Sesson Six - Holistic Health Counseling (Biopsychosocial Model)

You may want to print this session Holistic Health Counseling / Inventory(Biopsychosocial Model) for easier reading and refer to the Theory behind Holistic Health Counseling.

Near the Start of the Session...

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Mary: “Well Dr. Joan, I’m here for my wellness check in. No touchy, right?!”

Joan: “No touchy! I promise! I explained to you the last time that I like to do holistic health counseling or a biopsychosocial inventory – 'though normally I do this earlier in the sessions.”

Mary: “But I canceled.”

Joan: (Grins) “Actually, you “no-showed” first and then canceled. But that was ‘in the past.’(Another grin.)

For personal well being – the biopsycho part – there are six components – physical, social, emotional, spiritual, vocational and intellectual health. We’ll start with that. Ready!?”

Mary: “Ready.”


Physical Health

Joan: “Physical health is comprised of i) nutrition, ii) ‘anti-nutrition’, iii) sleep, iv) exercise, and v) a medical check up.

So, nutrition. If the National Food Guide recommendations are a ‘ten out of ten’ – where do you rate?”

Mary: “Probably about a ‘seven.’ I eat well enough, but sometimes I skip meals and I like my junk food.”

Joan: “Describe what you ate yesterday.”

Mary: “Hmm. Well I slept in and missed breakfast…”

Joan: “Not good to miss breakfast. Eating breakfast stimulates your metabolism.”

Mary: “So I ate lunch at 11 am – veggie pizza and coke and two cookies.”

Joan: “Glad about the pizza for the calcium and grain group – but it doesn’t count on the veggie group. By the way, cola has 12 teaspoons of sugar and cookies have no nutritional value at all.”

Mary: “You must be fun at a party. I had a banana in the afternoon and a carton of milk. And Andy made an amazing supper – veggie stir fry with lean chicken and whole grain rice.”

Joan: “Awesome – veggies and fruits are the most important part of our diet – followed by whole grains – followed by protein foods including calcium sources.”

Mary: “And then I ate a bag of chips with another coke in the evening.”

Joan: “You know, it wouldn’t be hard at all for you to have scored a perfect ten yesterday. For example:

Breakfast – milk, banana, whole wheat toast, and peanut butter

Lunch – veggie pizza, salad, apple and a diet coke

Supper – double servicing of stir fried veggies, whole grain rice, chicken,

Snack – trail mix or popcorn and a soda water– but make sure to brush your teeth! Oh yeah, and a good multivitamin wouldn’t hurt either.”

Mary – “Next!”

Joan: “Anti-nutrition. That’s alcohol, junk food, caffeine, illegal drugs, and nicotine consumption.”

Mary: “I only drink on weekends and not much because I fall asleep. I love my chips – have some almost every day – very hard for me to stop even though I need to – have way too much caffeine – two cokes and two coffees a day minimum – don’t do drugs and I don’t smoke.”

Joan: “Good about the alcohol. The chips – you could substitute dry popcorn for with some seasoned salt - if you want to stop. The caffeine is a no brainer – have one of those pops as caffeine free and sugar free – the same with one of those coffees.”

Mary: “Next. By the way - this is boring.”

Joan: “By the way – people who do this feel so much better and you wanted to do this.”

Mary: “True enough.”

Joan: “I forgot about the water – one to two litres a day.”

Mary: “I’ll never get out of the bathroom!”

Joan: “This from the girl who drinks two cokes and two large coffees a day! Sleep – any trouble there?”

Mary: “Not really. I have a hard time making myself go to bed and then it’s hard to get up in the morning…”

Joan: “Best to stay as close to the rhythm of the sun as possible. Folks who work nights have a higher than average suicide rate.” Mary: “You really are a bundle of joy aren’t you. Now you are going to ask me about exercise and I’m going to tell you I don’t have time to go to the gym.”

Joan: “Actually, I’m only looking for ½ hour of fast walking every day – preferably an hour. How far to walk from your apartment to the downtown bus station – instead of catching the bus?”

Mary: “Twenty minutes.”

Joan: “So you do that there and back and add a twenty minute walk with your sweetheart right after supper – and you’ve got your hour.”

Mary: “I’ve been to see the nurse practitioner for a medical check-up.”

Joan: “And…”

Mary: “You’re going to love this. She said I have higher than average blood pressure and cholesterol, and lower than average hemoglobin. And I’m 20 pounds overweight. She said I could fix this by eating more veggies and fruits, whole grains and lean meat and low-fat dairy; that I should cut back on the coffee and coke and drink more water; get more exercise; and take a vitamin with extra iron.”

Joan: “I’m not sayin’ a thing! We’ve covered physical health – let’s look at social health.”

Holistic health counseling (biopsychosocial model) is time consuming but well worth it. You pick up things you might otherwise have missed. For example, poor emotional health can show up in physical health, and so on.



Social Health

Joan: “ Social health is that component that looks at relationships with i) partner, ii) friends, iii) parents or guardians, and iv) children or dependents. Do you have any friends?”

