions. For instance, the use of film and other artistic mediums has been increasingly acknowledged for their capacity to prompt discussions surrounding difficult topics, offering clients a unique lens through which to explore their feelings more safely. As noted in contemporary studies, such interventions, including psychoeducational approaches, can significantly enhance individuals understanding of mental health issues and their symptoms, fostering improved communication and engagement in therapy (Jones B et al., 2017). This foundation sets the stage for a collaborative therapeutic environment where clients feel empowered to confront and navigate their emotional experiences, ultimately aiding in their journey toward recovery (Amann et al., 2010). Understanding this process is pivotal for counselors aiming to adapt their methods to meet the diverse needs of clients.

Finding emotional healing through counseling. Please also review AIHCP’s Healthcare Certifications

Please also review AIHCP’s healthcare certifications for healthcare professionals and also mental and behavioral health professionals.

A. Definition of emotional healing

Emotional healing can be defined as the process through which individuals address and work through their emotional wounds, ultimately leading to a state of psychological well-being and resilience. This journey involves recognizing one’s emotions, understanding their impacts, and developing coping mechanisms to manage them effectively. Within the counseling context, emotional healing is not merely about alleviating symptoms of distress but encompasses a holistic approach that integrates various therapeutic modalities. Such modalities may include cognitive-behavioral techniques, mindfulness practices, and interpersonal therapies, all of which aim to foster self-awareness and facilitate deeper emotional understanding. As highlighted in recent discussions about counseling psychology, integrating social justice and multicultural competencies into therapeutic practices can enhance emotional healing by acknowledging the diverse backgrounds and experiences of clients (Butler-Byrd et al., 2008). This comprehensive approach ultimately allows individuals to reclaim their emotional health and navigate their lives with renewed strength and perspective (Nurmalia (Editor) et al., 2015).

B. Importance of counseling in the healing process

In the realm of emotional healing, counseling serves as a pivotal component that facilitates recovery and resilience. Through structured dialogue and therapeutic interventions, individuals can explore their feelings and confront unresolved traumas, ultimately leading to greater self-awareness and personal growth. For instance, the psychosocial support provided by organizations like Save the Children underscores the importance of addressing emotional needs in the aftermath of traumatic events, such as natural disasters, where emotional turmoil is prevalent (Prewitt DD et al., 2019). Furthermore, traditional healing practices, as highlighted in recent studies, demonstrate that culturally sensitive approaches can enhance the effectiveness of counseling by integrating familiar rites and community support mechanisms (Hill et al., 2016). This synergy between clinical and traditional methods not only enriches the therapeutic experience but also fosters a sense of belonging and identity, essential elements in the healing journey. Thus, the role of counseling extends beyond mere symptom relief, embodying a holistic approach to emotional recovery.

C. Overview of the essay structure

To effectively convey the complexities of the emotional healing process in counseling, the structure of the essay is pivotal in guiding the reader through the central themes and arguments. Each section serves a distinct purpose: beginning with an introduction that outlines the importance of emotional healing, followed by a literature review that situates current theories within a pluralistic framework, as suggested by the belief that psychological difficulties may arise from multiple causes and thus require diverse therapeutic methods (Cooper et al., 2007). The subsequent analysis of different counseling techniques showcases the practical implications of these frameworks, while the conclusion reflects on the collaborative nature of the counseling relationship, emphasizing the synergy between therapist and client. Such an organized structure not only aids comprehension but also allows for a critical examination of the evolving discourse surrounding emotional healing as a dynamic process within the therapeutic setting (Siegel et al., 2007).

II. Understanding Emotional Healing

Emotional healing is a complex process that encompasses not only the alleviation of psychological distress but also the restoration of internal balance and self-awareness. This involves a multifaceted exploration of the individual’s emotional landscape, recognizing how feelings can manifest in both psychological and physical ailments, as highlighted in the discussion of holistic health approaches in cancer counseling (Miller et al., 1976). Therapists play a vital role by guiding clients through their feelings, yet they must respect the nuances of each persons belief system and expectations in therapy, as seen in the example of Len, who sought counseling within a Christian context (McMinn et al., 1991). This illustrates the importance of tailoring therapeutic interventions to the clients worldview, ultimately paving the way for a truly integrated healing experience. By fostering an environment that promotes self-reflection and personal responsibility, counselors can significantly facilitate the emotional healing journey for their clients.

Emotional healing is a process like any form of healing that takes time and also recognition of the emotions.

A. The psychological basis of emotional healing

The psychological basis of emotional healing centers on the interplay between emotional awareness and therapeutic processes, which are crucial in counseling. Acknowledging emotions is a foundational step in promoting psychological well-being, as it allows individuals to confront and process their feelings rather than suppress them. Techniques derived from emotion-focused therapy (EFT), for instance, advocate for the integration of emotional experiences into the therapeutic dialogue, enhancing clients emotional regulation and fostering insights into their behavioral patterns (Elliott et al., 2012). The importance of holistic approaches, which encompass various therapeutic modalities, is also emphasized in contemporary discussions surrounding emotional healing. These practices facilitate the acknowledgment of mind-body connections, reinforcing the notion that psychological healing transcends mere cognitive restructuring and includes bodily sensations and physiological responses (Nurmalia (Editor) et al., 2015). Ultimately, understanding the psychological mechanisms underlying emotional healing is imperative for effectively guiding individuals through their recovery journeys in counseling settings.

B. Stages of emotional healing

The stages of emotional healing are crucial in understanding the complexities of the counseling process and the individuals journey toward recovery. Initially, individuals often experience a profound sense of shock and denial, which can obstruct the path to acceptance and integration of their emotional wounds. As clients progress through the stages, they may encounter feelings of anger or guilt, which need to be processed to promote healing. This emotional turbulence is matched by the emerging realization of personal agency in the healing process, aligning with recent findings that underscore the clients role in therapy. For instance, qualitative studies suggest that clients are actively involved in their therapeutic journey, contributing significantly to the outcome, even in the face of challenges presented by their counselors (Bergin A E et al., 2003). Additionally, modalities like music therapy have proven beneficial, enhancing emotional expression and remembrance, ultimately facilitating deeper healing (Shotts et al., 2018). Understanding these stages allows counselors to tailor interventions that resonate with each unique emotional experience.

C. Factors influencing the healing process

The emotional healing process is profoundly impacted by a multitude of factors that inform both the individual’s psychological state and the counseling environment. One critical element is the quality of therapeutic relationships, as strong, trusting connections between counselor and client can significantly enhance the therapeutic experience and promote healing. Furthermore, individual characteristics such as personality traits, resilience, and prior experiences play an essential role in how clients navigate their emotional struggles. External influences, such as socio-cultural dynamics and access to supportive resources, including peer networks and community engagement, also shape recovery pathways. For instance, a study highlights that students’ consumption behaviors reflect social norms and accessibility, indicating that communal factors can influence personal choices, including those related to emotional well-being (Nurmalia (Editor) et al., 2015), (Nurrahima et al., 2015). Thus, understanding these multifaceted influences can provide counselors with a comprehensive framework for fostering healing and growth in their clients.

III. Role of the Counselor in Emotional Healing

The role of the counselor in emotional healing is multifaceted, encompassing various therapeutic strategies that facilitate recovery and personal growth. Counselors serve as supportive guides, creating a safe environment where clients can express their feelings and confront emotional turmoil. In this therapeutic setting, engagement and adherence to ongoing treatment processes are critical, as evidenced by studies indicating that successful recovery often hinges on participation in structured care programs (Foote et al., 2014). Furthermore, integrative therapies, such as family and storytelling approaches, can significantly enhance emotional healing by fostering a sense of belonging and understanding within familial units, particularly in children facing trauma (Desiningrum et al., 2016). Through these methods, counselors not only help individuals navigate their emotional landscapes but also cultivate resilience and coping mechanisms essential for long-term healing. Ultimately, the counselor’s role is pivotal in guiding clients toward achieving a healthier emotional state and improved life satisfaction.

