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Wellness is a global concept with no borders or boundaries and is culturally expressed and experienced. Wellness pioneer and 2017 NWI Halbert L. Dunn Wellness Award recipient, Jack Travis, states that “My summation of 40 yrs work in 6 words is: "The currency of wellness is connection." We have much to learn from one another no matter where we call home. Please join us to share your wellness stories here so expanding your connection with all wellness seekers across the world.

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Medical practice and Wellness Ideals: Some Transformative concepts

Posted By NWI, Monday, May 21, 2018
Originally Posted By NWI, Monday, May 8, 2017
To access the current and 60 plus members only archived International Wellness Connection articles, become a member
 HERE >>


Dr. Halima Goss, PhD 
Doctor and wellness advocate

As a small town medical doctor (with a Wellness framework in mind), I am challenged daily to balance treatment models and wellness goals.  In the crafting of patient care, my intention is to patiently combine modern medicine and Wellness based ideals with compassion and kindness.  I work with nurses, physiotherapists, podiatrists, optometrists and a host of other allied health professionals.  It is unfortunate in Australia that our public medical funds purse has yet to embrace Wellness coaches as allied health professionals.  The upshot is that we are unable to include Wellness coaches as part of “team care plans” for eligible patients.  If a person wishes to use a Wellness coach, they must fund 100% of the fees.  This is in contrast to other professional groups like for example psychologists, exercise physiologists, and dietitians whose fees are recoverable through our Medicare system.  With time, and greater attention to refining effective paradigms and practices in both medicine and other professions, Wellness constructs as guiding principles may flow more freely.  For now, those who adopt and practice Wellness in treating and helping patients with Illness are those individuals who strive to empathize and educate in transformative ways.

In authoring this article, I hope to share some ideas that are inspiring and helping me develop in my role.  Whilst these ideas may not come from the Wellness literature, I am convinced that they should be essential reading for those wanting to pursue Wellness based practice.

Recently, I learned about a concept called “presence” from the field of existential analysis in psychiatry.  Author, Kirk Schneider (2015) offers this definition:  “a complex mix of appreciative openness, concerted engagement, support, and expressiveness, and it both holds and illuminates that which is palpably significant within the client and between client and therapist.”

Schneider (2015) further notes that presence “ embraces a much fuller and richer range of elements that may include a degree of discord and discomfort with another person.”

In contrast to mindfulness, presence is a mutual currency which we spend freely to grow honest and respectful  curiosity within relationships. Schneider (2015) states that “unlike conventional mindfulness, presence does not concertedly aim to dissolve the identity of self (if that is even achievable), but to expand, deepen, and redefine the identity of self. Finally, unlike conventional conceptions of mindfulness, presence aims to coexist with and integrate not necessarily detach from suffering”.

I began to reflect on how this idea fitted with those from Wellness coaching paradigms.   Wolever et al (2013) defined Health and Wellness coaching as:

A patient-centered approach wherein patients at least partially determine their goals, use self-discovery or active learning processes together with content education to work toward their goals, and self-monitor behaviors to increase accountability, all within the context of an interpersonal relationship with a coach. The coach is a health care professional trained in behavior change theory, motivational strategies, and communication techniques, which are used to assist patients to develop intrinsic motivation and obtain skills to create sustainable change for improved health and well-being.

This definition is heavily technocentric and is perhaps more closely aligned to traditional medical approaches than humanistic approaches.   Transformative learning is the hoped for outcome, but without a shared journey of transformation, is the process likely to be effective?

Schneider strongly encourages that psychotherapy training must incorporate humanistic and relational qualities to help trainees become well-rounded (engaging-empathic) people, not just competent technicians. He (2015) concludes:

 ” the optimization of presence is neither “performed” nor “enacted.” It is lived.

Wellness based practice must also consider these urging.  Perhaps a good starting point may be found in the work of Geller and Green berg (2012) who describe four dimensions that are key to therapeutic presence

-the sense of being grounded, which includes feeling centered, steady, and integrated inside one’s own body and self;”

-the sense of being immersed “in the moment with the client;”

-the sense of “spaciousness or an expansion of awareness and sensation while being tuned into the many nuances that exist at any given moment with the client;” and

-the sense of “intention for presence to be with and for the client’s healing process” (p.109).

Knowing oneself first would seem to be the aim.  Could the spiritual dimension hold a key to unlocking personal qualities that blend to help one practice presence? Unfortunately, the spiritual dimension of wellness whilst recognized by many pioneers of wellness and certainly celebrated as integral by ancient scholars of wellness seems too often to be confused with orthodox belief systems, rituals  and structures.  It behooves us to consider re- elevating this dimension in the ranks of our training, work, research and promotion efforts.  Within it, alongside “encouragement” and “imagination”  sit so many values which hold the essence of human endeavour in the quest for optimum social, environmental and physical harmony.  Perhaps it holds a key to humanistic, relational transformative education for Wellness coaching training.  Could it be a pivot point as Eberst (1984) suggested many decades ago?