Mary: “That’s pretty harsh.”

Joan: “I mean, do you have folks you can call – other than your partner – to go for a decaf sugar-free coffee with? Who you can call and just blather to when you need to – and they, you?”

Mary: “Sarah, just Sarah.”

Joan: “One good friend – in addition to your partner – is all you need. It’s just that it is too hard on partners to have to be everything.”

Mary: “Yeah, I found that out, didn’t I!?”

Joan: “We’ve talked about your relationship with your partner Andy and that is going better now that you’re not leaning as heavily on him and you’re going to bed at the same time, so you see more of him. How about your parents?”

Mary: “Things have always been OK with Dad pretty much because he’s not in my face. And mom, I actually got up the courage to tell her that – since I’m so stressed with essays – would it be OK with her if I she only called once a week. Sunday evenings were good.”

Joan: “And???”

Mary: “She wasn’t very happy and continued to call. But we have ‘ident-i-cal’ so now I’m trying to only answer on Sunday evening. If she ever says anything, I’ll tell her I was at the library.”

Joan: “No kids or siblings.”

Mary: “Those are relationships I don’t have to worry about. At least not yet.”

Joan: “On to emotional health.”



Emotional

Joan: “Emotional health includes i) being nice to yourself, ii) hobbies, and iii) a good sense of humor. Do you do nice things for yourself?”

Mary: “Like I can afford to!”

Joan: “It doesn’t have to be expensive. It can be a bubble bath with a good book, an old movie, a really good cup of coffee (oops!), or going for a long walk.”

Mary: “What’s this got to do with anything?”

Joan: “Doing something nice for yourself is your way of saying ‘I’m OK! I matter! I count for something! I’m worth it!’ You and me – we cannot depend on others to make us happy. We have to do this for ourselves.”

Mary: “Funny you should mention this. I buy plants on sale, I adopt plants. I plain love rehabilitating other people’s plants. If there is such thing as a plant-a-holic, I am one!”

Joan: “Good! I think… It makes you happy and you aren’t doing it for anyone but yourself (and it doesn’t hurt anybody)?”

Mary: “Yep!”

Joan: “Fab! Do you have any hobbies?”

Mary: “Anything green. Seriously, I am a ‘guerilla gardener’. I grow stuff all winter when no one else can and in the spring – you cannot imagine what I grow on my balcony. Plus, I steal garden space in an abandoned warehouse lot and grow a vegetable garden.”

Joan: “Really! I can barely grow mould!”

Mary: “Actually, and this is really neat, I rescue perennials from abandoned gardens and decorate rooming houses.”

Joan: “You’re having me on!”

Mary: “It gets worse, or better, depending how you look at it. I’m part of a local chapter of Guerilla Gardeners. Our motto is ‘Let's fight the filth with forks and flowers.”

Joan: “Any problems with police?”

Mary: “Are you kidding? They love us. Make something lovable and guess what, the surroundings become more lovable.”

Joan: “I should know that, shouldn’t I?! How neat! And I need to get the contact info for other students. How about laughter? Do you ever have a good laugh? You know, watch a funny movie, get silly, that sort of thing?”

Mary: “Not enough. But I’ve discovered old movies. Ones like ‘Harvey’ and ‘Arsenic and Old Lace’. I can borrow them from the library for free. They are a scream. It’s my Saturday night special – if I can stay awake.”



Spiritual

Joan: “The next ‘block’ is Spiritual health. It’s a couple of things – i) having appreciation and gratitude that we are part of a larger whole, ii) knowing our purpose in life, iii) it can be religious practice, and iv) volunteering for a good cause .”

Mary: “I bet you think I’m an atheist or an agnostic.”

Joan: “Maybe…”

Mary: “I’m a card-carrying Roman Catholic. I’m not sure why – other than that was how I was raised. But it ‘took’.”

Joan: “Many people find that religious practice, that caring for their roots is very satisfying – if you’ll pardon the gardening pun.”

Mary: “That is certainly true for me. Andy doesn’t get it – but he’s the first to say that I have a somewhat other-worldly global perspective on things. I’m so grateful to be alive.”

Joan: “As part of the ‘Spirituality’ thing, I normally mention volunteering – but it sounds like you’re already doing that.”

Mary: “Absolutely. And I am particularly interested in Korean gardening – it’s very spiritual you know. I’m doing a major paper on that right now.”

Joan: “OK, I’m absolutely amazed! Hmm we just have a few minutes. Intellectual health I’m not concerned about with you – you are in university, writing essays. And vocational, how about we leave that to next time.

Mary: Actually, that’s a huge one for me. It’s worth a whole session. Not only do I not know what I’m going to do when I graduate, I don’t have a sense of purpose. I don’t mean that I want to be a nun. It’s just that nothing has grabbed me yet.”

Session Six on Holistic Health Counseling / Inventory (Biopsychosocial Model)winds down…


Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. - World Health Organization, 1948

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