Hi Cynthia,
Hear, Hear!
I think that the solutions we offer for lactation difficulties are WAY more effective if the LC has some counseling skills. IMO counseling boils down to good listening. An often neglected piece of this puzzle is the need for caregivers to get regular support for ourselves, so we are fresher/better listeners. I see so many bedside caregivers who are constantly giving of them selves to patients, family, and friends, and have few resources for their own support.
If we do not listen to the mother and father, the solutions we offer will be based in what WE think is best for them, not on the family's expressed needs and goals. Our goals are not always the same as the parents' goals, even if they received lots of good new information from us.
A quote from a UNICEF publication sums it up best:
"They won't care how much you now until they know how much you care."
Martha Johnson RN IBCLC
Eugene OR
-----Original Message-----
From: Cynthia Good Mojab [mailto:[log in to unmask]]
Sent: Friday, February 06, 2004 11:17 AM
Subject: Re: counseling skills
Barbara Wilson Clay wrote: "I'm a firm believer that all lactation
conferences should have sessions on counseling skills -- unfortunately, few
do."
I agree. Basic counseling skills are critical to the outcome of our
interactions with all breastfeeding mothers regardless of the type of
challenges the mother is experiencing. And, if we want to increase
effectiveness further, there are even more techniques and concepts (beyond
those of basic counseling) that I find highly applicable to breastfeeding
counseling. My training in the field of clinical psychology and my work with
breastfeeding mothers has convinced me of the utility of techniques and
concepts from family systems theory (the mother's experience of
breastfeeding does not happen in a vacuum), solution-focused therapy
(focusing on problems can be emotionally distressing and unproductive--and
it's what folks often automatically do; but focusing on what is already
working, how to continue it, and what to change to add to current success is
encouraging and effective), and brief therapy (i.e., breastfeeding
counseling often happens under major time constraints both in length of
session and number of sessions) applied to breastfeeding counseling. I have
never seen a session offered that addresses such topics in the context of
working with breastfeeding mothers. Have any of you?
I looked just now at the Recertification Application published by the IBLCE
(http://www.iblce.org/Booklet_Recert2004.pdf). It looks like 25 R CERPs are
accepted but not required as part of the 75 CERPs required for
recertification, but at least 50 L CERPs are required. I'm guessing that
sessions on counseling skills are likely to get categorized into the R CERP
category--topics related to the work of a lactation consultant but not
specifically in the area of breastfeeding. If my understanding is correct,
then current requirements can result in recertifying IBCLCs earning 75 CERPs
without ever having to take a session on counseling skills. Perhaps a change
in the requirements would better communicate the importance of counseling
skills to our work, increase the availability of sessions on the topic, and
improve our effectiveness, too. After all, counseling skills are at least as
important as ethics--and 5 E CERPs will be required for IBCLCs due to
recertify in 2007 and beyond.
Warmly,
Cynthia
Cynthia Good Mojab, MS clinical psychology, IBCLC, RLC
Ammawell
Website: http://home.comcast.net/~ammawell
Email: [log in to unmask]
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