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Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
December, 2015, Vol. 15, Issue 12
Facilitating a Coaching Conversation
By Ben Benjamin, PhD
In previous articles, I've made the argument that in many instances, it's less useful to give a client advice than to provide coaching that helps them discover their own solutions.Here, I'm going to discuss one particular circumstance in which advice-giving is both very tempting and potentially very risky: responding to a client who's facing a major decision and asks you directly what you think they should do. The decision may be closely related to the work you're doing with them (e.g., deciding whether to give up a sport in which they've sustained multiple injuries), or it may have little or no connection (e.g., deciding to start or end a personal or professional relationship).
It's often hard to know what to say in such situations. For decisions that are very personal or far outside your scope of work (such as whether to file for divorce or make a risky investment), an outside referral (to a psychotherapist, financial consultant, or other professional) is probably in order. But in other cases, simply advising the person to speak to someone else may feel inadequate. Suppose the person is considering quitting their job. They've talked to you repeatedly about how much stress they experience at work, and it seems to be contributing to extreme muscle tension and chronic headaches. When the client says, "Tell me honestly — what do you think I should do?" What's the best response?
On the one hand, you probably care about the client's well-being and want to encourage them to reduce the stress in their life. You also don't want to be evasive or hold back the truth of what you think. So it may be tempting to say, "Absolutely, I think you should do it."
On the other hand, you don't know all the details of the situation and you're not a counselor (although clients with strong transference may treat you as though you were). Furthermore, this decision is so significant that it really needs to be driven by the client's own values, judgments, preferences, and desires. When people base critical life choices on the recommendations of external authorities — whether it's a massage therapist, psychotherapist, religious leader, boss, elder family member, or self-help guru — they don't get the opportunity to learn from their own mistakes and successes. That type of learning is critical for developing a strong internal compass, sense of competence, and capacity for making better decisions in the future.
Answering a direct request for decision-making advice isn't necessarily unethical, and it may even be the right thing to do in certain circumstances (for example, in a case of physical abuse). However, many times, you can do more good by having a coaching conversation instead. I've talked about coaching in general as incorporating several key guidelines: get permission for having the discussion; inquire and reflect more than you advocate; remain curious; and focus on solutions, rather than problems. There's one specific approach that I've found to be particularly helpful when coaching a client attempting to make a decision, especially when that decision involves just two or three clearly defined alternatives (such as taking an action vs. doing nothing). It can help the person to see aspects of a complex issue that they've overlooked, which — in combination with skillful questioning and reflection — often enables them to discover a creative, satisfying resolution. What follows is an example of how you might describe this method to a client and then put it into practice.
Client: "Tell me honestly — what do you think I should do? Should I quit my job or not?"
Therapist: "That's a hard question. This is a big decision, and I don't know enough to say what's going to be best for you. I do know of a decision-making method that's often useful in this kind of situation, and I'd be happy to walk you through it to help you get clearer on what you really want. Would that be helpful, or no?"
Client: "I was hoping you'd just tell me what to do! But okay, sure, we can try that method."
Therapist: "Okay, great. What I'll invite you to do is to first spend some time thinking about all the advantages of leaving your job. Focus just on the positives — on how that makes sense and could improve your life. Then you'll switch and instead consider all the advantages of staying in your job. Do you want to give this a try?"
Therapist: "Okay, so what's good about the idea of leaving your job?"
Client: "At the moment, everything about leaving seems good! I'm so exhausted and burnt out. I think if I got out of this situation, I'd be a lot happier and more relaxed."
Therapist: "Anything else that would be good?"
Client: "I'd have more time with my kids. My oldest will be going off to college next year, and I want to be more present for her while she's still here. Of course, I can't go without an income forever. I can't be unemployed six months from now. So maybe this is a really irresponsible idea, and I should just stay where I am."
Therapist: "So now you're getting into the downsides of leaving your job. Before we go there, is there anything else that's positive about leaving?"
Client: "Oh, right. Yeah, I think if I could pull it off, I'd end up healthier outside of this work environment. I'm not eating well or sleeping well, and I'm tense all the time."
Therapist: "So you're thinking getting out, or getting into a different work environment, would help you get healthier?" (Reflection/clarification.)
Client: "I do. In my last job, I took real lunch breaks so I'd get out and go for a walk. And I had time and energy to cook at home, so I was making healthier food for myself. I really think that away from this job, I'd lose 30 pounds and my overall health and well-being would increase dramatically."
Therapist: "Can you think of any other positives of leaving your job, or are you ready to look at what's good about staying?"
Client: "I'm ready to look at why I should stay. I know it's risky to just quit without having another job. I won't get unemployment, and if I can't find anything else we'll be in real financial trouble. At the same time, I'm so burnt out that the last thing I feel up to is a job search."
Therapist: "So, in terms of the positives of staying, it's the financial security?" (Reflection/clarification.)
Client: "That's right. I make a very competitive salary, and the benefits are good, too."
Therapist: "And beyond that, is there anything else on the plus side?"
Client: "Well, I do like the work I do. I feel like I'm making a real difference in the world. And I've gotten to meet a lot of amazing people."
Therapist: "That's interesting. It's sounding as though you like a lot of things about your job." (Reflection/clarification.)
Client: "I do — or at least I would, if the workload weren't so crazy."
Therapist: "And what would need to change for the workload to not be so crazy?"
Client: "Basically, I'd need to get an assistant. I had one in my last job. But this position doesn't have a budget for that."
Therapist: "So, if you could get an assistant, you might achieve some of those benefits you'd hoped to get from leaving your job?" (Reflection/clarification.)
Client: "Yeah, then it would be more like that last position, a lot more manageable."
Notice how a possible creative solution has begun to emerge — one that's different from either option the client had been considering before. The coach didn't suggest this idea, but just helped the client consider both sides of the issue (focusing just on the positives), reflect and clarify what was heard, and ask a key open-ended question ("What would need to change?"). Figuring out the details of a resolution would take a little more time, and this first idea (hiring an assistant) may end up not working out. But one way or another, this type of coaching conversation is likely to help the client achieve greater clarity. And it does so in a way that is much more empowering and motivating than simply telling them what to do.
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