Counselling Skilss

Creating a Counselling Skills Professional Framework

There is a difference between a person who uses counselling skills and a qualified counsellor. A person who uses counselling skills may not be bound to an ethical framework or code of practice like a counsellor may be. Counsellors should be accredited to a professional organisation such as the BACP which will ensure that the counsellor is fit to practice, have consultative support and will reinforce the counsellor to remain focused on the client whereas someone working within a different organisation such as a Human Recourses company may not. There are many companies that like their managerial teams to attend Counselling skills courses as this enable??™s managers to learn how to handle people in a work environment and also helps them comfort people who have been made redundant. Doctors and Nurses may use counselling skills when speaking to patients. Having the appropriate counselling skills such as, active listening and empathy enables them to connect to their patients and helps the patients to feel valued and listened to. Although the professionals may be using counselling skills in the hospital it does not mean that they are under an accredited governing organisation.
The fact is that people are good, Give people affection and security, and they will give affection and be secure in their feelings and their behaviour. Abraham Maslow
The BACP (British Association for Counselling and Psychotherapy) has an Ethical Framework for Good Practice. It??™s important to have a framework in place as it keeps clients safe and enables the Counsellor to provide a high standard of care, personal moral qualities, maintain competence while practicing, and maintain Ethical Principles. The framework creates trust between the Counsellor and the Client. The main elements that are covered in the Ethical Framework are: Values, Ethical Principles, and Personal Moral Qualities. All these elements are very important and the framework ensures that the appropriate care is given to both Client and Counsellor.
Although Counselling and helping doesn??™t concern itself directly with life and death situations there are ethical dilemmas that counsellors and helpers can find themselves caught up in. This is because counselling concerns itself with damaged, distressed, or otherwise vulnerable people. Pete Sanders (2002)
There are other Ethical Frameworks which many professionals work to. These include social workers, doctors, midwives and nurses. When comparing the Standards of Conduct, performance and ethics for Nurses and midwives to the Ethical Framework for Good Practice in Counselling and Psychotherapy I found many similarities. It was clear that Trust and a High standard of care played a large part in each framework. Moral qualities, ethical principles, values, Team work, providing clients with adequate information and teaching and training were found in both however, in the Ethical Framework for Nurses and midwives, financial arrangements, Supervision, managing and researching were not referred to. The BACP is big on Confidentiality however Nurses work as a team with shared care so confidentiality is kept within the team. In some cases a person may need to work under different ethical frameworks for example; A woman who is a counsellor and a midwife would have to work under the Standards of Conduct, performance and ethics for Nurses and midwives and the BACP. This could become a problem if the midwife had to speak to one of her colleagues about a patient who has asked her to keep the information given to her confidential.
When offering Counselling to someone it??™s important that we conduct ourselves professionally. It??™s vital that we don??™t have prejudices towards people and that we keep improving ourselves and our skills. We must check our motives for helping others.
After ten years in therapy, my psychologist told me something very touching, he said, ???no hablo ingles. Dennis Wolfburg

Practitioners have a legal responsibility to understand the implications of their interactions with others. A law of contract should be used with fee paying clients to clarify the nature of the relationship. It??™s important that boundaries are clearly defined when counselling families and young people and you must be clear that children and young people understand your boundaries so that there is no confusion. You may be asked to act as a witness in court for a client and notes that you have taken may be used. A client could also claim defamation of character is confidentiality is broken. It??™s also very important that you protect your client by not withholding information from them. For example: if a client comes to you that has a physical problem but thinks it??™s a psychological problem and you keep hold of that client when you know that the client needs medical help and you can no longer help, it??™s called negligence.
It??™s important to have Ethics on your mind every time you counsel someone. Ethical conduct includes trying to act within the law, respecting human rights; respecting people??™s ability to look after them selves and that we keep the arrangements that we have made. It??™s important to understand that people have their own rights and beliefs and we cannot push our beliefs or way of doing things onto people. People should be treated fairly and you should always seek to do them good. For example: if your client is a Muslim and you are a Christian, it would be wrong of you to force your beliefs on him or judge him for being a Muslim. Another example could be you showing up 30 minutes late when you are supposed to be seeing a client, this is breaking an agreement that you have made with the client and is unfair.
Respecting client confidentiality is a fundamental requirement for keeping trust. For counselling to be effective, the client must feel secure in the knowledge that whatever they tell the counsellor must be treated with the highest degree of confidentiality. Gerald (2005) However, on some occasions this confidentiality may have to be broken for example if the client intends to cause harm to themselves or anybody else, raises any child protection issues, participates in any act of criminal activity such as Money Laundering, Acts of Terrorism or drug trafficking.
Confidentiality is a virtue of the loyal, as loyalty is the virtue of faithfulness.
Edwin Louis Cole
It??™s important to have clear boundaries in place when counselling as it??™s important for the client to know what to expect and what??™s expected of them. For example if a client comes into a room expecting to be your friend you must make it clear to them that you are there to help them but not to condone anything that they have done or are going through.
It??™s important for us to understand that we are all unique and different. We have different cultures, colours, classes, ages, sexual orientations, languages and emotional needs. People from other cultures may find it very hard to be counselled by someone who is not from their country as they may have different religious views and there may also be a language barrier. We also need to be mindful of physical disabilities. Reasonable adjustments need to be made for disabled clients and also counsellors.
Failing to follow your procedures when counselling, could result in negligence and clients making a claim. For example, if you do not follow health and safety rules and ensure that all the wires in the counselling room are in the adequate position, you may find yourself being taken to court by a client who came into the room and tripped over the wires.
When counselling, the counsellor is responsible for protecting the client from harm. There are three types of dangers that can occur within the counselling room; Physical Safety, Emotional Safety and Psychological Safety. Physical dangers, although rare, can occur and client??™s can make claims for negligence. Loose leads, broken chairs or wet floors can be the cause of accidents. It??™s important to inspect the counselling room thoroughly to look for health and safety issues that could cause harm if left. The Counsellor should ensure that he/she is covered with adequate insurance as this will ease financial burdens if a client decides to take legal action against them. Counsellors should also take into account how many hours they work to ensure they have enough rest. They should also think about personal physical safety when counselling. In some cases the counsellor may be asked to listen to a mentally ill patient who may be prone to violent outbursts so it??™s a good idea to think about the positioning of the furniture within the counselling room. Positioning the counsellor??™s chair near to the exit door may help if a quick get away is needed. A panic button may also be fitted to the inside of the counselling room to give the therapist peace of mind. Psychological Safety includes; feeling exposed or feeling distressed. When protecting the client psychologically, you must be aware that you do not force or push them into digging too deep emotionally, but allow them to open up in their own time. Creating trust between the Counsellor and client will create an environment for the client to disclose information without feeling pressured. You must make contracts very clear and understood before the counselling session begins. Both parties should be aware of what they are committing to. It??™s important for the counsellor to assess the client??™s situation and find an appropriate way of working with them. For the Counsellor to keep psychologically safe, he/she must ensure that she has supervision and that he/she is attending regular counselling sessions themselves. They too need to be able to vent their concerns. It??™s helpful for a counsellor to be a member of an accredited association such as the BACP as they have regular newsletters with information that Counsellors may find useful when practicing. To be emotionally safe as Counsellor it??™s important not to take on the problems of the people you are counselling but be aware that you are there to help the client. The client can also feel emotionally attached to a counsellor if he/she acts like a father/mother figure to the client. Counsellors should be mindful to keep a professional relationship between both parties and they should avoid anything that can be emotionally disturbing for the client. The kinds of words that are used in the counselling session such as ???Come on in my darling, take a seat and tell me all about it??? are not suitable when listening to a client. Ensure that the environment is private for the client so that they feel safe enough to disclose information.
It??™s important for Counsellors to have support and supervision when practicing. Supervision is formal support for counsellors and it not the same as Managerial Supervision.
Case work or Consultative Supervision is an arrangement between a counsellor and a supervisor. The supervisor is not the counsellors manager but he/she is there to support the counsellor with issues that they feel they need to talk about. Supervisors hold ethical responsibilities and are available to ensure that the counsellor is supported fully.
Managerial supervisors such a line manager, are more interested in the development of the companies that they work for. Managerial supervisors concentrate on managing budgets and targets. Their concerns are not about the welfare of a client or counsellor but rather the welfare of the company. Counsellors may have to answer to line managers within their companies who have no Counselling experience whatsoever. This can lead to disagreements between the Line manager and Counsellor as the manager could be at risk of putting pressure on the Counsellor to perform better.

Bibliography for Unit 1


Active Training Online (No Date) (Online) Available from

(Accessed on 3rd March 2010)

Dennis Wolfberg Online (No Date) (Online) Available from
(Accessed on 5th March 2010)

Maslows Hierarchy ??“ Safety Needs by Stanley Bronstein (6th January 2009) (Online) Available from


(Accessed on 5th March 2010)

Potomac Psychiatry (No Date) (Online) Available from
(Accessed on 5th March 2010


Book (3rd Edition) Sanders, P. (2002) First Steps in Counselling, Ross on Wye, PCCS Books.

Book (1st Edition) Gerald, K and Gerald, D. (2005) Practical Counselling Skills, New York, Palgrave Macmillan.

