What's realistic for a client with multiple problems?

In this and subsequent Blogs I’ll be writing more specifically about the rationale and content of The Wellness Programme, some of the practical and professional issues arising from the Pilot study, the implications for the training of Wellness Practitioners and making The Wellness Programme both financially viable and sustainable.

I ended the January Blog concluded with this definition:

                              

The Wellness Programme is a comprehensive programme of care, support, education and therapy which sets clients on the path to optimal physical, mental, social and emotional health and wellbeing 

 

The programme is the result of my professional experience in clinical practice. supported by the epidemiological and clinical evidence currently available from orthodox and complementary medicine. 

I gradually realised that clients need the time and opportunity to talk about their fears and hopes for their own physical, mental and emotional health but that they could be surprisingly unaware of everyday risks to their own health and wellbeing. 

The Wellness Programme is currently offered to people living with long term conditions, people experiencing current or recent stress or those whose lifestyle compromises health and wellbeing.

 It involves six weekly sessions lasting between 1½ hours and 2 hours.  Clients complete Pre-Programme Assessment documentation which helps to establish individual needs. The use of quantitative scales enables me to measure the severity of symptoms such as fatigue.  During the first session a semi-structured interview gives qualitative information about clients’ thoughts and feelings and can give greater meaning to the quantitative information obtained from the scales.

The care and support element of  the programme is achieved through a weekly ‘narrative review’.  This gives clients the opportunity to discuss any problems or anxieties occurring during the preceding week and helps me to identify where extra support may be required.

Not setting goals

 I avoid the use of individual ‘goal setting’.  Goals can be beneficial but they can also set people up to fail if done without knowledge of the complexities of a client’s life. 

Working with The Wellness Programme has given me insight into the overwhelming pressures on some people.  A single parent with a Body Mass Index of 48 (i.e. seriously overweight) who also has advanced arthritis and is caring for a severely autistic child who never sleeps for more than two hours at a time will find it almost impossible to look after their own health and wellbeing.  

We try to establish realistic expectations about what can be done, both in the long term and short term.  This is why the definition of this programme refers to ‘setting people on a path’ rather than making bold and unrealistic claims of success.

The educative element of The Wellness Programme includes information on nutrition, stress management, sleep quality, meditation and mind/body exercise with additional information tailored to clients’ individual needs.

The therapy element of The Wellness Programme is always the latter part of each session and involves a full reflexology treatment. This enables the client to experience and benefit from deep relaxation.  The physiological effects of the relaxation response are well documented and the therapeutic advantage of deep relaxation has been widely researched.  Meditation is known to elicit the relaxation response and clients are taught to use meditation at home to continue the therapeutic benefit of relaxation initially gained from reflexology. 

 At the sixth week each client completes the Post-Programme questionnaires and we discuss what changes have been made.  Evaluating the programme in this way provides essential evidence of effectiveness which is important if the programme is to be credible with the public, health professionals and complementary therapists.  

Some food for thought:

With the exception of the very young, the very ill, the very frail or those with learning difficulties do we all have the same responsibility for safeguarding and improving our own health? Is it really as simple as knowing what’s good for you and just doing it!!   What kind of things might stop people looking after themselves?