¿Cuáles son algunas estrategias para ayudar a los clientes a hacer frente a los contratiempos en su proceso de autocuidado?

Listening is our greatest skill, secondary to synthetizing the information imparted to us from our clients. When a veteran expresses to me that they've had a set-back, I let them know that we all have set-backs and that's part and parcel of the human experience. Normalizing the experience helps, and from there a psychotherapist can make progress with a client.

Teach Self-compassion: It “recognizes that the human condition is imperfect, so that we feel connected to others when we fail or suffer rather than feeling separate or isolated. It also involves mindfulness — the recognition and non-judgmental acceptance of painful emotions as they arise in the present moment. Rather than suppressing our pain or else making it into an exaggerated personal soap opera, we see ourselves and our situation clearly…It emphasizes interconnection rather than separateness. This means that with self-compassion, you don’t have to feel better than others to feel good about yourself… it is always there for you – when you’re on top of the world and when you fall flat on your face.” -Dr Kristin Neff

Es importante considerar que los pacientes no tendrán resultados perfectos en el primer intento por realizar un tratamiento o rutina de autocuidado, muchos de ellos experimentarán frustración al no conseguir su objetivo a la primera, es importante mencionar que como todo proceso llevará tiempo y pasos hacia adelante y algunos también hacia atrás pero eso no hace menos valioso su esfuerzo, poco a poco podrá aprender a afrontar los obstáculos en virtud de sus objetivos. Mientras tanto la autocompasión es de ayuda.

Inevitably, when we set a goal - become fitter, lose weight, go to bed earlier etc - new and unexected obstacles crop up as if to test our resolve. Helping them understand that we set the goal in concrete but the plans in sand opens up their minds to the ideas that they have to be flexible and create resilience as well. By keeping focused on what you want you can then create ways to keep you on track - it might be a different route from the one originally imagined but as long as you know where you are going, you will get there.

Affirming and validating the client's experience and distress is the first important step in helping clients cope with setbacks. While, as practitioners, we may intuitively understand that setbacks are a part of recovery, our clients may benefit from our acknowledging the intensity of their emotional experience before they can move forward. MI techniques are helpful in ensuring the client feels heard and understood and that their emotional experience isn't neglected in the change process.

When a patient slips or relapses when working towards quitting tobacco, I remind them nicotine is an addiction they use to cope and not an inherent flaw in character. I listen to their challenges and summarize their stresses. We discuss their progress and how any behavior change is a process. I always encourage patients by letting them know any effort towards behavior change is momentum towards changing behavior, and set backs are ways to learn.

Setbacks can happen, but instead of giving up, focus on what you CAN do, instead of what you CAN'T do. I recently had a setback and initially I was disappointed. I decided to explore another way to achieve my goal and treated the setback as a mere obstacle. By doing this, I still achieved my goal. There will always be things outside of my control, but instead of wasting energy on worrying about it, i focus my energy on what I can control instead, such as my attitude towards it. Self-care is an essential part of my life and no matter how busy I am, I always find ways to do something for myself everyday. It doesn't need to be big, but even the smallest of things can help my mood and mindset.

A key element that we must recognize is that after the coach discovers what the situation was that caused the set-back, is that the coach can provide information to the client about the self-care path. Explore and elicit helps the coach understand the information the client already knows so as not to repeat it. Before providing any information, the coach must ask permission to share it with the client.

Experiencing a setback is tough enough, and the last thing we want to do is block future progress with a lack of curiosity. Bringing curiosity is imperative to challenging situations. This will allow us to work together as client and practitioner to discover what could be more deeply at play. Peppering in plenty of empathy will allow for those truer statements to float to the top so we can elicit that deeper change talk. Get curious!

Everyday is a new chance to reset, regroup, and retry. Remind yourself the significance of this practice. Be accountable to you first and give yourself some mercy. Do you have a specific, time-bound plan? For example, can you start your day and end your day with a specific practice? Set the timer on your phone or use a calendar entry to remind you and hold you accountable. And remember what self-care is and isn’t. It’s not a daily spa visit or 4-hour meditation sessions. It’s practicing mindfulness, staying engaged, practicing emotional regulation and so much more. Your self-care toolbox needs to have the tools that work for you. Remember what motivated you to start the journey and find ways to keep those reminders front and center.

Self-expectation needs to be realistic. Small promises made and kept nourish self-trust. From that, confidence flows. Dividing personal goals into short and long term help patients manage the outcome and make adjustments along the way. Achievement of personal goals need not be 'all or nothing'; emphasis on this truth often requires reinforcment from the support system (i.e. coach, therapist). The human condition motivates us to self-protect unless we feel safe (emotionally and physically). An approach that embodies empathy and compassion creates a healing environment that encourages honest self-reflection and self-correction. Care, support, and understanding along with appreciative inquiry provide a patient-centered growth experience.