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Hris Preliminary Report

Preliminary Report to Senior Management: Implementation of a HRIS at STAR Industries

Prepared By molly bowman

STAR Industries is a manufacturer, wholesaler and retailer of quality windows and doors for residential and commercial premises that was founded by John Jackson, a builder who saw a gap in the market for higher quality, well designed window and door products in the Australia. Established the 1960??™s in Western Australia, Star has been operating for over 30 years. Star began operations in Western Australia for the first 10 years before establishing a manufacturing plant in NSW to better service the increasing eastern states market. Stars corporate headquarters are now operating in Sydney. Stars founder John Jackson sold the company to a consortium of investors in the 1980s and the company remains a private company with 11 shareholders. Star differentiates themselves against lower quality manufacturers and importers by making their focus on high quality design. They position themselves as ???The designer??™s choice for high quality Australian made window and door products??™ by competing in the higher-quality, higher-price market. Star operates on a set of goals in order to ensure they are establishing the best practice possible these are;

? Customers: to fully understand and exceed our customers??™ needs and deliver superior customer service
? People: to attract and keep innovative, customer-focused employees who can support our expanding business, and reward performance fairly and equitably
? Manufacturing: to use best-in-class door and window manufacturing techniques to maximise the quality of all of our product
? Design: to develop and maintain a product range which reflects modern architectural designs, colour and materials
? Operations: to achieve best-in-class warehousing, ordering, and distribution practices across our whole operation

Stars strategic direction is based on a 5 year plan that incorporates these goals and their mission statement to ???be the leading quality supplier of door and window product in our region by providing our customers with innovative goods and services which anticipate and fully satisfy their requirements.??™

Star has outlined their future business direction to expand in three new business directions;

??? Market expansion to South East Asia
??? Product expansion by manufacturing and selling awnings
??? Product expansion by offering a full installation service

Review of existing STAR HRMIS
General Systems
At present, the majority of STAR Industries??™ HR information is managed using various manual filing systems maintained by HR, line managers and the finance department. Basic electronic records are utilised for payroll. Information relating to employees has no collection or maintenance framework or policy and there is a limited capacity to track and locate information when required.
STAR HR staff have continued to meticulously collect comprehensive and detailed records on performance appraisals and records on staff however difficulties exist with keeping those records up-to-date. The current HRIS is not automated or centrally managed and as a result attaining access to information is difficult and time-consuming.
Presently STAR??™s payroll system is managed through a section of the company??™s accounting software and is administered by the accounts department. Line managers pass on staff timesheets, overtime and expense claims to the HR department and these are then passed on to the accounts staff for processing.
Annual and other leave
Staff and line managers currently provide the HR department with all leave applications, time-in-lieu and sick leave records. Any information related to payroll is then handed through to accounts as necessary. Frequent incidents have occurred as a result of this system where both over and under payment of staff has resulted as well as confusion over leave and other entitlements.
Storage and management of information
All of STARS??™ HR records are copied in triplicate and stored in various offices and locations throughout the company. The HR department stores information relating to personal contact details, salary and award conditions and leave entitlements. Line managers hold information such as performance appraisals, training and OH&S records and remuneration details are held by payroll and accounts. No mechanism currently exists to allow HR to review, update or correct information. Strategic HR planning does not exist at STAR because there has been no facility established to compare HR information across different divisions over various time frames.
Security and the Privacy Act
It is likely that STAR Industries is not meeting their obligations under the Privacy Act due to the number of different staff and departments that handle HR information. There is also serious concern due to the absence of a documented policy on the storage, maintenance and security of this information.

Major common findings relevant to the HRIS data integrity issues have emerged from various documents, consultations, interviews, workshops, and control effectiveness testing. After analyzing the existing HRIS we are able to determine the major internal and external strengths and weaknesses that the organisation faces as a result of their current HRIS. These are;

HRIS Negatives

??? Very limited functionalities
??? Not flexible for end user
??? Database security is compromised
??? Record retrieval takes longer
??? Mistakes and miscalculations are more likely to occur
??? Staff overworked
??? Higher incidence of record loss
??? Storage issues
??? Personal and professional development is impeded
??? Employee performance is not systematically monitored
??? Safety or work environment is compromised
??? Future needs are not forecasted
??? Future organisational development not forecasted
??? Current and future staffing resources are not reviewed against objectives
??? Limited recruitment opportunities
??? Not complying with the Privacy Act
??? Organisational goals not reviewed
??? Management and HR are overworked
??? Limited stakeholder involvement

HRIS Positives

??? Records are preserved in the case of a technological system failure
??? No HRIS product cost
??? Staff retention (lack of review process)
??? HR and management are more involved with HR systems

The STAR CEO has announced expansion and diversification plans which upon implementation will create a number of human resource challenges. Current STAR HRMIS is out of date including payroll and annual leave. The need for a new flexible system has been identified as well as the need for a service level agreement to assist the management team in using the system, including workforce planning.
The current HR Systems are insufficient and is in effect hindering STAR from achieving their strategic organisational objectives. Management, HR and accounts staff are overworked and busy concentrating on manual HR systems so the workplace is not functioning sufficiently. Systems need to be created in order to monitor employee performance and provide personal and professional development to the staff.

An HRIS generally should provide the capability to;

??? More effectively plan, control, and manage HR costs
??? Achieve improved efficiency and quality in HR decision making
??? Improve employee and managerial productivity and effectiveness.
The project to implement a new HRIS product into STAR Industries aims to help the HR executives to complete all of the HR related jobs in an automated and efficient manner. A new HRIS product will not only automate the data entry for employees of STAR, it will reduce the workload of the administration department by automating all the related processes electronically. The HRIS product must generate information that is accurate, timely and related to the achievement of STARS strategic business objectives. The new HRIS will increase Human Resource Managements capacity to leverage and assimilate new and emerging technologies, streamline workflow, maximize accuracy, reliability, and validity of workforce data and ease deployment and collection of data and information.

The HRIS needs to meet the needs of a number of STARS stakeholders. Typically, the people in the organisation who interact with the HRIS are segmented into three groups;

??? HR professionals,
??? Managers in functional areas (production, marketing, engineering etc.)
??? Employees.

HR professionals rely on the HRIS in fulfilling job functions such as regulatory reporting and compliance, compensation analysis, payroll, pension, profit sharing, administration, skill inventory and benefits administration. The HR professional will have an increasing reliance on the HRIS to fulfil even the most elementary job tasks.

Functional managers at STAR need the HRIS to provide functionality to meet the company??™s goals and objectives. Managers will rely on the HRIS??™s capabilities to provide superior data collection and analysis, especially for performance appraisal and performance management. Additionally, it also needs to include skill testing, assessment and development, resume processing, recruitment and retention, team and project management, and management development.

Finally, the individual employees become end users of many HRIS applications. The increased complexity of employee benefit options and the corresponding need to monitor and modify category selections more frequently has increased the awareness of HRIS functionality among employees.

An HRIS system represents a large investment decision for companies of all sizes. We believe that in the case of STAR industries the benefit of purchasing HRIS product far outweighs the cost. The common benefits of HRIS frequently cited in studies included improved accuracy, the provision of timely and quick access to information and the saving of costs. Similarly, Beckers & Bsat (2002) pointed out at least five reasons why companies should use HRIS. These are:

? Increase competitiveness by improving HR practices
? Produce a greater number and variety of HR operations
? Shift the focus of HR from the processing of transactions to strategic HRM
? Make employees part of HRIS, and
? Reengineer the entire HR function

Computerized HRIS functions enable faster decision making, development, planning, and administration of HR because data is much easier to store, update, classify, and analyse. In the case of STAR Industries purchasing a HRIS product would greatly improve their HR functions and allow them to continuously achieve their organisational objectives in preparation for the company??™s planned expansion.

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Counselling Skills

Counselling skills level 2 lesson 1 November 30th 2009 Kerry Moore pg 1

I was excited about starting the new course today. I think it is because for the last few weeks we have been revising for our test and last week we just had a tutorial with peter. Now we are back to the lessons and that is what??™s so exciting. When I got to college there was already a few of us waiting to go in so we were all keen. It was a bit nerving though because there will be new people starting and its the unknown but I??™m sure we will all get on. As it happens though there was only one new lady and she seemed really nice maybe some more next week. Peter started off the lesson the same way as the last course which was necessary for in case we had forgot any of the important things like fire escapes and the first aid etc. We discussed the group rules and how if we all stuck to the personal moral qualities then we would be fine. We spoke about attendance and hoe 85% was needed and if we had more than 3 weeks of then we would be getting a phone call to see why. If we let college know and we have good reason to be off then that would be fine. Journals were next on the list and this course 600 to 800 words is necessary. Anything over 800 will not be read so we have to check our word counter.

Activity one and we had to get into groups of four and we had to discuss people in our life that had helped us in some way and what skill or attitude they had used. We came up with:-

* Teachers life skills (guidance)
* Parents life skills (guidance)
* Doctor counselling skills
* Friends counselling skills
* Sister counselling skills

I also remembered one later on in the lesson which was support worker. I went to see one a few years ago when I had moved back to Worksop from Blackpool where I had been in a bad relationship and the support worker helped me immensely and if it wasn??™t for her I wouldn??™t be where I am today. We went on to discuss what we all had come up with and then we wrote down some helpful attitudes:-
* Non-judgemental
* Honest
* Confidence boosting
* Caring
* Polite
* Helpful
* Respectful
* Patient
* Ability to listen
* Confidential
* empathy

a sense of humour can also help but in some cases people don??™t want the humour so you have to be careful when to use it.

Activity 2 we discussed the helping continuum and how much power each one had and how it changes along the list. Teaching was the first and the power lies with the teacher. Advising is the same, the power lies with the advisor. The third one changes slightly, and with guidance the power is shared this is the same with the forth which is mentoring. The fifth and sixth befriending and counselling the power lies with the client. With counselling the client holds all the power because they are there of their own free will to change something themselves. If the client doesn??™t want to be there they can leave at any time they want they also speak of what they want to when they are ready. A counsellor never gives advice they are there to listen the only time the client hasn??™t got power is when there is boundary issues such as time and if they have to break confidentiality.
In activity 3 we discussed our own definitions of what counselling is and this is my idea:-
Counselling is somewhere that a person goes when they have issues that they want to resolve and get over. A client has to learn to own their own problems and find a way to deal with them in their own way. The client also has to understand what has happened to them and they do this by speaking about their problem. You help the client to do this by actively listening to them and showing empathy. Counselling can only be done by a qualified counsellor on a one to one basis. Counselling skills can be done by anybody unless they have a position of power over the person.
To end today??™s session we did some skills. I don??™t like the skills but it helps us so that we eventually can do them naturally. I don??™t like the talking because I struggle to think of things to say. Today in class I learnt about the helping continuum and I felt that this is useful to know about the power changes and I liked my group also its good to be back.