In my doctoral thesis, I had a unique opportunity to offer a synthesized description of the Wellness paradigm.  In writing this article, I decided to revisit that description (copied below for your reference)

The Wellness paradigm is concerned with the optimum functioning of individuals in society. A Well person’s awareness, understanding and active decision-making capacity align with their values and aspirations. A Wellness lifestyle is the commitment and approach adopted by an individual aiming to reach their highest potential for purposes greater than themselves. The outcome of a Wellness lifestyle is a capacity to contribute in positive and meaningful ways to one’s community, society and the welfare of the earth. An individual who adopts a Wellness lifestyle aims to seek and use knowledge to live with balance across the multiple dimensions of their health and wellbeing in concert with others and their environment. On a continuum between low-level Wellness and high-level Wellness, individuals continually move between various states of physical, psychological and spiritual harmony and vary in their capacity to reach aspirations and goals. Appropriate learning strategies, tools and techniques are necessary for one to achieve higher levels of Wellness. (Goss, 2015)

On reflection, I would probably add one more sentence which I recently heard uttered by a respected Australian (our former Governor General  Ms Quentin Bryce): The greatest journey we must make is the journey to the center of our self.

I have realized that often times the seemingly simple act of being present with my patients is the key to open the door to the healing process for them.   Whilst many of my colleagues in medicine may feel a little uncomfortable with quotations from complementary and alternative medicine or therapy,  I believe the collective wisdom is far too valuable to ignore.  I share the following quote as an acknowledgment and a reminder to those who wish to be transformed by their practice and to support others in their journeys to Wellness and Health.

Samuel Hahnemann, the founder of homeopathy, gave a magnificent description of health, when he wrote, ‘In the healthy condition of man, the spiritual vital force, the dynamics that animates the material body, rules with unbounded sway, and retains all the parts of the organism in admirable, harmonious, vital operation … so that our indwelling, reason-gifted mind can freely employ this living, healthy instrument for the higher purpose of our existence.’ [Aphorism 9, The Organon].

As an international wellness community, we have a unique opportunity to encourage the scholars of the future from all over the world to continue to seek integrative paradigms, methods and practices that serve to unlock the secrets to curing every disease that exists.  May your journeys be fruitful.


References

Eberst, R. (1984).  Defining Health: A Multidimensional Model.  Journal of School Health,54. 99-104.

Geller, S.M. & Greenberg, L.S. (2012). Therapeutic presence: A mindful approach to effective psychotherapy. Washington, DC: APA Press.

Goss, H.B. (2011).  Wellness education: An integrated theoretical framework for fostering Transformative Learning.  PhD Dissertation, School of Human Movement Studies, Institute of Health and Biomedical Innovation, Queensland University of Technology.

Schneider, K. (2015). Presence: the core contextual factor of effective psychotherapy. Existential Analysis, 26(2), 304-313.

Wolever RQ, Simmons LA, Sforzo GA, Dill D, Kaye M, Bechard EM, Southard ME, Kennedy M, Vosloo J, Yang N. A systematic review of the literature on health and wellness coaching: Defining a key behavioral intervention in healthcare. Global Adv Health Med. 2013;2(4):34–53.


Dr Halima Goss (PhD, MBBS, B App Sci, Grad Cert Mgt, Dip Teach) is a medical doctor and wellness advocate in Far North Queensland, Australia.  Her career has spanned a number of fields including science, education, technology, health and wellness, psychiatry and family medicine. 

 A founding member of the National Wellness Institute of Australia (NWIA) she has presented Wellness topics to wide and varied professional groups from the corporate, government, industrial, medical and education sectors.  She retains a heartfelt hope and enthusiasm for the coalescence of ideas and ideals born of cultural values which seek a kinder, more caring world with love as the most valued commodity.  She can be contacted via email at halbbgoss@gmail.com.

Tags:  Australia  International Wellness 

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NWC First-Timer Reports On Post-Conference Progress in Teacher Wellness Influenced by Her Conference Experience

Posted By NWI, Monday, January 29, 2018

Originally Posted By NWI, Tuesday, January 10, 2017
To access the current and 60 plus members only archived International Wellness Connection articles, become a member
HERE >>


Tabatha Kellett, Australia
Master of Teaching, BEd, IT Grad Cert, Reg Fitness Leader

My husband Gavin attended his first National Wellness Conference in 2014. For two years I listened to stories about the people he met, the presentations he engaged with, and places he visited. When he talked about going back in 2016 I was disappointed to realize the conference was during term time and I would once again need to stay behind; teachers don’t take time off to travel during term time! Then my husband suggested that I apply to present on teacher wellness at the conference; I did and my proposal was accepted to present as one of the six international invited speakers during the three international breakout sessions. My school principal granted me paid professional learning leave to attend as well as some financial assistance towards the cost of travel. Before I left I was pleasantly surprised to be invited to speak with the senior executive in the Australian Capital Territory (ACT) Education Directorate about teacher wellness on my return. This affirmed my research and experience that teacher wellness needs to be high on the list of priorities to ensure quality teachers are attracted to and remain in the profession.

