Modality Problem Proposed counseling programme
Behaviour working too hard Examine work ethic ‘I must put 100%
effort into everything I do.’ Discuss pros and cons. Dispute self-defeating beliefs Bibliotherapy
Affect Exhausted Feeling identification Relaxation
work/shift patterns, workplace stressors. Lifestyle changes. Physician referral
‘On an emotional roller coaster’ Teach REBT ABCDE paradigm. Self-monitoring. Diary
Depressed Physician supervised antidepressants
Angry and irritable Anxiety management. Dispute irrational demands about others’ behaviour
Scared of not coping Coping strategies/imagery
Panic attacks Anxiety management, breathing exercises. Cognitive cycle of panic
Sensation Tension headaches Relaxation training, massage or
biofeedback. Prescribed medication
Imagery images of ‘making things Explore meaning; discuss
better for patients’ pros & cons
Images of not coping Coping imagery dealing with
/losing control difficult work situations
Images of being alone Rational emotive imagery
Cognition Muddled thinking Self=monitor; focusing
Poor concentration
‘I must prove to the Dispute self-defeating thinking;
world I can do better’ unrealistic
‘I’ve made poor choices expectations of self and others.
in my life’ cognitive
‘I can’t forgive dishonesty’ restructuring
‘The managers should recognize my work’
Values: social rights and justice
Loss of confidence Constructive self-talk; self-acceptance training; assertiveness training, guided imagery. Bibliotherapy
Interpersonal Passive/aggressive Assertiveness training
in relationships
independent Learn to ask for help
& self-reliant
Unsupported Explore work culture; support/friendship
Not valued networks, clinical supervision; stress map
Not listened to of workplace relationships; unrealistic
Let down by team expectations
Conflict with Anger management;
consultants communication skills:
Lost trust in colleagues body language; dispute self-
/managers defeating thinking
Difficult relationship Examine beliefs about
with step mother manipulation and insincerity
recently separated Explore unrealistic expectations
and emotionally and loss
disappointed in husband
Illness of close friend Explore feelings and consequences
Bereavement of Explore unresolved grief,
father five years ago bereavement counseling
loss of mentor and
confidante
Drugs/biology Hypertension; mild Physician supervised medication
asthma; rhinitis
Little exercise Fitness programme swimming
Unhealthy diet chips Nutrition programme, reduce caffeine intake
Consumes 10 cups intake