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Hrd Application

Human Resource Development Case Study Report

Table of Contents

Executive Summary? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?  2
Introduction? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?  ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 3
Scope/Aims? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?  4
Main Body? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?  4-7
Induction of new staff
Customer service
Interpersonal skills
Development of team skills
Development of leadership? skills
Evaluation of interventions, determine level of effectiveness? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?  7-8
Discussion and explanation of appropriate evaluation methods? ? ? ? ? ? ? ? ? ? ? ?  8-9
The human capital monitor
The balanced? scorecard
Recommendations? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?  9-10
Conclusion? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?  ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 10-11
References? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?  11-13

Executive Summary
The report is about HR development needs investigation and the evaluation of methods, discussing in lieu to assessing certain HRDNI ??“ Human Resource Development needs Investigation also, the demonstration of knowledge as appropriate for the latter with steps, processes and methods that Mr. Ian Vaughan and the rest of the senior management team of Ford Australia could adopt into and follow accordingly. Aside, the noting in understanding as well as awareness of various interpersonal skills which are related to the process of leadership and team development which implies an analysis of the issues through known cases and literature research that have ample relevance to the topic focus and pressing in desirable and accurate ideas and concepts achieving in effective. This report will be presented to Mr. Ian Vaughan as well as the senior management team of Ford Australia, recognizing and identifying several human resource developments to be applied and executed for Ford Australia, creating and determining effective engineers as part of the Ford??™s management process allowing in impetus assimilation and success towards leadership skills and team skills from within interpersonal skills are linked into the communication as well as the known stature of development. There has to be learning strategies or interventions to adhere about with several discussions for introducing new staff, customer service skills and others. Thus, methods for evaluating the strategies at hand are needed to be achieved within the company, determining ample level of effectiveness from within HRD aspects for Ford Australia to comply with.? ? 

HR development needs are identified and the value based indicators of learning strategies for introducing new staff, customer service, interpersonal skills, team skills development,? leadership skills development? pressing in critical areas and role regarding to the evaluation of methods upon determining effectiveness of the case research as presented accordingly. The gaining of HR success in terms of several aspects and ways will be conforming to the overall structure and paradigm for Ford Australia to use and apply, for the engineering management team to follow and the rest of the senior executives in various levels of the company. Thus, to come up with useful recommendations in order to achieve effective stance of certain skills needed for Ford Australia human resource to function well according to the standards of leadership, team as well as interpersonal skills as positive as possible. The introduction of new staff, conforms to proper employee and work orientation so that the other Ford staff can easily adjust to the coming of the new staff and lines of communication are open with ample space to work, perform and grow within the team. Customer service is imperative sense it may impose the core cycle of interpersonal skills needed by the Ford management, as business key players will be of effective formation through customer service at its best shape, team skills and? leadership skills development? unites the overall aura and stature of Ford??™s human resource development needs such as those that signifies winning and ideal relationship pace with the rest of the company staff and management mostly, to the technical division of Ford. Learning how to apply, execute and handle all those areas mention deserves a one definite reality to the human resource impetus not just for Ford??™s case but as well as others.

? ? ? ? ? ? ? ? ? ? ?  The aim/scope of this report is amiably to bring in effective and spontaneous case study information and the encountering of detailed content analysis of such human resource development needs investigation, from within several evaluation of methods linked into learning intervention of certain interpersonal skills through team and? leadership skills development? and assimilation and be able to create useful recommendations for Mr. Ian Vaughan to consider and utilize from the senior management of Ford Australia.
? ? ? ? ? ? ? ? ? ? ?  The sub-sections of the report, in the main body adhere to the following points: Induction of new staff; Customer service; Interpersonal skills; Development of team skills;? Development of leadership? skills

Main Body
Thus, if Ford engineers are to be more than technical functionaries in the next millennium, there is a need to provide young engineers? with an understanding of the social context within which? they will work, together with skills in critical analysis and
ethical judgement and an ability to assess the long-term consequences of their work. Engineering in the modern world also involves many social skills, the ability to understand and realize business goals; mobilize and coordinate human and physical resources; to advise social, environmental aspects of their work (Webster, 1996). There is also an increasing need for Ford engineers to choose technological solutions that are appropriate to their social context and to give consideration to the long-term impacts of their work, if only because the work of engineers can have wide ranging effects as technologies can affect the whole globe and future generations. Never before has there been such a moral imperative to consider what may have been thought of as unintended consequences in the past. Engineering (1995), noted that, ???recognition of the responsibility of engineers to consider the social and environmental impact of their work??? (p. 14). For HR development needs at Ford Australia, there accounts for new staff needs, customer service needs, and needs geared for interpersonal skills also ample needs for team skills and leadership skills with a touching indicative recognition towards human resource management areas as effectively identified along with several learning strategies at hand.? 
Induction of new staff
There is importance to introduce new staff with formal interaction at Ford staff as they cannot occur in a vacuum; such interactions are influenced by the situation in which they take place. As one significant influence on the interaction is the goal or purpose of the encounter. It is possible to identify a number of situations all of which will have a slightly different influence on the interaction process Aside, in the case of dealing with complaints, it is imperative that the staff member concerned receives training on how to handle this kind of situation. There will be better atmosphere to the orientation of new staff as Ford team can be?  amenable and open to communication if they approach them on their territory rather than summoning them into their managerial space. The interaction will be affected by the roles that people occupy at a particular time and their relative status. A role can be defined as the pattern of behavior typical of people
occupying a particular position (Brown, 1986).

Customer service
Customer service has become a critical success factor for many? organizations? today (Phillips, 1990; Schneider and Bowen, 1985). Indeed, realized importance of customer service has led to a great deal of? research, especially in the marketing area. Most research focuses on the? different types of services, the organizational dynamics of the service sector (Bowen, Siehl and Schneider, 1989; Schneider and Bowen, 1985),marketing aspects of customer service design, or design and delivery systems? (Klaus, 1985). Thus, measurement of customer service orientation has created more confusion that definitive answers, difficulty of measuring customer service orientation stems from the ongoing debate in the industrial literature on the use of broad versus narrow measures of personality (Ones and Viswesvaran, 1996) for Ford, such narrow approach to customer service orientation is to be preferred over the broad approach since traits are better able to retain specific variance that can enhance criterion-related validity. This will help to ensure greater uniformity in terms of Ford??™s quality service criteria, to know the cost of providing quality service so they look for ways of measuring quality through quality assurance schemes and standard systems, should seek to create an Ford environment which supports quality and enhances communication between employees and customers.

Interpersonal skills
The incorporation of multiple measures of customer service performance in attempting to establish concurrent validity. Including in subjective and objective performance measures is beneficial from a customer service orientation perspective, since it provides a measurement of differences regarding the performance factors that a measure of interpersonal skills impacts. Expecting interpersonal skills to impact both subjective and
objective measures of performance and that, dyadic interaction between customer service providers and customers is an important determinant of a customer satisfaction with service (Solomon, Surprenant, Czepiel and Gutman, 1985). Ford??™s interpersonal skills provide narrow focus, it is expected that it will better correlate with specific measures of service performance than broader measures such as extroversion or general disposition.

Development of team skills
Research has been? encouraging in that the use of teams has led to desirable performance improvements for numerous? organizations in a variety of industries (Banker, Lee, Potter and Srinivasan, 1996), although teams obviously do not always? work well (Hackman, 1990).? The scientific base for understanding teamwork has relied heavily on social models derived from laboratory research with short-lived groups of students that often poorly mirror organizational environments. Research needs to identify the mechanisms that make teams work, as well as how to make them more effective (Cohen, 1993; Sundstrom, de Meuse and Futrell, 1990), the increasing Ford reliance on teams, coupled with literature criticized for limited utility to real-world problems, is pushing practice that favors approaches that do almost anything imaginable in the hope that something will work.
Development of leadership skills
McCauley et al (2000), implies leadership development as expanding the collective capacity of organizational members to engage effectively in leadership roles and processes, come in with formal authority, focuses on performance in formal
managerial roles and the need to work together in meaningful ways (Keys and Wolfe, 1988). Leadership development is thought to be similar to the notion of cognitive and behavioral complexity in that expanded capacity provides for better individual and collective adaptability across a wide range of situations (Hooijberg, Bullis and Hunt, 1999),?  good example is found in transformational leadership theory, as the leaders engage in behaviors related to the dimensions of Charisma, Intellectual Stimulation, and Individualized Consideration (Bass, 1985) and in building Ford leadership capacity it maybe necessary continually to reinvent themselves, organizations need to attend to both individual leader and collective leadership development (Brower, Schoorman and Tan, 2000).

Evaluation of interventions, determine level of effectiveness

For, intervention evaluation, it is ideal to assume and recognize measures towards human resource capital along with sufficient support of research preciseness and spontaneous delivery of related ideas and concepts towards HR development needs and other important specifications. For leadership effectiveness authors such as, Sweetland??™s (1978), have reviewed managerial productivity asserted that effective leadership and increased group output were function of interaction between managers and their subordinates. Murphy and Cleveland (1991) noted that the evaluation of manager??™s performance depends, in part, on the relationships that the person has established with his or her subordinates. There has to be self-ratings of leadership being used as evaluative criteria (Farh and Dobbins, 1989) and clear that self-ratings tell us little about leader effectiveness. But there is a kind of manager who routinely over evaluates his or her performance, and that tendency is associated with poor leadership (Nilsen and Campbell, 1993; Van Velsor, Taylor and Leslie, 1992). The one aspect of strategy effectiveness is talented personnel as being equal, a more talented team will outperform a less talented team. Talented Ford personnel are to be identified by good selection methods, and recruited by good leadership. Next, is the motivated personnel, Ford staff who are willing to perform to the limits of their ability as the team will outperform a demoralized team. The level of motivation in a team or organization is directly related to the performance of management (Harter et al., 2002). Furthermore, the effective strategy for outperforming the competition that depends on systematic research and deep knowledge of industry trends and will allow Ford??™s senior leadership to keep track of the talent level of the staff, the motivational level of the staff, the performance of the management group, and the effectiveness of the business strategy.