Counselors play a large role in helping healing through the therapeutic relationship

A. Establishing a therapeutic relationship

The establishment of a therapeutic relationship serves as a foundational pillar in the emotional healing process within counseling environments. This relationship is a delicate interplay of trust, compassion, and mutual understanding, fostering an atmosphere where clients feel safe to explore their innermost feelings. The therapist’s role extends beyond mere guidance; it involves creating a setting where clients can articulate their struggles, as exemplified by Len, who revealed critical personal information early in his session due to the perceived shared values of his Christian counselor (McMinn et al., 1991). Furthermore, therapeutic tools such as film have shown potential in aiding this process by offering clients a way to confront and discuss difficult topics more comfortably, thus bridging gaps in communication (Amann et al., 2010). Ultimately, the quality of the therapeutic relationship significantly influences treatment outcomes, helping clients navigate their emotional landscapes effectively.

B. Techniques and approaches used in counseling

Counseling success hinges quite a bit on the techniques and methods used; these are very important for helping people heal emotionally. Integrating film into therapy is one approach gaining traction, acting like a bridge to tough emotional subjects. Counselors use movies to create a secure space, allowing clients to address sensitive issues more freely, which they might otherwise avoid. (Amann et al., 2010). This helps improve communication and offers a reflective outlet, making it easier for clients to look at their experiences. Research also highlights how important active client involvement is these days. Studies show that how well counseling works isn’t just about the therapist’s skill; the client’s engagement and how they see the therapy matter a lot, suggesting a need to rethink what “success” means in this context (Bergin A E et al., 2003). Generally speaking, these components show just how varied and important counseling techniques are for promoting emotional healing.

C. Ethical considerations in the counseling process

Ethical considerations, within counseling’s complex field, are key for emotional healing to occur. Counselors need to put client well-being and independence first. They have to make sure the client feels secure and valued throughout the therapy. This means knowing how much cultural diversity matters, especially when it comes to religion and spirituality, and understanding how these things shape who a person is and what they’ve gone through. Ethical guidelines push counselors to change how they do things. Think about assimilative, accommodative, and collaborative methods that bring spirituality into therapy (McMinn et al., 2012). And, tools such as movies can be a healing method enabling clients to participate in difficult topics; encouraging reflection (Amann et al., 2010). Navigating these complexities, counselors boost their professional image and add significantly to a clients emotional road to recovery.

IV. Challenges in the Emotional Healing Process

Embarking on the emotional healing journey presents real hurdles, doesn’t it? It’s tough for both clients and counselors in therapy. Clients, you see, often come in carrying a lot of emotional baggage, really wanting to get better but also feeling pretty vulnerable and worried about what’s going to happen. Take Len, for example. He was really nervous about talking about his feelings in counseling and felt more comfortable with a Christian counselor. This shows that clients sometimes have fixed ideas about what kind of help they need. These kinds of assumptions? Well, they can actually get in the way of therapy by making it harder to open up and really dig into those emotions (McMinn et al., 1991). Counselors, on the other hand, are trying to juggle integrating social justice and multicultural awareness into what they do. It’s not easy; it means they have to keep learning and working with all kinds of different people (Butler-Byrd et al., 2008). This back-and-forth between what clients are going through personally and what counselors need to do professionally really shows how complicated emotional healing is, highlighting that a really thoughtful approach is necessary in counseling.

Many individuals resist healing due to obstacles they must overcome emotionally and mentally. Please also review AIHCP’s Healthcare certifications

A. Common obstacles faced by clients

Those seeking counseling frequently run into hurdles that might actually slow down their emotional recovery. A big one? Sometimes it’s simply not understanding what therapy is all about. Like Len, many show up with ideas already set in their minds about what counseling should be, especially if their faith plays a significant role (McMinn et al., 1991). Plus, it’s common to feel anxious and exposed, and that feeling makes it hard to really open up to the counselor. Societal stigmas definitely don’t help, making it tough for people to dive fully into therapy. Work stress, rocky relationships — these outside factors can also pull focus away from the therapy itself, showing just how crucial a supportive environment is for feeling better. Addressing these obstacles, and building trust through good communication, is vital for making progress in therapy (Lawson et al., 2019).

B. The impact of trauma on healing

Counseling presents significant hurdles, largely due to the complex dance between trauma and the journey to heal. Trauma, be it from natural disasters, violence between people, or overarching systemic conflicts, doesn’t just upset emotional stability, it also weakens one’s ability to bounce back. Take, for example, events such as Hurricanes Harvey and Maria; psychosocial support is extremely important in helping people, especially kids, deal with emotional chaos and start over (Prewitt DD et al., 2019). In similar fashion, the experience of young people involved in intergroup conflicts creates specific vulnerabilities. These vulnerabilities can impede their ability to participate in healing and peacebuilding activities, thus underscoring how necessary trauma-aware strategies are in therapeutic environments (Hester et al., 2016). In helping their clients find emotional healing, therapists need to recognize and address the lasting marks of trauma. Only then can they establish a safe and encouraging space for recovery. To put it another way, trauma’s impact isn’t a minor issue; instead, it’s a major factor that deserves close attention in counseling.

C. Strategies for overcoming challenges

When individuals seek counseling, the path to emotional healing usually involves utilizing diverse methods designed to help them conquer individual hurdles, thereby sparking profound change. A particularly important method is nurturing supportive connections, which can encourage feelings of acceptance and empathy. In fact, peer support, as seen in several studies, shows that engaging with people who’ve gone through similar situations can boost confidence and aid recovery (Murti et al., 2016). Additionally, factoring in a client’s values and belief system within the therapeutic process, especially in Christian counseling, can be essential in building trust and opening the door to self-discovery. Clients such as Len, for instance, have noted how crucial it is that therapy aligns with their faith, demonstrating their need for specialized support that’s in sync with their beliefs (McMinn et al., 1991). Therefore, combining both strong support systems and customized techniques serves as a vital element in successfully handling the emotional struggles involved in a client’s therapeutic journey.

V. Conclusion

To wrap things up, emotional healing through counseling proves to be intricate, yet essential, calling for understanding and a collaborative spirit from both the counselor and the client. It’s been suggested that clients sometimes come to therapy with established ideas on what it should be like, often looking for something that matches their values. Take, for instance, religious clients, such as Len, who came seeking specific emotional support and a counselor whose beliefs were in sync with his (McMinn et al., 1991). Furthermore, peer support highlights the significance of shared experiences in healing. This underscores individual counseling methods, as well as community and relationships, which can really boost a person’s confidence during their journey (Murti et al., 2016). Recognizing these different aspects is what helps counselors offer better support, encouraging emotional growth and the ability to bounce back in a healing setting.

Please also review AIHCP’s healthcare certifications as well as its mental and behavioral health certifications.

Please also review AIHCP’s Mental and Behavioral Health certifications

A. Summary of key points

To recap, when looking at emotional healing during counseling, what really stands out is how helpful therapy can be in letting people express and understand their feelings. Take Emotion-Focused Therapy (EFT), for example. It blends ideas from gestalt and humanistic therapies to build a strong, client-focused relationship that values emotional awareness (Elliott, Watson, Goldman & Greenberg, 2004) (Elliott et al., 2012). This approach uses modern ideas about emotion and attachment, which are so important for helping clients heal as they look into and accept their feelings. Then there are influences, like that from Counseling and the Demonic, that really show the tricky parts of emotional healing, making it clear that dealing with the real root of problems can really change how therapy goes (Bufford et al., 1988). Basically, these ideas emphasize how emotional exploration is needed during counseling, and this exploration can really help people change and heal in a big way.

B. The significance of emotional healing in overall well-being

Within the realm of counseling, attending to emotional healing is quite important for boosting general well-being. During therapy, clients can work through their feelings, which could build personal growth and toughness. Studies show that when clients really put effort into their therapy, it’s usually more helpful (Bergin A E et al., 2003). This effort can cause huge changes in how they handle their feelings. Digging deeper into who you are really helps with coping and fixing your relationships. Also, things like movies and art can really help people show and think about their emotions, which in turn helps them heal (Amann et al., 2010). By looking at emotional hurts, people can get mentally healthier and maybe even feel more connected and happy.

C. Future directions for research and practice in counseling

Looking ahead, as counseling changes, we need to focus on new types of therapy that help people heal emotionally. Adventure therapy is one idea that seems to hold promise, with studies indicating it may significantly help people cope better while also fostering improved relationships with their counselors. Evidence suggests these hands-on approaches don’t just lessen stress; they also support the development of good coping mechanisms, really enhancing what counseling offers (Gass et al., 2015). Additionally, working with professionals from other fields — something discussed at recent conferences — may help us see holistic methods in new ways, giving counselors more techniques to use (Nurmalia (Editor) et al., 2015). Exploring this area allows us to build improved frameworks for deeper emotional healing, leading to life-changing results for people facing emotional difficulties.