Discussion and explanation of appropriate evaluation methods
The need for human capital measurement,? case for evolving methods of valuing human resource needs upon identifying people management drivers and modeling the effect of varying them. The issue is to develop a framework within which reliable information can be collected and analyzed such as added value per employee, productivity and measures of employee behavior. Becker et al (2001) refer to the need to develop a ???high-performance perspective??™ in which HR and other executives view HR as a system embedded within the larger system of the firm??™s strategy implementation. High-performance work system is crucial part for Ford to apply as there links to selection and promotion to validate competency and develop strategies that provide timely and effective support for the skills demanded by Ford HR implementation, the measurements can be used to monitor progress in achieving strategic HR goals and evaluate effectiveness of HR practices as described below.

The human capital monitor
Mayo (2001) has developed the human capital monitor serves as weighted average assessment of capability, potential to grow, personal performance and alignment to the organization??™s values set in the context of the workforce environment. The absolute figure is not important. What does matter is that the process of measurement leads you to consider whether human capital is sufficient, increasing, or decreasing, and highlights issues to address. Mayo advises against using too many measures and instead to concentrate on a few organization-wide measures that are critical in creating shareholder value or achieving current and future organizational goals. Mayo (2001), believes that value added per person is a good measure of the effectiveness of human capital, especially for making inter firm comparisons. But he considers that the most critical indicator for the value of human capital is the level of expertise possessed by an organization.

The balanced scorecard
The balanced scorecard as originally developed by Kaplan and Norton (1996) is
Frequently used as the basis for measurement. Their aim was to counter the tendency
of companies to concentrate on short-term financial reporting. They take the view
that ???what you measure is what you get as the proponents emphasize that ???no single measure can provide clear performance target or focus attention on the critical areas of the business. Managers want balanced presentation of both financial and operational
measures??™, Kaplan and Norton emphasize that the balanced scorecard approach ???puts strategy and vision, not control at the centre, assumes that people will adopt whatever behaviors and take whatever actions are required to achieve goals as the measures on Balanced Scorecard should be used as the cornerstone of a management system that communicates strategy, aligns individuals and teams to the strategy, establishes long-term strategic targets, aligns initiatives, allocates resources and provides feedback and learning about the strategy.

For recommendations, it is imperative for Ian Vaughan and Ford Australia to do the following:
-? ? ? ? ? ? ? ? ? ? To have staff and manager brainstorming sessions with the team executives to identify areas where they could improve their service to customers. The key items detailed in these and subsequent training sessions that occurred during the intervention stage that will focus on job-role knowledge, customer relations and HR needs investigation
-? ? ? ? ? ? ? ? ? ? To ensure Ford??™s customer service quality interaction to be rated by Ford customers on such greeting of customer, eye contact, speed of service, degree of help offered, personal recognition of the customer and appreciation for the customer??™s business
-? ? ? ? ? ? ? ? ? ? To achieve in baseline data on the quality service as operationalized by dimensions gathered from customers immediately after the interaction
-? ? ? ? ? ? ? ? ? ? To complete in customer ratings and be aware of HR understanding and such points as related
-? ? ? ? ? ? ? ? ? ? To assure in training and development in order to achieve points mentioned in the main body as the training technique to be used in intervention may consists of structured training sessions in social skills relevant to the service encounter

The orientation toward human capital emphasizes the development of individual capabilities such as those related to self-awareness, self-regulation and self-motivation that serve as the foundation of intrapersonal competence (McCauley, 2000) upon underlying assumption that effective leadership occurs through the development of individual leaders that leadership is something that can be added to Ford Australia in order to improve social and operational effectiveness. HR development needs to evolve to level of contribution whereby it is considered an investment in the social capital of the organization, to complement its human and intellectual capital (Nahapiet and Ghoshal, 1998).

The conclusion can be implied within the HRD needs of Ford Australia, and be noted that the company have such acknowledged commitment to HR ways and processes linked through better management service through such Ford management HR policies and committing in significant resources to staff interpersonal skills, team skills and leadership development from within matters known for rigorous staff training and development at Ford. It is reasonable to suggest that the competitive edge in a service environment may be considerably enhanced by appropriate training and development activities. ? Training and development can be used to reinforce certain behaviors and attitudes which contribute to effective service while stressing the need for improvement in behaviors which do not facilitate the attainment of desired service quality goals. Such training and development interventions are posited on the assumption that employees have capacity for change, moderator on Ford staff??™s ability to adopt HR needs and certain change facilitation.? Ford may recognize balanced scorecard as mechanism for implementing HR needs, interpersonal skills strategy and measuring performance against Ford objectives and critical success factors to achieve the strategy as cascaded throughout the company to measure the operational activities at Ford. The HR measurement is concerned with the impact of people management practices on performance so that steps can be taken to do better. It is not just about measuring the efficiency of the HR department in terms of activity levels. It needs to be value-focused rather than activity-based. For example, it is not enough just to record the number of training days or the expenditure on training; it is necessary to assess the return on investment generated by that training.? Ford need to do better in stronger connections between production and application of knowledge, team development is prime content area to examine ways to improve strategy connections from ways to create better HR development links regarding their work teams into various HR areas and content.

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Counselling Skills

Title: Discuss the ways in which counselling differs from other ways of helping.

???Counselling is an activity freely entered into by the person seeking help, it offers the opportunity to identify things for the client themselves that are troubling or perplexing. It is clearly and explicitly contracted and the boundaries of the relationship identified. The activity itself is designed to help self-exploration and understanding. The process should help to identify thoughts, emotions and behaviours that, once assessed, may offer the client a greater sense of personal resources and self-determined change.??? (Russell, Dexter and Bond, 1992.)
Counselling is voluntary; otherwise the client ???may be exposed to the best efforts of expert counsellors for long periods of time, but what will happen will not be counselling.??? Other professions use counselling skills (nursing, social work) but are not counselling. Good helping skills facilitate relationships, but interactions with the Police, Social Services or nurses are often determined by circumstance, not choice. These professionals meet people in emotive situations and crises, and elicit information to provide a service. The professional has an outcome leading them to use counselling skills. Duration of a counselling relationship is more likely determined by the client, other professionals maintain involvement and support until they achieve their aims. A counsellor has no personal or business aim from the interaction.
BAC (1984) identified the aim of counselling as ???to give the ???client??™ an opportunity to explore, discover and clarify ways of living more satisfyingly and resourcefully.???
Aims advertised by counselling services include ???growth??™, ???self-actualisation??™ and ???potential??™ ??“ non-directional outcomes. Teaching and medicine use helping skills to maximise their ability to impart knowledge, but have set knowledge to impart over a set time ??“ they are delivered en-masse in a centralised fashion. Counselling is individually tailored; it is flexible and dynamic, changing to incorporate client experience. Time is centred solely on the client. Buber describes it as a situation whereby the ???other person is experienced without labels or conditions.???
Counselling enables the client to identify behaviour and emotions that are maladaptive or limiting; unlike medicine there is no formal diagnosis. The client receives a non-judgemental, safe place to express themselves without fear of reprisals. What troubles one person challenges and motivates another; counselling is open to all at any time. ???An approach to counselling that was, for example, purely scientific or purely religious in nature would soon be seen not to be counselling at all, in its denial of key areas of client and practitioner experience.??? Whilst support from religion is beneficial to many, particularly in times of distress, the support is not counselling. A service promoting one set of beliefs, is not client-led. It is unhelpful to suggest that a client??™s own lifestyle is ???wrong??™ because it doesn??™t follow, for example, a Christian code. Counsellors have no place imposing their beliefs or standards; counselling challenges the client to consider themselves and their alternatives, but does not guide them towards any particular answer ??“ the client is responsible for their own destiny and counselling aims to improve the client??™s coping skills, equipping them with the future confidence to make decisions and manage consequences.
Services in hospital settings are often called counselling, but are likely to be a condition of ???recovery??™ (not voluntary) and only accessible to those determined to be in a critical condition by another professional (i.e sectioned.)
Counselling has a strong code of ethics and boundaries. The counsellor will normally follow the ethical code of a professional body, e.g. the BACP Ethical Framework. Elsewhere, ???people using helping skills in other roles may be bound by ethical codes, but those will relate to the responsibilities of that role.??? (UK & Ireland Directory of Counselling and Psychotherapy.) Counselling services in other roles, like infertility regulated by the Human Infertility and Embryology Authority, have guidelines from their profession governing their conduct and qualifications. The guidelines from their profession potentially limit the service available, and whilst counselling skills are used, it cannot be counselling.
Counselling relies on confidentiality, and potential for ???safe??™ disclosure. Counselling is ???more disciplined and confidential than friendship??? (Feltham and Dryden 1993.) Counsellors tend to have no other role in the clients life, not friend, colleague or acquaintance. This enables honest dialogue without fear of losing another relationship, and ceases any blurred boundaries due to friendship circles and gossip. Other services can manage several roles, e.g. your neighbour being your child??™s teacher, or attending a leisure activity and meeting a nurse. Neither professional compromises their capacity to offer a service by knowing you from elsewhere, nor would you be likely to engage with them differently due to it. Counsellors maintain professional distance, and there is little reason for the client to know any personal details of the counsellor; the counsellor is unlikely to discuss personal experience as a tool for helping their client. Other services err towards advice and offer up personal experience, and experience of others to validate options and provide reassurance ??“ in a counselling relationship the options are presented equally, and the fear, anticipation and limitations of the individual determine the path taken.
Confidentiality is essential, and the client must feel happy making disclosures. Instances where confidentiality may be broken should be clear from the contracting stage of the relationship ??“ i.e. if the client was a risk to themselves or others, or if legally obliged to provide information to the Criminal Justice system. A client may leave the setting and discuss whatever they wish with whomever they like. A counsellor is unlikely to discuss any information outside the session, unless perhaps anonymously in supervision, which is again a confidential environment. Other services, such as Police and Social Services, usually gather information to be used elsewhere and confidentiality is not guaranteed. In hospital, a patient meets several nurses, and disclosure amongst professionals may be necessary to offer continuity of care. Counselling relationships differ in that the bond is built between the client and counsellor, not the ???service.??™
It is difficult to determine a set practice that will apply in every counselling situation ??“ not all clients require the same treatment, seek the same outcome, or have the same limitations. Other services, like the Police, have more clearly defined goals determining their intervention.
Services which limit participants, participation and have an underlying aim cannot offer a true counselling service. Counselling skills have meaningful applications in front-line professions and everyday life, helping to promote good relationships, resolve conflicts and improve understanding of ourselves and our interactions.

Words: 1056

Active listening, letting yourself be led by the client, and challenging someone whom you fear may not appreciate or accept it, I think, come with emotional maturity and practice. My social care role does not easily lend itself to some of the skills necessary to be a successful counsellor. Henry (1977) identifies ???the motive to care on its own is more likely to lead to a career in social work, whereas therapy requires a strong interest in making sense of the inner world of clients.??? I have the inner-reflection to acknowledge potential development, but sometimes lack the confidence and concentration to change.
I become attached to the people I work with, and would need to work towards the professional distance required in a therapeutic relationship.
I find it difficult to accept my fallibility. Whereas a counsellor is non-directional, I step in, take over, and attempt to resolve. As an employee, and mother, occasionally it is easier to take over, and sometimes necessary. In a counselling role, I would need to promote independence, not impose my standards, and value others??™ choices.
Negative capability, to me, is failure; the strive for perfection is motivating. I am ???open to inquiry;??™ keen to learn and apply new skills. I am aware that ???a narrow range of techniques might be more valuable that a more superficial capacity to use a wider range.??? (McLeod interprets Mahrer, 1987, 1989.) I will consider the benefits of developing one or two main areas.
In practice, I ???fire??™ questions at clients to elicit important information more quickly. In a therapeutic setting, I would need to allow the client to rationalise and verbalise in their own time, and reach their own conclusions. I use closed questions to determine issues, leaving more time for resolution; this would need addressing to develop client involvement. I am trying to change; open questions can be used quite naturally, and practice will make it subconscious.
Counsellors use active listening, paraphrasing and reflection to display empathy and evidence that they are alert and open to the client??™s needs and emotions. For me, reflection and paraphrasing feel unnatural, disrupting the conversational flow. My tendency to ???take over??™ can mean that I stop listening and start planning once I ascertain the problem ??“ a counsellor would not determine or resolve it. I find it challenging to let others take charge, especially if I feel they are making bad decisions. I think things through quickly and consider consequences, and do so on other people??™s behalf.
Shaw and Dobson identified ???clinical memory??? as a ???key cognitive competency??? of a counsellor. I am confident that I possess and practise this daily.
I feel confident challenging my own and other people??™s negative stereotypes. I am conscious that I can make assumptions based on appearance and social background ??“ a counsellor would need to offer UPR, to effectively practise active listening. I practice ???core conditions??™ of congruence, empathy and warmth, but success is the skilful delivery ensuring that the client experiences them; this can only be assessed by the client.
I like to put people at ease, reassure them. The therapeutic relationship is about challenging and developing the client towards positive change. It is unhelpful to simply make the client feel comfortable with their behaviour without seeking to identify emotional content.
Counsellors need resilience and strength; when maintaining boundaries, defying the urge to gossip, advise or judge. I think a counsellor needs self-confidence, life experience to enable genuine empathy and the ability to think quickly. Some skills I have, others come with maturity and the remainder I can consciously practise.

Words: 594


BAC (1984) ??“ taken from Introduction to counselling, McLeod, J., 3rd Ed McGraw-Hill / OU Press 2008, pg 14

Buber, M., – taken from Introduction to counselling, McLeod, J., 3rd Ed McGraw-Hill / OU Press 2008, pg 217

Feltham and Dryden (1993) – taken from Introduction to counselling, McLeod, J., 3rd Ed McGraw-Hill / OU Press 2008, pg 14

Henry (1977) – taken from Introduction to counselling, McLeod, J., 3rd Ed McGraw-Hill / OU Press 2008, pg 265

Mahrer (1987, 1989) ??“ interpretations by McLeod from Introduction to counselling, McLeod, J., 3rd Ed McGraw-Hill / OU Press 2008, pg 264

? McLeod from Introduction to counselling, McLeod, J., 3rd Ed McGraw-Hill / OU Press 2008, pg 23

? McLeod from Introduction to counselling, McLeod, J., 3rd Ed McGraw-Hill / OU Press 2008, pg 22

Russell, Dexter and Bond, 1992 ??“ Differentiation between Advice, Guidance, Befriending, Counselling Skills and Counselling taken from First Steps in Counselling, PCCS Books, 2002, Ross on Wye

Shaw and Dobson (1988) – taken from Introduction to counselling, McLeod, J., 3rd Ed McGraw-Hill / OU Press 2008, pg 260

UK & Ireland Directory of Counselling and Psychotherapy ??“ ???What to Expect??™ ??“, accessed 31/03/2009

Other documents accessed when researching:

BACP Ethical Framework

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Hr Theory-Johari Window

Understanding giving and receiving of information. Explanation of the Johari Window of Joseph Luft and Harry Ingham. (50)

What is the Johari Window Description


1. Arena. What is known by the person about him/herself and is also known by others. Examples:
your name, the color of your hair, the fact you own a dog. One can and should increase the size of this region by increasing Exposure and Feedback Solicitation. (Diagram 2)
2. Blind Spot. What is unknown by the person about him/herself but what others know.
Examples: your own manners, the feelings of other persons about you.
3. Facade. What the person knows about him/herself that others do not know. Such as: your
secrets, your hopes, desires, what you like and what you dislike.
4. The Unknown. What is unknown by the person about him/herself and is also unknown by
others. This information has an unknown potential to influence the rest of the JW.

In the beginning of a communication process, when you meet someone, the size of the Arena quadrant is not very large, since there has been little time and opportunity to exchange information. The general rule of thumb is that you should try to expand the Arena to become the dominant window, thus demonstrating transparency, openness and honesty in interactions (Diagram 2). Probably when you do this, the other party will also open himself up.

The writing about this topic often refers to the singular (“self”). But by changing the word “self” into “team”, the model also allows a team dynamic approach.

Origin of the Johari Window. History


Usage of the Johari Window. Applications

??? How individuals communicate with themselves and with others.
??? How individuals present themselves to themselves and to others.
??? How individuals perceive their place in the world.
With a little consideration Johari is also suitable for multiple usage:
??? Coaching to facilitate conversations around actions vs. perceived motivations.
??? As an Organizational Development tool to visualize the political and cultural issues that may be in or out of sync within a business.
??? As a management tool to demonstrate the dynamics in a team.
??? As a self-development tool that helps to consider ones own behavior vs. reaction.

Steps in the Johari Window. Process



??? The method catalyses open information sharing.
??? The method will create a shared reference point.

Limitations of the Johari Window. Disadvantages

problems or large-scale failures).
??? Some people may pass on the information they received further than you desire.
??? Some people may react negatively.
??? Using the JW is a useless exercise if it is not linked to activities that reinforce positive behavior, or
that correct negative behaviors.

Assumptions of the Johari Window. Conditions


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Counselling Skills Essay

Take two themes related to the use of Counselling skills and describe their importance in the counselling relationship with reference to relevant literature and your observations of interactions during role play.

???A counselling relationship occurs when a counsellor sees a client in a private and confidential setting to explore any distress that the client might be experiencing. The client has be a willing volunteer for such a situation to take place??™ (BACP definition of counselling ??“

According to Carl Rogers who was the founder of the Person centred therapeutic approach, if a counsellor adopts certain therapeutic conditions and creates a proper and safe climate, the process of ???therapeutic healing will inevitably occur within a client??™ ( – Introduction to Carl Rogers and Gloria??™s video).

Rogers also believed that the only human motive that exists within a being is ???a self actualising tendency??™. The term ???self actualisation??™ means striving to maximise one??™s potential.
(Class Handout 2010)

The obstacles that get in the way of self actualisation are the ???conditions of worth??™ that one places on one??™s self. These conditions of worth are created by society??™s expectations of individuals, which in turn undermines the positive self regard of an individual.

Rogers bases his theory largely on Maslow??™s ???Hierarchy of needs??™. Maslow??™s needs are based in the form of a pyramid, with the most basic needs at the bottom, security needs are second, the third need is the feeling of belonging, the fourth need is self esteem and the final need is of self actualisation. This highest need of maximising one??™s potential can only be obtained if the lower needs are first met. (Class handouts and

Rogers believed that if a counsellor participated in a ???spontaneous prizing??™ and if he or she fosters an attitude of ???non possessive love??™ and warmth towards the client, the latter is then enabled towards developing unconditional positive self regard and is thus able to come up with their own resolution of his or her problems.

Person centred therapy is based on three core conditions which are unconditional positive regard, or warmth, empathy and congruence. I shall discuss the themes of ???Unconditional regard??™ and ???Congruence??™ in more detail, with reference to my own personal observations of interactions during role plays. In most of our role plays we were divided into groups of three individuals. Each of us took turns in playing the counsellor, client and observer whose main role was to give feedback after the session came to an end.

I shall discuss each of the themes under two separate headings.

Before starting a counselling session a few ethical guidelines need to be maintained. It is advisable that the counsellor goes over a ???contract??™ with a client. This establishes the professional relationship and should cover basics like time boundaries as well. At the start of the session the counsellor should inform the client about the session being completely private and confidential as long as his or her health or a third party??™s health is at risk. In which case then the counsellor would have to report the client to the appropriate authorities. These rules can be customised to accommodate a counsellor??™s unique values and the rules play an important part in setting the all important atmosphere of trust with the client. If the client is able to perceive and appreciate the counsellor??™s qualities, then he or she will feel safe enough to explore hidden dimensions of their selves.

Unconditional Positive Regard

In order for a counselling relationship to be successful, Rogers believed that the counsellor should make the client feel accepted without any conditions. This form of acceptance on the part of the counsellor fosters an environment of trust, thereby enabling the client to achieve self actualisation. This form of communication also creates a feeling of genuine caring towards the client and is unhindered by obstacles of either stereotyping or being judgemental of the client??™s behaviour, feelings and thought processes. By exhibiting a quality of ???non possessive love??™ and warmth towards the client, the counsellor is allowing the client to increase his or her self worth and is decreasing the ???conditions of worth??™ that is imposed by society.

A person who is used to constant criticism from others might find it difficult to trust the counsellor at first, but if the latter perseveres and the core conditions are administered constantly, then emotional barriers might cease to be an obstacle.