Additional AIHCP BLOGS

Coping vs Healing. Access here

Additional Resources

“The 7 Stages of Emotional Healing: A Roadmap to Peace”. Growing Self. Access here

“The Stages of Emotional Healing: Understanding the Journey” (2023). A Beautiful Soul. Access here

“Therapy Explained: Exploring The Therapeutic Process Steps” (2025). Better Help. Access here

Blanchfield, T. (2025). “How to Find Emotional Healing”. Very Well Mind. Access here

Trauma Counseling: Regulating Trauma and Emotion During Counseling

Posted on by Mark Moran

Many times in counseling when discussing trauma, emotions can emerge tied to the unresolved trauma that can de-regulate a client/victim/survivor.  Discussing issues of abuse, or loss, or traumatic memories whether current or in the past can cause individuals suffering from unresolved trauma to dissociate from the present, flashback to the past, or enter into states of emotional dysregulation.  Licensed counselors who specialize in trauma care and crisis intervention have strong understandings to utilize techniques to help ground and contain negative emotions associated with trauma.  Unlicensed mental health professionals in crisis response or even pastoral care may sometimes come across individuals who also need these same techniques due to acute crisis or trauma.  It is hence important to understand how to help individuals suffering from PTSD, acute trauma, or unresolved trauma with the appropriate techniques to help victims or survivors find stabilization.  This article will focus more on in session counseling and long term trauma care than immediate psychological first aid which is addressed in other blogs.  Primarily, we will discuss the therapeutic relationship’s window of tolerance with a victim/survivor, how to expand this window, and review various techniques found in grounding and containment to help others find calm and peace.

Many clients/survivors/victims need aid in regulating emotion after trauma. Please review AIHCP’s healthcare certifications

Please also review AIHCP’s Trauma Informed Care Program, as well as its Crisis Intervention program and also all of AIHCP’s Healthcare Certifications.

Window of Tolerance

In counseling, individuals can experience emotional dysregulation due to unresolved past trauma.  Simple triggers of retelling the story, to similar images in a room, or a familiar scent can reset a person and dissociate, flashback, or cause intense states of hyperarousal or hypoarousal.   Compton explains that individuals can experience two types of dysregulation.  In hyperarousal, the person becomes angry, anxious, hypervigilant, or impulsive (2024, p. 208).  Compton points out that with hypoarousal the opposite occurs when the person experiences withdraw, numbness and lack of emotion even in some cases to a state of dissociation (2024. p. 209).  In the fight or flight response, counselors will see anger and anxiety, but during the freeze response, counselors will see the shutdown.  These are natural ways the body and brain responds to past trauma.  The key is how easily can one’s system return to a state or emotional regulation when dealing with these triggers or reminders that cause emotions to emerge.  Individuals in trauma can be stuck in a variety of phases, some may exist in a state where they feel no safety anywhere, others may exist in a state where safety may not be an issue but trust is totally lacking.  It is the goal of the counselor through the therapeutic relationship to help victims again find phases of regained power, regained self esteem and eventually the phase where they can again reintegrate with society and form healthy relationships.  It is within the Window of Tolerance of a person’s emotional state where this healing can occur.

The Window of Tolerance is term phrased by Ogden, Minton and Pain that refers to the optimal window of time between hyper and hypoarousal states in which a person can experience balance (Compton, 2024, p. 209).  Within this period of time, therapeutic counseling can occur where the trauma can be discussed and better ways to cope can learned by the client.  During this time as well, the reasoning part of the brain as opposed to the emotional part has more awareness to communicate, reason, learn and grow (Compton, 2024, p. 209).   Counselors can help clients learn how to operate and heal within the window but also learn ways to expand this window in real world settings through a variety of skills.   Counselors can help clients co-regulate their emotions within the window and expand it through supplying empathy, support, a safe and secure environment and also preventing re-trauma by limiting or eliminating potential triggers.

Counselors during this time through the therapeutic relationship can help with focusing on the needs of the client and being aware of discomfort or physical manifestations associated with mental discomfort.  Compton points out that the term “interoception” best describes the ability of a counselor to have this type of awareness of what is happening inside someone based on what the body is displaying or doing in the moment (2024, p. 196).  this is why watching for non-verbal cues is key in counseling during the selective attention skill of focusing.   During this important window, counselors should engage their clients.  By focusing, reflecting and providing context, counselors can help survivors understand their trauma better (2024, p. 197).   In addition to engaging, counselors need to help clients process emotion and then help them reflect on it.  The biggest part of processing is not only discussing it, understanding it,  and reframing it but to also learn how to manage it.

Tracking and Identifying Emotional States

Within trauma counseling, it is important to utilize the window of tolerance but it is also equally important to track the client’s body and behavior for signs of either hyperarousal or hypoarousal.  It is also important to track oneself, since sometimes the stories and events relayed can even shock a counselor and cause deregulation within.  It is important to note that most individuals exist within a normal operating existence of balance when viewing safety and conditions.  The securing of safe environments and the scanning by the brain to ensure safety within a environment is referred to as neuroception.  A person in a calm and secure state is not activating the sympathetic nervous system but is existing in normal state where the cognitive functions of the brain are operating.  When the sympathetic nervous system strikes it can close down cognitive functioning and increase emotional responses.  Fight, flight or freeze, or even fawn can emerge as reactions to this.  Interesting enough in cases of hypoarousal, the parasympathetic system, the calming aspect of our nervous system, can deactivate an individual due to the intensity of the trauma or recalling the trauma.  When working with survivors or victims, merely recalling traumatic events can cause a hyper or hypoarousal response.  This can affect healing and reduce the window time tolerance to discuss the trauma with the cognitive functions operating.

Tracking emotions and signs is hence an important skill for a counselor in any session but even more so when helping individuals in intense grief, loss, crisis or intense trauma.  In states of hyperarousal a person will display various physical and also behavioral symptoms. In essence the person cannot calm down.   Clients in hyperarousal can display anxiety, irritability, panic or rage.  They may have racing thoughts, or an inability to concentrate and may display signs of hypervigilance during the session.  Physically they have increased heartrate, muscle tension, clenched jaw, closed fists, display sweating or have a racing heart rate.  Behaviorally, they can display an overall restlessness which may be affecting their sleep and impulse control.  They may fidget and move and express emotions easily during the session.  This can lead outside the counseling room to regular life in feelings of being on edge, easily irritated, over-thinking social interactions, and feeling uneasy in social settings (Mindset Explained, 2025).

When tracking, a counselor also needs to track possible signs of hypoarousal.  Hypoarousal can be induced by either the sympathetic or parasympathetic.  It is usually tied to parasympathetic functions that relax the body but in these cases it shuts the body down as a self defense mechanism to the trauma or even thought of the past event.  A person experiencing hypoarousal will display detachment, numbness and seem withdrawn and lacking motivation.  Cognitively, they may be slow to speak and appear confused and lacking details about events.  Physically they will seem lethargic and have a slower heart rate, display fatigue, or over relaxed muscle state.  During a session, they may zone out or seem distracted.  Behaviorally this can lead to intense isolation outside the counseling room. Many may have a hard time getting out of bed, or detach from loved ones, feel powerless and lose interest in things they like to do (Mindset Explained, 2025).

In both cases, counselors need to be aware of these signs but also know when to utilize activation strategies for hypoarousal or settling techniques for hyperarousal.    In these cases, settling or activating becomes the choice a counselor needs to make.  In states of hypoarousal activities that help the person activate the nervous system include helping the client begin to move, via stretching, or walking around can be a first good start.  Other ways to activate include grounding techniques that are tied to touch and sense, such a the feeling of a cold object or ice cube, or the splash of water on the face.   Other forms of breathwork, as well as cognitive activation through counting or labeling things in the room can also aid the client. Sometimes music can be helpful, or even the scent of a candle (Mindset Explained, 2025).