For example, in role play 1, I played the role of a client and D played the role of the counsellor. I told D that I felt like I was losing my identity after being married and that I missed being the dynamic personality that I once was. I felt like D created a safe place for me and had a very non threatening manner which put me completely at ease. The environment felt warm and caring and I felt valued and accepted for being myself. It felt like she genuinely was interested in what I had to say, no matter how trivial it may have seemed. There were no interruptions and I felt like she understood what I was saying and communicating, both consciously and unconsciously. Her demeanour throughout was positive and I felt no pressure to reveal any more than I wanted to.

During role play 2, I played the role of a counsellor to C. At first, C came across as being very defensive. His body language seemed to convey that he was very uncomfortable. His arms were held tightly over his chest and he told me that he was embarrassed about opening up to me because I was a stranger and that he wasn??™t comfortable discussing his personal problems with me. I then conveyed back to him that it was not uncommon to feel uncomfortable talking to an outsider about personal information. I also reassured him that many people, who are wary at first, actually start to feel quite relieved once they unburden themselves. I kept a soft tone of voice throughout the session and continued to show warmth towards him.
He gradually let his defences down and told me that he was having marital problems at home and was unhappy with the relationship with his wife and that he was having an affair with a colleague at work. Even though I may have not approved of what he was doing, I did not impose my views on him nor did I allow his behaviour to influence me against him. I gave him my attention and focus and showed him respect and acceptance throughout by positive focus and attention, good eye contact and appropriate summarizing, paraphrasing and other cues ( Greenspoon Techniques).


???When a therapist is completely genuine and congruent, he or she ??¦is freely and deeply himself in the relationship. He is open to experiences and feelings of all types – both pleasant and hurtful – without traces of defensiveness or retreating into professionalism. Although there may be contradictory feelings, these are accepted and recognised. The therapist is clearly being himself in all of his responses, whether they are personally meaningful or trite??™. (Traux & Carkhuff, 1967)

According to Carl Rogers, Congruence can also be termed as Genuineness. This, according to Rogers is one of the key core conditions.

In order to establish a counselling relationship that is based on trust, it is of prime importance that the counsellor is completely open and honest from the start of the therapeutic relationship. The counsellor should exhibit a ???transparency??™ which will enable the client to ???see all the way through ???the therapist, where there is nothing hidden??™ ( – Introduction to Carl Rogers and Gloria??™s video).
On no account should the therapist display any form of ???cognitive dissonance??™. i.e. there should not be any discrepancy between what the therapist is actually thinking as opposed to what he or she is saying.

According to Rogers, sometimes the therapist??™s own thoughts ???bubble up into awareness??™. The therapist should express the way he or she feels, freely and without imposing their views on the client. The more congruent a therapist is, the greater the chance of constructive growth within the client. In fact, Rogers also suggests that a therapist should ???not pretend a caring that he or she doesn??™t feel and if the therapist finds that he or she persistently dislikes a client, it would be better to express it??™

During one of the role plays, E was in the role of the client and I was the counsellor. E told me of how frustrated and angry she feels at having no say in the bringing up of her children. She feels like all her efforts are constantly undermined by her mother in law??™s interference. There appeared to be many emotions that were bubbling up within the surface. She felt undervalued as a mother and wife and I was open and honest enough to make known to her that as she was telling me her problems and the way she was being treated, I found myself feeling angry too. She felt confident and comfortable enough to confide in me and I felt that I was being genuine and I did not have to make a conscious effort to be caring and positive. It just seemed to come naturally. I maintained good eye contact throughout and did not rush to fill in the gaps and silences. I allowed her to continue to express her feelings and ease. I could see beneath the surface, her pain, her anger and her having to grapple with depression that stemmed due to painful situations from her past. I felt that I demonstrated genuineness throughout. I did not have to feign any shallow responses towards her. I felt that she could trust me even more as the feeling of sincerity from me was prominent.

I played the observer in role play 3. This time C was the client and E was the counsellor. C played the part of a client who seemed very frustrated with her life experiences. She seemed angry and she conveyed it effectively through her body language. She was insistent that the therapist help her and give her solutions to her problems and was adamant that E gave her a straightforward answer. C seemed fed up because she said that she had seen many counsellors previously and none of them seemed to help her. She conveyed the emotion of feeling bitter and let down. I thought E handled the situation exceedingly well. E remained calm and showed congruence throughout. She was open and honest with C and said that while she couldn??™t provide direct solutions to C??™s problems, she was willing to help C discover the answers and solutions within her self.


I feel richer for the all the experiences that the course offered me. The role plays offered me an avenue to help express myself without any inhibitions or any feeling of judgement. I also feel that the interactions during our role plays, fostered a sense of trust, warmth and camaraderie, and it is such an immense joy to have formed significant bonds with my other fellow students in such a short period of time.

I feel that the success of a counselling relationship depends upon how well a therapist or counsellor integrates and imbibes all the qualities of the core conditions.

This course has been a start to my intense introspection and I feel like I have gained useful skills that will help towards my personal development and I am pleased that
this course is a stepping stone to my journey towards further learning in both a professional and personal capacity.

References website accessed on 7/7/2010

Class Handouts 2010 website accessed on 7/7/2010

List of Books that I have read during this course

De Board , R (2005) Counselling for Toads. Hove, Sussex, Routledge

Jacobs, M. (2000) Swift to Hear. London SPCK

McLeod, J (2007) Counselling Skill. Maidenhead. Open University Press

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Hr Strategy

How are workforce plans related to business and HR strategies

Workforce planning and human resource strategies are reliant upon each other in some aspects of the firm??™s business strategy. An organization??™s human resource strategy corresponds with the strategies of the organization??™s business plan and it also makes the plan a reality in developing a workforce plan ensuring that the workplace plan is applicable to the business plan. The strategies of human resources is to assist a company with the alignment of resources, policies, and programs so that they coincide with the business plan with consideration to possible outside limitations and requirements, short term preparation for long term needs, management procedures, and development.

For example, my organization decided that it wanted to offer our phone service to our existing commercial customers after the launch to residential subscribers. Our human resource department was responsible for the workforce planning. In doing so human resources worked along with management from our phone and high speed internet department to develop positions that would assist the company in meeting the following objectives:
* Sales
* Installation
* Service and repair
* Customer service

The business strategy was to sell to existing commercial customers that subscriber to business class internet through packaging offers; this in turn would grow our phone product by approximately 20% over 3 years.

Discuss the similarities and differences between job analysis and competency

According to Cascio (2006), ???competency models are a form of job analysis that focuses on broader characteristics of individuals and on using these characteristics to inform HR practices???. Competency models are used to recognize variables connected to organizational fit in general and to seek out personality characteristics that is in line with the company??™s plan. A competency focuses on a broader view of individual characteristics for example a characteristic for a sales representative is the ability to recognize opportunity. A job analysis is geared more towards the requirements needed in effort to be successful in completing the tasks of the job. It does not make a connection in terms of the broad purpose of the organization. Both the job analysis and the competency model have the same goal and that is to recognize the skills that an individual will need to perform the job.

Cascio, W. (2006). Managing human resources: Productivity quality of work life profits (7th ed.). New York, NY: McGraw Hill.

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Hr Responsibility

What does the Nurse contribute to the play, in your view

In ???Romeo and Juliet??™, the Nurse plays a vital role where she works as a servant to Juliet in the Capulet family for years. She is a trusted character who loves and understands Juliet very well. They have good mother and daughter like relationship. In this play, the Nurse also brings tragedy and immense tension when she betrays Juliet. After all, Juliet trusted the Nurse completely. However, the Nurse is an immense character that shows rudeness and obscenity humor, which entertains the audience.

(Act 1 Scene 3 line 21-22)

???Well, Susan is with God, she was too good for me???

(Act 1 Scene 3 line 63-64)

???Thou wast the prettiest babe that ever I nursed???

The above lines shows that the Nurse reflects past memories of her daughter, Susan. Susan who was born at the same time as Juliet had died . Hence, the Nurse thinks of Juliet as her own daughter and tries to fulfill her every wish.

(Act 1 Scene 3 line 53)

???Enough of this; I pray thee, hold thy peace.???

While talking about Juliet??™s age, the Nurse speaks about her daughter Susan and how she became a wet-nurse and breast feeded Juliet. At that time, rich women like Lady Capulet did not like to feed their children. She even spoke about her husband who had died ???thou wilt fall backward when thou comest to age??™. Thus, Lady Capulet tells the Nurse to keep silent. This shows that the Nurse is tiresomely talkative and vulgar.

(Act 1 Scene 3 line 97)

??? No less Nay, bigger. Women grow by men.???

These remarks have been made by the Nurse because of what Lady Capulet said. Lady Capulet suggests Juliet to marry Paris but the Nurse states that when Juliet will have her baby, she will also have a wet-nurse like her to feed them. This reflected the Nurse??™s character to be arrogant.

The Nurse acts as a negotiator between Romeo and Juliet when they meet for the first time during ???masked ball???. Romeo and Juliet wanted to know more about eachother.

(Act 1 Scene 5 line 23-24)

???I tell you he that can lay hold of her, shall have the chinks???.

When the Nurse finds out that Romeo was from the Montague family, she refused Juliet to talk to him. But the Nurse warns Romeo about the consequences if he leads Juliet astray. She let them meet without anyone knowing.This showed that the Nurse wanted Juliet??™s happiness. This was how Romeo and Juliet had a close romantic interaction.

(Act 2 Scene 4 line 98-99)

???Good Peter, to hide her face;for her fans the fairer of the two???

This refers to the sexual teasing by Romeo??™s friend, Merquito indicating the Nurse.The Nurse goes to the town square to meet Romeo requesting a marriage proposal from Juliet. Merquito and Benvolio insults the Nurse by telling her that she is too ugly and big. They showed rude manner by telling her that she is a prostitute and a brothel which really tempered the Nurse. ? ? ? ? ? ? ? ? ? 

(Act 2 Scene 4 line 152-153)

???if ye should lead her into a fools paradise, as they say, it were a very gross kind of behaviour???