With hyperarousal, the concern is to settle, not activate.  Hence, breathing exercises, ground techniques such as holding something, or touching something, as well as sensory and cognitive ways to help the person remain in the present.   Progressive muscle relation techniques as well as guided meditation and visualization can help a person induce the parasympathetic system as well.  We will discuss more types of ground and containment strategies later in this article.  What is optimal is a stable state of being.  Stable and emotionally regulated states allow the window of tolerance to be utilized in therapeutic sessions.  Healthy states permit better focus, cognitive functions, stronger relationships, better sleep and better energy levels to cope with stressors and potential triggers (Mindset Explained, 2025).

One thing to consider and be aware of is that while helping others, counselors can also enter into various states of hyperarousal or hypoarousal.  The term reciprocal defense mobilization is the mirroring of emotional states.  While ideally the counselor is the co-regulator in a session providing energy, trust and security to the person, sometimes horrible stories or emotional breakdowns can affect the counselor.  In fact, past trauma of the counselor can also be triggered in counseling.  This type of vicarious trauma can have acute affects on the session but also long term affects and burnout for the counselor.  If a counselor is affected via hyper or hypoarousal, the ability to listen, exercise empathy, or help the person heal can be at risk.  Hence counselors may sometimes need to activate or settle themselves.  It is harder though for a counselor to express these feelings or exhibit certain strategies while counseling and because of this counselors need to be able to subtly activate or settle themselves.  In cases of hypoarousal, a counselor may notice one’s own signs of shutting down and look to activate by clenching one’s fist or hand or shifting or tapping one’s foot.  A counselor can also discuss both parties standing up and stretching as a ploy to not only help the client but oneself.  A break or a pause can be helpful for both client and counselor in these cases.  During hyperarousal, a counselor can label, or count, or focus on one’s own breathing.

One should consider basic strategies to manage both hyperarousal and hypoarousal in daily life.  In regards to hypo, utilize frequent exercise if possible, alone, if public gyms are unsettling.  Utilize breathing and mindfulness, and create and stick to routines that give a sense of accomplishment and work on connecting with others, especially those who are closest.  Even if a short phone call or text!  For hyperarousal, one will utilize more grounding techniques in daily life which will be discussed below and also employ relaxation and meditation, as well as with creating a calmer environment with music, or scented candles (Echowave, 2025).

 

Grounding and Containment

A person during counseling who becomes hyperarousal needs various help to manage his or her emotions within the session.  These skills and techniques can help not only help them regulate and expand the window of tolerance in session but also be applied later to out of session in the world experiences.  The two most common types of skills taught in counseling for individuals with unresolved trauma and PTSD are grounding and containment.

Grounding a way to help survivors stay in the present moment when hyperarousal or hypoarousal overtake them in life or in a counseling session. Please review AIHCP’s healthcare certifications as well as its Trauma Informed Care Program

Grounding techniques can be sensory, cognitive or somatic in nature.   In sensory grounding, the counselor utilizes the five senses to help a survivor find placement in the present.  In regards to the sense of touch, it can be as a simple as feeling the feet on the ground or the soft touch of the couch on the finger tips.  A counselor should help the survivor with calming words describing the sensation one feels as the fingers sway across the texture of the couch, or the firm feel of the foot against the hard floor.  In some extreme cases, ice in a person’s hand can be used to help a person find the present.  In all cases, the sense of touch should be used especially carefully when counselor or client come into contract via a tap on the shoulder or a hug because these things could possibly be a trigger to the prior abuse (Compton, 2024, p. 214).   With sight, the counselor can direct the client to note anything in the room they see and what color it may be or details one may not have noticed before.  The scent of smell can help calm through oils, incense or candles that can help a person find calm but again be aware of your client’s history and scents that could trigger him or her.  With taste, sometimes, one can focus on a piece of candy available and the taste of it, or imagine a particular dessert.  The counselor gently inputs into the mind these scenes to help the client find regulation (Compton, 2024, p. 212).  From a cognitive approach, a counselor can have a client count from a higher number down to zero to exert awareness of the now or have the client name things within the room to help the person find connection to the present.   From a somatic approach, breathing exercises can be employed to help grounding.  In fact, breathing exercises are sometimes the first utilized to help a person calm.  Deep breathing initiate the parasympathetic nervous system which reverses the affects of the fight or flight response.  The deep inhale and exhaling can lower the heart rate and help a person find calmness.  Usually the breathing is done with some type of visualization.   One common theme is balloon breathing where the client is told to imagine a balloon inside oneself and as one inhales to imagine the balloon inflating and while exhaling to imagine the balloon deflating (Compton, 2024. p. 212).   The breathing should be coming from the abdomen and not the chest since chest breathing is usually associated with anxiety.  To ensure proper breathing, one can tell the client to put his or her hand on ones chest and stomach and see which part of the body is moving more.  One can also utilize touching the shoulders to see if the shoulders are rising which is indicator of chest breathing.

While grounding helps a survivor find the present and remain engaged, containment skills can help clients learn to control uneasy emotions.    The tool of containment helps clients break away from traumatic memories and feelings (Compton, 2024, p. 215).   Containment tools include visualization and various expressive arts.  Most of these tools are also utilized with breathing techniques and can be used in session as well as in the real world.   When working with clients expressive arts are similar to play therapy with children.  They can help a person find calm when discussing difficult issues.  Compton references vertical regulation as way for the survivor to draw lines of different colors up and down a page while deep breathing.  Other expressive arts include dance and music to help with hypoarousal to push energy into the person.  Liturgical or spiritual music can be utilized if it provides the necessary calm, or secular music that the client enjoys (2024, p. 211).  Creative writing is another expressive art used to contain emotion.  In expressive writing, one can write a note to oneself, or a parent, or God, or anyone the client freely wishes to write too.  The message can be a positive one that employs safety and security (2024, p. 212).   Visualization and breathing remain one of the most used containment practices in sessions.  With guided breathing and the visual scripts from the counselor, the client can visualize safe and secure places when facing trauma memories or uncontrolled emotions.   One classic visualization technique is imagining the a container in which the client can put all the unwanted emotions into and cover with a lid.  The counselor guides the client to understand that any intrusive thoughts at any time can be stored in this container, box, or chest when needed (Compton, 2024, p.216).   The key is to discover a safe, secure and calm place.  Many times counselors will lead a guided visualization of a place the client finds peaceful.  Whether a cabin in the mountains, or a spot on the beach, the counselor can take the client back to that place or peaceful place in time.  During which the client will close his or her eyes, breath deeply and follow the voice of the counselor describing the calm associated with these places and times.   Butterfly hugs are also a tool that can be utilized during visualization in which the client is taught to hug oneself and allow their hands to tap their back in assurance and calmness (Compton, 2024, p. 217).

In all of these exercises, if the person is spiritual or religious, spiritual aspects and words can be utilized on a case by case basis to help the person find calm.  For some, spirituality may be beneficial but for others who were exposed to spiritual abuse, it may not be warranted.  If spirituality is accepted and desired, sometimes clients can breathe in with a statement about God and breathe out with a statement of safety, such as “God is good” and “I am safe”.  In other cases, scriptural references that the client enjoys can be utilized from whatever sacred book he or she adheres to (Compton, 2024, p. 218).

In all cases, help the client be in control.  The purpose it to help the client learn to regulate and being in control is key, especially when the survivor is not in session.  In such cases, when introducing breathing techniques or new tools, instead of dictating, or saying “do this”, utilize phrases such as “would this be helpful to do this?”.  This reduces distress and gives autonomy to the survivor who in many cases, if abused, was told what to do numerous times.

Conclusion

Please also review AIHCP’s Healthcare Certifications as well as AIHCP’s Trauma Informed Care Certification

Many situations in counseling trauma victims/survivors require helping them to learn to regulate emotions.  These skills are important both in session and out in the real world.  In session, it helps extend the window of tolerance which then can be applied to real world situations.  Skills in grounding and containment help clients with hyper/hypoarousal and maintain control and learn to deal with the symptoms of trauma in a positive fashion.  These tools in counseling also allow for the discussion, reflection and processing of the unresolved trauma.  It is important to remember that when treating trauma, it is a marathon not a sprint.  These skills take time to implement and the body and mind need time to heal.

Please also review AIHCP’s Trauma Informed Care Program, as well as its many healthcare certifications in crisis intervention, grief counseling, stress management and Christian spiritual counseling.  All programs are open to qualified healthcare and mental health professionals seeking four year certifications to utilize within the scope of their practice.  The healthcare programs are online and independent study and have mentorship as needed.

Resource

Compton, L & Patterson, T (2024). “Skills for Safeguarding: A Guide to Preventing Abuse and Fostering Healing

“Hypo-Arousal and Hyper-Arousal: Nervous System Dysregulation”. (2025). Mindset Explained.  Access here

“Feeling Hypo or Hyper Aroused How to Spot the Subtle Signs”. (2025). Echowave. Access here

 

Additional Blogs from AIHCP

PTSD-click here

Counseling Clients through Crisis, Danger and Harm-click

Additional Resources

“13 Grounding Techniques for When You Feel Overwhelmed”. Cleveland Clinic.  Access here

Schuldt, W. “Grounding Techniques”. Therapist Aid.  Access here

Sutton, J. (2022). “7 Best Grounding Tools and Techniques to Manage Anxiety”. PositivePsychology.com. Access here

Caporuscio, J. (2024). “Step-by-step guide on grounding techniques”. Medical News Today.  Access here

Gale, A. (2025). “Hyperarousal vs. Hypoarousal”. Carepatron. Access here

Alpern, P. (2025). “Is the freeze response a form of hyperarousal or hypoarousal?”.  The Trauma Journal. Access here

“Feeling Hypo or Hyper Aroused How to Spot the Subtle Signs”.

 

 

Counseling Clients Through Crisis, Danger and Harm

Posted on by Mark Moran

In counseling, especially Trauma Informed Care counseling, counselors will not always discuss issues of the past.  Trauma from the past can scar emotionally and create many present issues, but many crisis situations exist also in the present.  Counselors or social workers or pastoral caregivers may discover clients that are in distress due to day to day threats and dangers.  This creates a difficult situation for counselors to discern legal and ethical obligations to protect someone from harm versus situations that while potential dangerous are not imminent and require the empathetic and therapeutic relationship to resolve.  New counselors have especially deeper concerns in this murky waters, while more seasoned counselors have a better understanding when and how to report, hospitalize or walk with a person in crisis that is facing danger or harm.  In this blog article, we will review various situations and how to deal with them, as well as important concepts in the therapeutic relationship that can help respect the autonomy and dignity of the person while also protecting the person.

Understanding how to help clients in potential or imminent danger and crisis. Please also review AIHCP’s Healthcare Certifications

Please also review AIHCP’s multiple certification programs in mental and behavioral health, including programs in Crisis Intervention, Grief Counseling, Christian Counseling and Trauma Informed Care.

The Importance of the Therapeutic Relationship in Resolving Crisis

Cochran points out that wrong decisions in counseling can have drastic consequences in helping those in crisis.  This means that following ethical and legal protocols are key, but assessing imminent danger and potential danger is a key skill.  Furthermore, even if as a counselor, one prescribes and writes down a plan for one to follow, there is never guarantee a client will listen. Many refuse to listen, or if feel coerced into doing something, fail to completely fulfill it because they do not believe in the course of action (2021, p. 222).  This is where not only discernment and assessment come into play but also understanding the dynamic role of the therapeutic relationship and how it can help a client in potential danger or even in some cases, imminent danger, a way to properly find safety without violating the person’s autonomy.  It is far more purposeful to help a person not only escape crisis and danger but understand how to progress and continue to heal and find better ways to to avoid it in the future.

Within the therapeutic relationship, Cochran emphasizes instilling within the client self responsibility that preserves dignity and integrity of the client with less restrictive interventions (2021, p. 222).  Why?  Simply because this allows the person to own the situation, understand the danger, be proactive in finding safety and share in the decision making process for finding that safety or care.  If this means convincing someone who is suicidal to admit oneself to a psych unit at a hospital, or help a person report an abuser, it is also best to guide and help the client make decisions with the counselor so the client can be fully on board.  When clients doubt, or question, or feel forced, they many times abandon the course of action and this is why the therapeutic relationship is so critical in helping clients escape danger.  Of course, unfortunately, there are cases where the client refuses to listen to reason, or refuses to report a crime, or puts oneself in harms way.  This is when a counselor reluctantly must obey legal obligations as a licensed counselor to protect a client.  Obviously these situations involve imminent danger, criminal activity, and a client unwilling to work with the counselor in a plan of action.  In addition to trying to utilize the counseling relationship to foster the best plans, it is also critical for the counselor to employ unconditional positive regard for the client and not just merely hear the situation, but to accept the person and the feelings behind it.  While one may be expressing self harm, or threat of being hurt by others, or hurting others, the counselor needs to employ empathy to help the person not only choose the best option but to also help the person heal.  Instead of judging, the counselor needs to hear the pain to better help the person correct the story (Cochran, 2021, p. 223).

Cochran points out that these situations of imminent threat to a client are some of the most difficult ones for counselors (2021, p. 249).   When dealing with suicidal clients, or domestic abuse victims, leave any counselors, much less new counselors feel a strong stress level when dealing with life and death.  Cochran points out that one of the biggest fears is never being 100 percent sure.  If a client completes a non-self harm agreement, a counselor can be left with a nervous feeling if the client will keep his or her word and not harm oneself.  In addition, Cochran points out that many times, counselors can be preoccupied with liability.  Rightfully so, liability is a key concern, and when necessary, legal actions need taken, but to focus solely on liability at the expense of the over-all situation and maintaining focus on the client, then larger errors can occur in the handling of a situation (2021, p. 252).  In addition to rookie jitters, lack of self confidence or experience, many new counselors sometimes also fear coordination with other counselors and professionals.  They may fear this may broach confidentiality but in many agencies, clients are seen by numerous other professionals and the seal of confidentiality is within the staff.  In addition, many times,  the discussions of imminent danger can be discussed with family, or other professionals due to legal laws (2021, p. 253-254).   If within the therapeutic relationship, family or other professional’s opinions can be inserted into the session without taking control away from the client.  These situations since they are so life altering sometimes need other minds and ideas and experiences to help provide the best outcome for the client.  When the client is working with the team and following a plan, instead of fighting against it and being forced into something, then these are the best situations.  Unfortunately sometimes, not all situations are ideal nor the existence of a therapeutic relationship’s existence.

Situations of Crisis that Can be Potentially or Imminent in Threat or Harm

Most situations of crisis that pose potential to imminent levels of harm include suicidal ideation, domestic violence and sexual abuse.  It is always best to utilize a therapeutic relationship in fostering the best play of action as opposed to arbitrary decisions, albeit sometimes when clients refuse to accept themselves, drastic decisions that may not fix the problem long term, but at least protect the client short term must be applied.

Helping those in distress can be difficult when trying to weight and balance legal duties as a counselor and also the autonomy of a client. The therapeutic relationship attempts to honor both

In all situations, it is best to help clients make the plan and be part of it.  Cochran points out that it may be tempting to take over and make it your plan for the client’s safety, but a counselor wants a client to have personal investment and ownership of a plan (2021, p. 225).   In planning, Cochran also calls for these situations to specifics in each plans that looks at all pitfalls or “what ifs” to help a client navigate the dangers of the crisis.  In addition, when a clients hint or speculate about things that may seem harmful, it is the duty of the counselor to error on the side of caution to broach the subject when necessary and even more so, say the words of “suicide”, or “abuse” if necessary to bring to the light the situation.  If a counselor feels a dangerous situation was implied, it should be saved for the end of the session to counter, but within the next few minutes to redirect to what was said to have a clear understanding of the danger the client is facing (2021, p. 226).

The Situation of Suicidal Threats

Suicide is nothing to ignore.  Many times, individuals dismiss these threats as attention seeking, or merely a state of momentary sadness.  While sometimes they may be benign statements, counselors, nor anyone should ever under estimate a possible suicidal threat.  Instead each needs to be taken seriously and with compassion and without judgement.  Each statement needs confronted and completely understood to see if it is merely a statement, or a wish that has potential or imminent harm intended.  Suicide assessment charts are common place in any counseling office.  These guides help counselors assess and discern situations but also help counselors better work with those who feel this way.