This indicates that the Nurse cares for Juliet very much and she wouldn??™t bear if Juliet??™s feelings got hurt. She even warns Romeo that if he trifles with Juliet then he would be punished. This shows that the Nurse has a great bonding with Juliet.

(Act 2 Scene 5 line)

???But old folks ??“ many feign as they were dead; unwieldy, slow, heavy and pale as lead.???

After the meeting with Romeo, the Nurse sees that Juliet is waiting for her return. She is desperate for the news of Romeo. So Juliet tells her that she is old and slow. The

Nurse teases Juliet by not talking about Romeo and tells her that she is out of breath and ill of health. And she finally spits out the news to Juliet that Romeo had accepted the marriage proposal. Therefore, the Nurse is shown as a comedy maker and she enjoys teasing Juliet.

In Act 3 Scene 2,just shortly after Romeo married Juliet, the Nurse tells Juliet that Tybalt, Juliet??™s cousin is dead. She later on even tells Juliet that? Romeo killed Tybalt and he is banished. Juliet becomes angry with the Nurse because the Nurse seemed to be blaming Romeo.

(Act 3 Scene 3 line 143)

???Hie to your chamber, I??™ll find Romeo to comfort you???.? 

The Nurse tries to comfort Juliet because of banishment of Romeo. Juliet feels very emotional due to this situation and the Nurse even goes to meet Romeo. She tells Romeo that Juliet remembers him a lot and weeps for him.The Nurse is a character who plays as a communicator between Romeo and Juliet.

In Act 3 Scene 5, the Nurse brings Romeo to meet Juliet in her chamber for one night only. Later, the Nurse warns Juliet that her mother, Lady Capulet is coming to see Juliet. Romeo takes off and bids farewell promising Juliet to meet again.

(Act 3 Scene 5 line 27-28)

???I think it best you married with the County. O, he??™s a lovely gentleman???.

The Nurse tells Juliet that Romeo is dead and she should marry with County Paris. The Nurse betrays Juliet by telling Lady Capulet to marry her off with the County Paris. The Nurse thinks that Romeo is nothing compared to Paris. That??™s when she realized she was taking advantage of her employers, the Capulets. This showed that she changes her mind and allegiance.

The Nurse was the only support that Juliet had that brought Romeo and her together. But since the Nurse betrayed Juliet, she had no one to share her sorrow with which led her to depression.

(Act 4 Scene 5 line 15,19,53,54)

???Alas, alas! Help! My lady??™s dead!…Most lamentable day! Most woeful day??¦Ever did I yet behold???.

When Juliet takes the poison and pretends to be dead, the Nurse seems to be really upset and acts in a hysterical way. The Nurse shows her grief of her daughter??™s death with great sorrow stating this day is the worst day she has ever had in her life. The Nurse is really terrified by Juliet??™s death.

The character of the Nurse is comedic and of great relief. She has used sexual implications and humor that entertain the audience. In addition to that, she has created quite a tension and tragedy to the drama. She is very kind and loving but everything changes after she betrays Juliet. This story has been depicted as in love, hatred and

betrayal. However, the romance between Romeo and Juliet had been possible only because of the Nurse. She was the only one who could bring them together. The play would not have ended this way if her character was absent. Therefore, she is partly responsible for Romeo and Juliet??™s death as she started the chaos. Overall, the play would not have worked without her.

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Counselling Issues

Global AIDS Program Technical Strategy: Palliative Care

May 16, 2004

Palliative Care
Background The philosophy and models of palliative care that center on improving the quality of life for patients and their families grew out of approaches aimed at offering pain relief and comfort measures for adult and children cancer patients. Palliative care for HIV/AIDS includes interventions that respond to the physical, emotional, psychosocial, spiritual, and bereavement needs of adults and children with HIV/AIDS and their families; from the time of diagnosis, through final stages of disease and death. Although AIDS is an ultimately fatal disease, advances in care and treatment over the past two decades have extended life expectancy and improved quality of life for persons living with HIV disease such that earlier manifestations of the disease are now preventable or curable. The distinction between active, curative treatment and palliation is blurred. Current definitions of palliative care reflect a holistic approach that begins with the onset of disease and continues throughout the course of this chronic condition. Palliative Care Definitions In the year 2000, the World Health Organization (WHO) defined??¦palliative care as an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. It goes on to include earlier language from the 1987 definition. . . Palliative care affirms life and regards dying as a normal process??¦ neither hastens nor postpones death??¦ provides relief from pain and other distressing symptoms??¦ integrates the psychological and spiritual aspects of patient care??¦ offers a support system to help patients live as actively as possible until death and to help the family cope during the patients illness and in their own bereavement??¦ uses a team approach to address the needs of patients and their families, including bereavement counseling, if indicated??¦will enhance quality of life, and may also positively influence the course of illness??¦is applicable early in the course of illness, in conjunction with other therapies. The Health Resources and Services Administration (HRSA) has set forth the following working definition??¦Palliative care is patient- and family-centered care. It optimizes quality of life by active anticipation, prevention, and treatment of suffering. It emphasizes use of an interdisciplinary team approach throughout the continuum of illness, placing critical importance on the building of respectful and trusting relationships. Palliative care addresses physical, intellectual, emotional, social, and spiritual needs. It facilitates patient autonomy, access to information, and choice. Building upon definitions of palliative care developed by HRSA and WHO; the President??™s Emergency Plan for AIDS Relief (the Emergency Plan) envisions expansion of an interdisciplinary approach to palliative care and support making use of interventions to relieve physical, emotional, and spiritual suffering. Palliative care that includes basic health care and support, symptom management, and end-of-life care will involve the following elements: Routine clinical monitoring and management of HIV/AIDS


Global AIDS Program Technical Strategy: Palliative Care

May 16, 2004

complications??¦opportunistic infection prophylaxis and treatment??¦management of opportunistic cancers??¦ management of neurological and other diseases associated with HIV/AIDS??¦Symptom diagnosis and relief??¦social support, including organization of basic necessities such as nutrition, financial assistance, legal aid, housing and permanency planning. End of life care that includes mental health care and support??¦social support ??¦support for care givers, and bereavement support for family members. Palliative care, including end-of-life care, is an essential component of a comprehensive package of care for adults and children living with HIV/AIDS and their families. However, the range of services provided and the availability of caregivers varies by country and region. All definitions stress the fact that palliative care emphasizes the need for a team approach that will provide services all through the course of the disease and in various settings, e.g., in health care facilities, in the community, and in the home. In order to provide the broad range of palliative care services included in the most current definitions, effective linkages between health facility and community-based programs need to be established. This will contribute to establishing a continuum of care that capitalizes on the relative strengths and opportunities that each setting and personnel can offer. As mentioned above, palliative care services may be provided in health facilities (e.g., central medical centers, district hospitals, public/private health centers, etc), or in the community. In the community, home-based care programs have been the typical venue through which palliative care services, including end-of-life care, reach the individual and the family. Although palliative care and home-based care sometimes have been used as synonyms, there are important differences to note. Palliative care is one of the services that a home-based care program can deliver. In the context of HIV/AIDS, home-based care programs may also serve to provide educational services, nutritional support and counseling, enhance follow-up and referrals, and more recently be used as a means to provide adherence support and to provide secondary prevention counseling. Health systems in many African countries, Asia, and India are barely coping with the burden of acute diseases such as malaria, bacterial pneumonia, TB, and diarrheal diseases. Because of HIV infection itself, medical and nursing personnel are inadequate while medications and supplies may be in short supply. Shortages of medical personnel can be expected to worsen. Over 50 percent of beds on medical wards are occupied by HIV-infected patients in some countries where the Global AIDS Program (GAP) is providing assistance. Existing health infrastructures are inadequate to provide in-hospital care for AIDS patients resulting in pressure on hospital personnel to discharge patients quickly, often without treatment. To cope with this crisis, many nations have encouraged ???home-based care??? (HBC) for persons with an HIV or AIDS diagnosis. Many programs have been developed, and some provide good models that ease suffering and improve quality of life. For example, the Chikankata Hospital program in Zambia provides both hospital care and an intensive program of follow-up in the community. The AIDS Support Organization (TASO) in Uganda has established eight day care centers that provide medical treatment, counseling, and food supplements for AIDS patients, plus a limited program of home care, and they have partnered with Hospice Africa.


Global AIDS Program Technical Strategy: Palliative Care

May 16, 2004

Introduction of highly active antiretroviral therapy (HAART) has created new options for those infected with HIV. People receiving drug therapy will be coping with a chronic disease rather than a terminal disease. Palliative care in concert with curative therapies should be a goal for the standard of care for all HIV-infected persons. Palliative Care Models There are several programs providing palliative services that serve as models for providing palliative care. For example, Hospice Africa Uganda (HAU) has been described as a public health success. The government supports the organization and its program as a resource and training center for community and home-based care. HAU has successfully introduced oral morphine into the majority of government health units and trained clinicians on its use. Uganda is one of the few countries that includes palliative care as an integral part of the country??™s health plan. Various NGOs, including the AIDS Support Organization (TASO), provide counseling, care and support services, further increasing the reach of palliative care in underserved areas. Uganda??™s Partnership for Home-Based Care in Rural Areas, and the Mildmay Center for Palliative HIV/AIDS Care in Kampala have been cited in UNAIDS??™ Best Practice Collection. The WHO Africa project on palliative care ???A Community Health Approach to Palliative Care for HIV and Cancer Patients in Africa??? is being developed in five of the countries in which the Global AIDS Program has programs. Each participating country–Botswana, Ethiopia, Tanzania, Uganda, and Zimbabwe–asked to develop and integrate palliative care initiatives into their national health care policies. In the United States, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, of the Health Resources and Services Administration??™s HIV/AIDS Bureau (HRSA/HAB), is a national program of the US Government which supports medical care and supportive services for underserved and resource-poor populations affected by HIV/AIDS. Several HRSA-funded programs are operating palliative care programs in the United States and its territories. Examples are the AIDS Services Center, an integrated care program providing patient centered care to disenfranchised patients suffering from HIV/AIDS in rural Alabama. The community-based hospice/palliative care center provides home and clinical-based hospice palliative care to HIV/AIDS patients, and maintains residence for a limited number of homeless clients. Estancia Corazon, Inc., a non-profit community-based organization located in Mayaguez, Puerto Rico provides care for medically indigent persons in the final stages of AIDS. These organizations operate in resource-poor areas similar to sites in Africa and Asia. Years of experience garnered through these programs can be useful lessons learned for developing countries. There are also Palliative Care Programs at the University of Maryland??™s Institute of Human Virology in Baltimore, the Montefiore Program in New York, and with Volunteers of America in selected city jails. CDC Experiences and Capabilities In close partnership with HRSA, a Global AIDS Program (GAP) goal is to provide, strengthen, and expand care and treatment services to people suffering from HIV/AIDS and opportunistic infections, building on the strengths of communities to provide options ranging from home-based care to clinical care and social support. Some countries that GAP works with, such as Uganda, South Africa, Kenya, Malawi, and Thailand, have