Counselors when broaching the subject of suicide, need to identify a plan of the person.  This plan entails why, when and how a person would kill oneself.  By discussing the details of each plan, counselors and trauma informed care specialists can better ascertain if the risk is minimal and requires therapeutic counseling or if it does pose a true and valid threat.  If it is a legitimate threat or desire, counselors need to determine the lethality of the plan.  The how of one wishes to kill oneself can be very revealing.  If one merely hopes to crash into a tree, or punch oneself, as opposed to shooting oneself, overdosing, or leaving a car running in a garage, then plans that involve less likely hood of death can be categorized as a lower risk level.   However, if more lethal methods are described, then the plan needs to be taken far more seriously.  Compounding the seriousness and lethality of the threat, counselors need to address if the means to carry out a plan is possible.  If a client owns a gun, or has a script that he or she could overdose on, then the level of imminent threat becomes a reality.

Counselors, however, can look for other clues to see the mindset of a client.  Clients may casually state I would like to kill myself, but it may hurt my family too much (Cochran, 2021, 229), or may state what would my baby do at home?  These types of clues are good ways to open the mind of the client to the counselor to better assess and determine.  In addition to preventative factors, counselors should look for future orientation (Cochran, 2021, p. 229).  If a client speaks of chores, events, or work schedules in the next coming weeks, then it is a good sign of no imminent threat, but if clients dismiss schedules, or events, or show no care these things, then a more imminent harm conclusion is warranted.   Another closely related clue to imminent threat is switch or sudden change in emotion about life.  If a client suddenly cares nothing about family, hobbies, or sports, or whatever interest that anchored to his or her reality, then this is a sign of danger that a counselor should take seriously (Cochran, 2021, p. 229).  In addition, a counselor should question the client on previous attempts of suicide.  Those with previous attempts pose a more serious threat to themselves.  Also, a counselor should discuss drug and alcohol abuse and the role it plays on inhibitions in regards to a person questioning life and whether to take it or not.

Through therapeutic counseling, the relationship in these conversations needs to end with some type of non-self harm contract.  The contract should include a time table of security, as well as persons to call if one feels sad or depressed or intrusive thoughts of harming oneself appear.  With this contract is safety planning, where the counselor attempts to receive from the client a promise of no self harm at least between sessions, as well as a call list of individuals that can help, as well as a promise to avoid substances that can limit inhibitions to prevent suicide (Cochran, 2021, p. 231).  One of the most important aspects of a plan is also removing any means that may exist.  If a person has access to a gun, then their is a promise to remove it, and if necessary facilitated through a family member.  If prescription medications are available, then the scripts are removed from the home or access of the person.

Some plans may not be able to be completed merely between the word of a counselor and client.  Some plans may need temporary hospitalization, or family intervention.  It is best that these plans are accepted by the client.  Hospitalization is important for individuals who cannot promise their own safety or commit to a plan.  It is good during this plan to discuss how the process will occur and the potential costs.  It may be helpful to to guide a client to the best facility to meet his or her needs.  It is also best to include family in this decision but also to not be afraid to ask for professional peer advice.   If a client is a threat to him or herself and refuses these measures, then unfortunately, the short term safety of the patient outweighs the therapeutic alliance (Cochran, 2021, p. 237).  It is always the best to have a client on board.  Good counseling and good relationships foster the trust for a client to follow the suggestion of a counselor he or she perceives as genuine and trustworthy.  Unfortunately, many in mental health may only see a client once or twice or in an emergency situation and may be forced making the tough but right decision on the spot.  It is however important to at least try to work with the client and empathetically guide them instead of stripping the person of all autonomy without conversation and empathy and respect.

Domestic Violence and Sexual Abuse

A client who discloses sexual abuse or domestic violence poses a real ethical issue for some counselors.  A counselor is ordered to report crimes of physical or sexual abuse.  How it is reported is another thing.  When joined together with the client in reporting physical abuse or sexual assault, a victim can retain autonomy and healing.  A victim may have a difficult time reporting in confidence this horrific trauma and may have conflicting feelings for the perpetrator, or remain in intense fear, or have shame about the story becoming public.  It is imperative to reflect these concerns with empathy and non-judgement but also reflect the imminent danger and legal responsibilities of the situation.  In previous blogs, we have discussed the importance of safety, security and trust in trauma informed care and this is especially important here.

Those facing potential harm need the ear of a good counselor to help guide them and protect them with an appropriate plan for the given situation. Please also review AIHCP’s Healthcare Certifications

Situations that do not denote reporting that lack physical violence or sexual assault can be more tricky.  There is definitely potential for harm and it may be imminent but has yet occurred.  In cases of emotional and verbal abuse, a very careful plan must be construed that utilizes the strengths of the therapeutic relationship.  Cochran points out that many relationships in crisis that carry emotional and verbal dysfunction may be unhappy but not necessarily imminent to harm (2021, p. 248).   It is important for counselors to understand the underlying causes for the dysfunction, approach ways to reduce triggers by both parties,  as well as ways to help them manage emotions.  Counselors should also seek to understand the past history of violence, if any physical violence occurred in the past to help ascertain the situation and its lethality.  Counselors may also suggest avoidance of high risk activities that lower inhibitions.  The use of drugs and drinking can correlate with violence.  Finally, whether, verbal or physical, anger in the home can be detrimental to children.  Special considerations need to be discussed regarding what children hear and what they feel regarding the uneasy tension (Cochran, 2021, p. 249).

If a situation does not warrant reporting yet has potential or imminent possible harm scenarios, a plan needs developed that guarantees the safety of the client.   Discussions on how to remove oneself from the situation, de-escalate, who to call, or where to possibly stay should all be highlighted.   Counselors are there in the therapeutic relationship to discuss the possible hardships and issues that surround all decisions (Cochran, 2021, p. 249).

In some cases, the counselor may speaking with the offender.  This may occur in solo sessions or couple counseling-The offender who admits to verbal or emotional abuse or to past incidents.  In this therapeutic setting, the counselor is to display unconditional positive regard despite any disgust or disapproval.  The point is this client or person has come for help.  They may at first make excuses but through empathy and good counseling skills, a person can start to see what he or she is doing is wrong in the situation.  This involves patience and no judgement to help facilitate the change necessary internally for the person to seek reform instead of being told to do something.  The counselor can help these individuals identify their own triggers, as well as circumstances, or situations that affect them.  The counselor can also identify if the client had been abused in the past and how to help the person heal and not pass on the same abuse.  Plans can involve identifying triggers, avoiding substances, and seeking the necessary help that may be beyond individual counseling sessions (Cochran, 2021, p. 243).

Conclusion

Counseling is not always about past trauma or issues that do not pertain to present potential or imminent harm.  Counselors need to understand their legal obligations when presented to report crimes or potential harm to a client or others, but they can also employ the therapeutic relationship which understands the pain of the individual and the distress of the entirety of the situation.  Sometimes this involves helping the person come to the conclusion that direct help beyond counseling is required, other times it may involve a plan for non imminent or criminal threats to a person’s safety.  The counselor in the therapeutic relationship manages the crisis with empathy but also respects the dignity and autonomy of the individual in coming to logical conclusions and safety plans that protect the individual and others.  When a client works with a plan instead of being coerced, then healing is more possible.  Unfortunately, some clients who are victims of crimes, or are a harm to themselves that refuse to work with a counselor, must be hospitalized, or the situation reported despite the pain it causes.  These are difficult times for counselors, especially new counselors.  Hence, it is important to employ a health therapeutic relationship when applicable, assess situations, consult with other professional peers and make the best decision for the welfare of the client.  It is not an immediate assessment but one that is made with many considerations, facts, and complications considered for the best outcome that respects the law but also safety of a client.

Please also review AIHCP’s healthcare certification programs in trauma informed care, crisis intervention and grief counseling

Always remember though

“The American Psychological Association (APA) offers ethical guidance through its “Ethical Principles of Psychologists and Code of Conduct.” Under these principles, therapists can disclose information without client consent if deemed necessary to protect the client or others from harm. This authorization for disclosure also extends to situations where the client has given permission, or when required by law, such as when providing professional services, seeking consultation from other professionals, or obtaining payment for services.” (Deibel, 2024).

Trauma Informed Care Specialists, those in crisis counseling, and any licensed mental and behavioral health professional, as well as healthcare professional can face these situations and must have a clear understanding what to do but also have the skills necessary to facilitate health client interaction that leads to joint conclusions when possible.

Please also review AIHCP’s multiple healthcare certifications and see which ones best meet your academic and professional goals.