Global AIDS Program Technical Strategy: Palliative Care

May 16, 2004

national AIDS plans that include protocols and support of palliative care and HHS/CDC (CDC) works closely with Ministries of Health to achieve host countries??™ goals. In other countries where there is no national palliative care policy, GAP works with partners, such as the US Agency for International Development (USAID), non-governmental organizations (NGOs), and community-based organizations (CBOs) to support areas in the continuum of care that includes palliative care, such as training lay health workers for home-based care and strengthening service coordination for persons living with AIDS. There are multiple faith-based clinics and home-based care providers throughout Africa providing in-home terminal care. In collaboration with the Mildmay Center for Palliative HIV/AIDS Care, GAP Uganda provides technical and financial assistance for strengthening the capacity of health care workers in HIV/AIDS palliative care management, as well as training in the prevention and treatment of opportunistic infections. GAP Uganda is also working with Makerere University Department of Pediatrics, Makerere University Medical School to develop clinical guidelines and training curricula for pediatric HIV/AIDS care. In the past, CDC worked with Save the Children Fund UK (SCF-UK) to produce a Pediatric HIV/AIDS Handbook for Community care for use by community workers on children and families affected or infected by HIV. In partnership with TASO, the plan is to provide home-based care for the terminally ill clients using community-based medical workers, care givers, and TASO staff in an integrated set up. GAP Thailand??™s palliative care focus is on improving the quality of life of children and families affected by HIV through strengthening the network of organizations that provide services by assessing and developing plans to strengthen current programs based on available data, and initiating death and dying counseling services in 3 provinces. This is a classic example of bereavement care being provided by hospice programs as an integral part of palliative care. GAP Malawi is working closely with a hospital-based pediatric palliative care program to strengthen their program by developing guidelines and curriculum for the hospital??™s pediatric department. GAP South Africa has provided technical assistance and support for the development of guidelines, training and training manuals for lay health workers to improve AIDS patient and family counseling, home-based care and coordination of community services for AIDS patients being discharged from hospital, which supports the MOH??™s ???Step Down??? hospital discharge program. GAP Kenya has partnered with USAID to support the continuum of care for people living with AIDS by assisting with home-based care (through training) where needed to support other CDC activities. Illustrative Activities Local expertise, planning, participation, and guidance are central features of successful care and treatment infrastructures, including palliative care. The first step for instituting interventions for palliative care, including end-of-life care should be to recruit local experts to ensure their participation in all steps of the process. Following the buy-in of local participants, assessing current practices, resources, materials, and training opportunities


Global AIDS Program Technical Strategy: Palliative Care

May 16, 2004

can help identify gaps. This assessment then leads to planning and implementing palliative care services. Throughout this process, patients, providers, funding sources (government and NGO), family, and community resources must all be included. The following activities are recommended: Assess existing programs (governmental and non-governmental organizations) in the countries providing palliative care to AIDS patients to identify current practices, resources and training needs. Establish and enhance linkages between hospitals, health units, and programs that provide palliative and end-of-life care to AIDS patients. Assist with efforts to inform, educate, and mobilize the community to promote community understanding and secure support. In collaboration with the MOH, NGOs, and donors, provide training to health providers, community health workers, community volunteers, and family members. Build capacity for long-term sustainability of palliative and end-of-life care. Using the WHO essential drug list in cooperation with the Hospice Palliative Care Association of South Africa, Hospice Africa in Uganda, and Mildmay Hospital, review and confirm the medications and supplies (analgesics, adjuvant drugs for analgesia and symptom control, antibiotics, antiretroviral drugs for prophylaxis, bandages, soap, alcohol, etc.) needed for optimum palliative care delivery. This may require providing infrastructure support such as storage facilities and technical assistance to procure, distribute, and maintain a steady supply of drugs and supplies. This might also include a ???minimum care package??? to be used by family members and community workers. In collaboration with WHO, UNAIDS and other collaborators, identify donors to procure the drugs and supplies needed for palliative care. Assess various models for providing palliative care, including end-of-life care to AIDS patients in developing countries to identify best practices criteria and develop guidelines. Operational and Technical Considerations According to the HRSA publication, A Clinical Guide to Supportive & Palliative Care for HIV/AIDS, 2003 edition, a national public health approach to palliative care is a first step for ensuring success. WHO endorses a national program strategy that requires an initial three-part process for improving palliative care. The foundation measures for this public health approach are: Governmental policy: adoption of a national palliative care policy??¦ Education: training of health care professional and the public??¦Drug availability: assuring availability of drugs for pain control, symptom management, and for prevention and treatment of OIs. The President??™s Emergency Plan for AIDS Relief will work with local regulatory authorities to remove barriers to opioids and other analgesics to treat pain and mitigate other symptoms. Specific activities may include: implementation of policies to expand the use of oral opioids??¦liberalization of laws restricting medicinal use of opioids??¦expanding the ability of nurses to dispense pain medication, including opioids, and especially in the home setting??¦strengthening of laws to prevent diversion of opioids for illicit purposes. Operational and technical strategies for building long-term sustainability for palliative care, including end-of-life care involve the following elements:


Global AIDS Program Technical Strategy: Palliative Care

May 16, 2004

Provide technical assistance for development of appropriate supportive care protocols throughout the trajectory of illness including the end of life; Support and strengthen home-based care; Change curricula in health professional schools to reflect need for relief of suffering and necessity of an interdisciplinary team for care delivery; Increase links between HIV prevention and care programs near the end of life; Expand and integrate hospice services; Promote consideration and offering of pain control; nutritional support; prevention/treatment of OIs; and medical treatment for symptom management; Promote alternative and traditional health approaches where appropriate; Provide psychosocial and spiritual counseling support; Reduce stigma and discrimination of PLWA; Strengthen the ability of families and communities to care for vulnerable children, including orphans, in recognition of the major impact on this group by grief and bereavement; Expand voluntary HIV counseling and testing first in areas where antiretroviral therapy is being introduced; Identify new public-private partnership opportunities; Provide essential supplies including medications, nutrition, and physical aides needed for providing comfort; and Respect and honor local culture and spirituality. Resources Palliative care financial and human resources should be allocated within national AIDS programs as part of the continuum of care. It is important to stress that these programs should avoid viewing palliative care and disease-specific therapies as competing program areas. The more modern and ethically appropriate approach is to view active diseasespecific therapies and palliative care as a part of a continuum in which patient needs and available resources determine the prioritization and balanced use of care strategies. Attention should be given to how the available resources can be fairly distributed to the largest population in a cost-effective and efficient system of healthcare delivery. Necessary resources should cut across the spectrum ??“ human resources, (including training), financial resources, and material resources, e.g., medications, supplies, and nutrition. Donor resources should support national efforts whenever possible. The Department of Health and Human Services??™ Health Resources and Services Administration (HRSA), the Centers for Disease Control and Prevention (CDC) and their academically-based partners provide expertise for training and other cross-cutting activities that strengthen existing infrastructure for the delivery of palliative care. It is anticipated that the President??™s Emergency Plan for AIDS Relief will provide resources to implement basic supplies and medication for palliative care to meet its goal of providing care for 10 million HIV-infected persons and orphans. Key Partners: Health Resources and Services Administration HIV/AIDS Bureau (HRSA/HAB) International Training and Education Center on HIV (I-TECH) University Technical Assistance Projects (UTAP) The US Agency for International Development (USAID) The Joint United Nations Program on HIV/AIDS (UNAIDS)


Global AIDS Program Technical Strategy: Palliative Care

May 16, 2004

The World Health Organization (WHO) Ministry of Health, non-governmental organizations, faith base organizations, persons living with HIV/AIDS, local experts and other community resources. Private industry (i.e. pharmaceutical companies??¦activities similar to the ones that provide drugs for HIV needs to be developed with pharmaceutical companies to make drugs available to patients for palliative care). Working Group Members Blanch Brown, HRSA,GAP,CDC; Emilia Rivadeneira, GAP, CDC; Diane Narkunas, GAP, CDC; Michael Johnson, GAP, CDC, (Trinidad); Raul Romaguera, DHAP, CDC; Alice Namale, GAP, CDC (Uganda); Joan Holloway, HRSA; Katherine Marconi, HRSA; Thurma Goldman, HRSA; and Carla Alexander, NHPCO. Suggested Readings “A Clinical Guide to Supportive and Palliative Care for HIV/AIDS,” offers authoritative guidelines and practical, experience-based advice. This guide urges clinicians to treat not just the symptoms of this terrible disease, but to provide care that meets the physical, emotional, and spiritual needs of the individual. The clinical guide is available at the Health Resources and Services Administrations HIV/AIDS Bureau Website: An African version is being written at this time and will be published later this year being developed by HRSA and NHPCO. U.S. Department of State (2004). ???Critical Interventions in the Focus Countries: Care???. Retrieved: March 25, 2004, ???Palliative Care for HIV/AIDS in Less Developed Countries,??? (1998). Unites States Agency for International Development (USAID) discussion paper provides a preliminary review of some of the current thinking and research on palliative care. This document is available at USAID; The Synergy Project Website: ???A Community Health Approach to Palliative Care for HIV and Cancer Patients in Africa??? is a World Health Organization (WHO) project in five countries ??“ Botswana, Ethiopia, Tanzania, Uganda, and Zimbabwe to improve the quality of life for HIV/AIDS and cancer patients. A description of the project is available at the following Website:


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