Resource

Cochran, J & Cochran, N. (2021). “The Heart of Counseling: Practical Counseling Skills Through Therapeutic Relationships” 3rd Ed. Routledge

Additional AIHCP Blogs

Suicide Assessment. Click here

Suicide Lethality.  Click here

When Trauma Emerges in Counseling.  Click here

Additional Resources

Health Information Privacy. US Department of Health and Human Services.  Access here

Barsky, A. (2023). “Duty to Protect and the “Red Flag” Option”. Psychology Today.  Access here

“Guidelines for working with clients when there is a risk of serious harm to others” APS. Click here

Diebel, A. (2024). “What is a Therapist’s ‘Duty to Warn’ and Why is it so Important?” Grow Therapy. Click here

 

Healthcare Certification Blog: Empathy in Counseling

Posted on by Mark Moran

Empathy is big word in counseling.  It is also foundational in how counselors and pastors help others heal.  One of the biggest misnomers of counseling is the counselor fixes the person and details the agenda a person must follow to heal.  This is farther from the truth.  Emotional pain is not so easy to heal as if a recipe in a cook book.  Instead it is a messy, usually not outlined path of progress and regress, emotions, and time.   The counselor is more a beacon that guides than a drill sergeant who commands.  Empathy is one of the key skills that serves as a way to help the client heal and become resilient.  This does not mean that confrontation is not sometimes needed when maladaptive ideas and practices are destroying a client’s life but it does mean that empathy gives room for mutual sojourning and walking together in the feelings of the situation.  This allows for self awareness and real conversion within the person instead of superficial direction and forced change that never lasts.  So why counselors would on many occasions love to tell the client this is what the you need to do and how to do it, the science of psychology and counseling suggests otherwise.

Listening and responding with empathy means as a counselor you feel what your client feels. Please also review AIHCP’s Healthcare Certifications

In this short blog we will take a closer look at the role of empathy in the therapeutic counseling relationship.  Please also review AIHCP’s Healthcare Certifications and see which ones best match your academic and professional goals.

Empathy vs Sympathy

Carl Rogers emphasized in counseling the critical importance of genuineness, empathy and unconditional positive regard.   While these may seem like fluffy and soft terms that overlook right and wrong, they are critical to counseling in helping individuals discover right and wrong without scolding, admonishing, or ridiculing.  Those in trauma or pain need a non-judgmental caring ear to listen and through that listening, foster change.  The traumatized, mentally ill, and emotional unstable face a cold world already where they are marginalized, ridiculed, and judged.  While abuse destroys human bonds, empathy can restore them.  Counseling is a therapy that is not meant to make judgements but to help individuals discover healthy and good ways to heal.  Instead of the dogmatic voice that says this is right or wrong (and it has a place), the counseling session looks to heal via listening and understanding and helping the person come to self actualization of the correct course.  The counseling room is not the pulpit, but is a healing modality that looks to guide via a different route.  Counseling understands empathy best produces change rather than lectures that only create more anger and disobedience and resistance.  Ultimately empathy in counseling can lead a client to higher self-awareness, self experience and find a true joy in connecting and continuing the communication and connection with the counselor (Cochran, 2021, p. 64-67).

According to Cochran, empathy is not a thought process (2021, p. 56).  Instead it is a natural connection with a person.  It permits the counselor to feel what the other person feels.  So when a gay man traumatically describes abuse at a young age, a counselor who is heterosexual does not see different sexual orientations, but the feeling of rejection and pain with their fellow human being.  Likewise, a Caucasian counselor, can find empathy with a African American client who discusses the trauma of being racially profiled by the police.  One does not need to share the event, or even agree with the client but they share the emotions felt by the client.  This is the key difference between empathy and sympathy.  Sympathy does not share in the feeling but it feels sorry for the person.  Sympathy is good to have for someone but in counseling it is counter productive.  Clients are not looking for someone to feel sorry for them but for someone to help them.  They are looking for someone to feel what they feel and help them move forward.  Empathy is hence walking with the person not just merely observing and offering condolences (Cochran, 2021, p. 57). Rogers states, empathy means to “sense the client’s private world as if it were your own but without ever losing the “as if” quality” (Cochran, 2021, p. 58).  Of course, this does not mean, one who is empathetic must agree with the person’s choices, life styles or past actions, but it allows the counselor to help the person at a deep level to find healing and change.

This closely ties into Unconditional Positive Regard which is another key concept of Rogers which demands counselors fully accept the client in all their complete wholeness and shower them with unconditional understanding.   Unconditional Positive Regard retains the autonomy of the client to learn how to change on their own terms. Rogers listed warmth, acceptance and prizing as three key elements of UPR.   Warmth represents the care of the client and genuine empathy.  It is the fertile soil that produces a an atmosphere of trust and disclosure.  Acceptance is the ability of the counselor without bias to accept the immediate emotions of a person in counseling-whether illogical, angry, hateful, confused or resenting (Cochran, 2021, p. 103).  Prizing involves raising the self esteem of the patient by accepting them with praise as they are but also highlighting their strengths and weaknesses in a honest and genuine way.  Again, this type of emotional connection does not mean counselors accept statements, values, or actions of a client, but it does mean the regard is sincere and grants the client a sense of trust that if they make a mistake or trip and fall emotionally, there is no condition.  When conditions are placed for approval, then the healing process becomes manufactured.  It is through this type of positive regard that a client can flourish and heal because the client knows someone has their back in the good and the bad.  This type of positive relationship in fact helps the client at an internal level look to become better intrinsically based not on reward but because it is the right thing to do.  Once a client believe it is the right path without being told, then the client begins to truly transform and change.  Through empathy, genuineness and employment of unconditional positive regard, the necessary emotional seeds can plant natural and self employed change at the guidance of a gentle counseling hand.

 

Displaying Empathy

Sometimes the hardest part for empathy to flourish in a counseling relationship is the counselor.  Whether lack of practicing it or lack of patience for its fruits to develop, the counselor is ultimately responsible for establishing a secure and trusting environment where difficult emotions can be felt and discussed.  One element is the fear of letting go.  Some counselors may feel the need to control and direct a session and conditionally expect certain behaviors and decisions.  They lack an empathetic skillset to confront a client with an emotional situation.   It is hence important for counselors sometimes to allow the session to develop as the client dictates and to attempt to understand the client by what is revealed.

There are a variety ways counselors can employ empathy and exhibit it in their practice.

In expressing empathy, counselors need to match emotions with tones, expressions, movements and words (Cochran, 2021., p. 79 to 80). Sometimes naming the emotion and restating it to a client can help reflection but also show empathetic listening.  This is also true when expressing empathetic confrontation which looks to indirectly help a person reflect on a statement.  When stating a statement about what the person is feeling, state in in a declarative statement, but if uncertain, express it in a tentative declarative tone that is open for correction. In these reflections, a counselor can also reflect themes in paraphrasing one’s feelings.  Themes that keep appearing in a person’s story or how one feels can be expertly restated and paraphrased to an individual to again not only show the counselor is listening but also to emphasize.  This can be done in a statement but also in an attempt to empathetically confront a particular feeling (Cochran, 2021, p. 81-82).  Empathetic confrontation eliminates the fear to allow clients to be confronted with some of their own statements.  Counselors should be prepared to be corrected at times, if they misstate what a client said, or if their tentative declaration is misspoken.  In these cases, this should not be seen as an affront but for a better opportunity to understand and help heal.  Most clients will not be offended by this but thankful the counselor is listening and trying to understand.  This can open to further and deeper exploration of the topic.  Of course, it is also good to use appropriate questions to better understand.  The questions must be natural however and  not in the probing nature that looks to pick.  This can make a client feel as if he or she is being interrogated.

Within empathetic counseling, it is important as the counselor to avoid making assessment statements or make the client feel as if he or she is being assessed. In addition, the counselor should not have a surprise hidden agenda that the counselor hopes to reveal and have the client realize.  This leads to an unnatural direction that is void of truly listening and feeling.   Counselors should also avoid doing most of the speaking and talking in these types of sessions, as well as avoid “me too” or “must feel” statements that can assume or take away from the client’s expression of feelings (Cochran, 2021, p. 82).

Counselors hence need to be able to employ empathy in multiple ways.  Compton lists numerous ways, counselors can better express empathy and utilize it in counseling.  He suggests becoming attuned with the client.  Through attunement the counselor resonates the feelings of the victim/survivor (2024, p. 181).  In addition Compton emphasizes the importance of co-regulation where the counselor is better able to help the client manage emotions.  This is accomplished through mirroring and reflecting back, modeling after the client’s tone and motions and checking in on the level of distress a victim/survivor is feeling (2024, p. 182).  The counselor enters into a posture of curiosity that portrays a genuine desire to understand the client (Compton, 2024, p. 183).  In helping with emotions, counselors can also via prizing help highlight strengths of clients and adopt a perspective that looks how those strengths helped them survive and continue to survive.

Counselors also need to practice humility with empathy.  Humility realizes that not all the right answers or skills are found within oneself but to look to the client as well as other professionals to find the needed solutions.  This leads to not becoming over defensive if one is wrong with assumption, as well as being humble before a person’s experience as well as a person’s cultural identity (Compton, 2024. p. 183-184).   Through this humility, the counselor looks to empower the victim/survivor to take an active role in healing and working with the counselor to find it.

Counselors in empathy must also display patience.  The healing process is not linear or fast.  It takes time to help someone find healing.  When in empathy, feelings are not rushed but felt as they truly are and experienced until resolution and healing is found.  During this process, empathy shares in the small victories and joys of self actualization, self worth and healing as the person transforms (Compton, 2024. p. 185).

Of course in all empathy, one finds that all important circle of trust.  Within that trust comes a no-judgement zone and unconditional positive regard.  However, trust is earned.  Individuals suffering from abuse and trauma may not trust at first and be wary of words and especially physical touch.  Through time and patience, confidentiality will be restored but again, empathy demands to feel what the moment dictates and the state of being currently within the client (Compton, 2024, p. 187).

Conclusion

Please also review AIHCP’s Healthcare certifications and see which ones meet your academic and professional goals

Empathy is critical to helping people change because it is not authoritarian or dogmatic.  Counseling is a healing modality and through empathy, one heals but also is guided through an empathetic ear with unconditional positive regard and genuineness that permits the person to see him/herself and come to conclusions that are healthy and good for his/her feeling.  Counselors must be willing to let go of control, face hard feelings, eliminate personal judgement and bias, and allow the person to learn about oneself as the sessions continue.  This does not mean the counselor can disagree internally, or not confront negative thoughts and emotions in an empathetic way, but it does does mean it gives the client a driver seat in pushing forward in self discovery, healing and a future way of living.  Counselors need to facilitate the environment for this by displaying certain skills of empathy, unconditional positive regard and genuineness as espoused by Carl Rogers to achieve these results. Ultimately empathy in every venue of care is essential.  It not just a counseling issue but also in all venues of healthcare itself.

Please also review AIHCP’s Healthcare Certifications, especially in Crisis Intervention, Grief Counseling, Christian and Spiritual Counseling and Trauma Informed Care programs.

Additional Blogs

Counseling When Trauma Emerges- Click here

Rogerian Counseling- Click here

Resource

Cochran, J & Cochran, N. (2021). “The Heart of Counseling: Practical Counseling Skills Through Therapeutic Relationships” 3rd Ed. Routledge

Compton, L & Patterson, T (2024). “Skills for Safeguarding: A Guide to Preventing Abuse and Fostering Healing in the Church” Intervarsity Press.

 

Additional Resources

The Role of Empathy in Effective Counselling. (2024). Mental Mastery. Access here

“Accurate Empathic Understanding: A Core Component of Client-Centered Counseling” (2024). Psychology Town. Access here

Sutton, J. (2021). “Unconditional Positive Regard: 17 Worksheets & Activities”. Positive Psychology.  Access here

Cherry, K. (2024). “Unconditional Positive Regard in Psychology”. Very Well Mind. Access here

 

 

 

 

 

Healthcare Certifications Article on High Blood Pressure

Posted on by Dominick Flarey

High blood pressure is a silent killer.  It causes heart disease, heart attack and stroke.  It is the world’s leading killer and many do not even feel its presence until it is too late.  Heart health through better diet, exercise and blood screening for cholesterol are important steps in fighting back against high blood pressure.  One needs to become involved in one’s health and take an active part in preserving one’s health.

To stop high blood pressure, people must become more heart conscious. Please also review AIHCP’s Healthcare Certifications

 

The article, “Taming the world’s leading killer: high blood pressure” by Dr Tom Freiden looks closer at high blood pressure and the problems it poses and how one can fight back.  He states,

“High blood pressure is the world’s leading killer — and will kill more people, including more young people, than Covid-19 (and, in usual years, more than all other infectious diseases combined). High blood pressure can be prevented, mostly by reducing dietary sodium, and is effectively treated with safe, low-cost medications.”

To read the entire article, please click here

Please also review AIHCP’s Healthcare Certifications for Healthcare Professionals.  AIHCP offers a wide variety of programs ranging from nursing certifications to be various behavioral health programs for qualified professionals.  The programs are online and independent study and lead to a four year certification.  Please review the programs ands see if they match your academic and professional goals.

How to Make Sure You’re in Good Hands Before Going Into Surgery

Posted on by Dominick Flarey

Even with some amazing breakthroughs in the healthcare industry, going into surgery can be quite stressful for patients. Many are unsure of what they can do to find the best surgical team or prepare themselves for the physical stress of a medical procedure. Whether you are getting ready for a life-altering operation or recently decided to take a look at your options for plastic surgery, here are a few tips that you can use to make sure you are in good hands.

Start with Referrals and Reviews

The easiest way to begin this process is to start asking for referrals and taking a look at online reviews. While you don’t want to choose a surgeon based entirely on reviews and referrals, they should help you narrow your options down. One of the best people to ask about medical specialists is your primary doctor. These individuals know the most about your general health, and they should be able to point you in the right direction.

Take a Look at Their History

After you have narrowed your choices to a few surgeons or medical centers, you can then begin researching them individually. The most important information you are looking for is how often they have carried out your particular surgery. You want to have a surgical team that is extremely familiar with your operation. They don’t need to focus on your type of procedure exclusively, but they should be carrying it out at least a few times every year.

Interviewing the Surgeon

Before having any procedure carried out, patients have the right to speak with the surgeon and other members of the surgical team. In addition to asking them about their experience, you should also inquire about the state of their facility. Their medical center should have cutting-edge safety features, such as smoke evacuation machines and an on-site emergency support space (ESS). Depending on your insurance and what type of procedure is being carried out, these initial consultation might be covered by your policy. Patients who would like to make these consultations easier can write down their questions beforehand. With the questions written down, you can be sure that you do not miss any key points.

Pre-Op Instructions

Your surgical team should supply you with a full set of instructions for before and after your procedure. These instructions often include basic information such as what to wear and when you need to stop eating. There should also be suggestions on how you can prepare your home so that you remain as comfortable as possible during your recovery. If the instructions are unclear, then you should schedule another consultation with the surgeon to clarify the information. Even though every procedure is slightly different, you will also be given a basic timeline to follow during your recovery. That includes when you can begin bathing, exercising, and working.

A Second Opinion

Patients have the option to get a second opinion before any procedure is carried out. No matter how experienced your surgeon might be, it doesn’t take much for them to overlook small details regarding your medical history or overall health. As a general rule, patients should always seek out a second opinion if they have been diagnosed with a life-threatening condition. You might also want to consider seeing another doctor if your original surgeon has suggested a major procedure for a medical issue that is not an emergency.

When it comes to invasive medical procedures, it is always better to err on the side of caution. All patients should feel completely confident that they are in good hands before, during, and after their operations.

 

Hannah Whittenly is a freelance writer and mother of two from Sacramento, CA. She enjoys kayaking and reading books by the lake.

 

If you would like to learn more about healthcare certifications then please review our programs

HEALTHCARE CERTIFICATIONS ARTICLE ON BIG DATA AND HEALTHCARE

Posted on by Dominick Flarey

Good article about big date and healthcare.

The article, “Strong Opportunities for Big Data in Healthcare – Population Health Management, Clinical Decision Support and Real-World Data”, by Frost & Sullivan states,

“The healthcare industry is steadily realizing the value offered by Big Data solutions, particularly in “-omics” research and medical record mining. However, current investments are focused on serving immediate needs of the investing stakeholders, which often makes them siloed and incrementally beneficial, as opposed to a strategic organizational redesign of the data strategy that provides exponential returns on investment.”

To read the entire article, please click here

If you would like to learn more about AIHCP’s healthcare certifications then please review our programs