 

Teacher Wellness has been identified as an important focus in recent times as research links Teacher Wellness to Student Wellness that leads to improved student outcomes. This link has influenced change in Initial Teacher Education Programs, as well as Induction and ongoing Mentoring and Coaching of teachers at all stages of their career.

 

One of the advantages of presenting at the National Wellness Institute Conference in 2016 was that I needed to organize my research and practice in teacher wellness into presentation structure. I focused on education in the Western world with a particular spotlight on practice in my home city of Canberra, Australia.

 

 

This report includes some of the current issues around Teacher Wellness and changes I have observed since attending the 2016 National Wellness Conference:

 

Teachers usually enter Initial Teacher Education Programs with a strong commitment to, ”make a difference.”  Teachers stay in the profession of teaching because they can see the value of what they do; students grow physically, socially/emotionally, and academically and teachers do make a difference which makes teaching a rewarding and meaningful career. However, in Australia many teachers are leaving the profession. The issue of teacher retention is a concern throughout the Western world with the rates of teacher burnout being similar in the US, the UK and Australia. Between 25% and 50% of teachers leave the profession during their first 3-5 years. The reasons teachers give are that although their motives for entering the teaching profession remain, they feel undervalued, overwhelmed, unsupported and unheard. Somewhere the teacher’s self-efficacy is lost.

 

As well as the financial costs (i.e. in educating and recruiting teachers to replace those exiting the profession) this attrition has personal costs for the teacher as well as for the students who have developed a learning relationship with their teacher(s). In addition, the student’s family, staff members and the wider community are affected whenever a teacher leaves a school due to workplace stress.

 

Experienced teachers who stay in the profession struggle with low perceived autonomy. They may feel that they are “mice in a wheel,” with directives being imposed by policy makers rather than feeling supported and valued in their teaching practice. 

 

So, why are some teachers experiencing such poor self-efficacy? Teaching is a job with high ‘emotional labor’ and very high levels of occupational stress which often leads to job dissatisfaction and mental health related problems. The prevalence of stress in teaching is recognized with reports of high levels of occupational stress in Australia, similar to that in the UK and the US.

 

In the Australian context the Australian Council of Educational Research claim that one of the causes of teacher stress is the new Australian Curriculum which has too much content to cover in the time available. The same research also claims that overall there is more administration for teachers to complete and access to email at home means teachers now more than ever continue to work outside the physical school building. The “Report of the Expert Panel on students with complex needs and challenging behaviours” identifies the complexity of the classrooms in Australia. Teachers need to individualize the curriculum to meet a wide range of student needs.

 

In Australia, local and federal governments measure student outcomes, and their Return on Investment, using high stakes testing such as the Australian National Assessment Program – Literacy and Numeracy, the Programme for International Student Assessment and Trends in International Mathematics and Science Study. There is inequity around funding students with the highest needs with some state governments reluctance to adjusting funding to the requirements outlined in the Gonski report.

 

A meme on Facebook recently stated “If you ever want to know what a teacher’s mind is like, imagine a browser with 1,324 tabs open. All. The. Time.” A teacher has multiple interactions with staff, students and members of the wider community each day. Many of these interactions require real time decision making that have an impact on student achievement and social/emotional development. Unfortunately, more often than not, the teacher will leave the physical school building and keep all 1,324 browser tabs open to mull over while engaging in the numerous other activities in their personal life. These tabs are still open well into the night causing disrupted sleep patterns leading to the physical and mental health issues caused by lack of sleep.

 

One of the game changers in Teacher Wellness came through the need to understand how to improve student outcomes. Researchers examined the relationship between the teacher and student and the impact this relationship has on student outcomes. Not surprisingly the research shows that this relationship is important. In 2009, educational researcher John Hattie found that beyond the student themselves, teachers have the greatest impact on student outcomes.

 

For example research into the link between Teacher and Student Wellness, found that when a teacher feels good about themselves and what they do “they have a high self-efficacy…[and] student cognitive outcomes are higher” (Scheerens 2010). In 2014 research conducted by Vesely, Saklofske and Nordstokke concluded that teacher wellbeing directly impacts the educational, personal, social, and emotional outcomes of their students.

 

In the past decade there has been a positive change in approach to Wellness in Australia and an increasing awareness of the need to promote wellness in the workplace. Most recently, at the National Workplace Wellness Symposium in Canberra, May 2016, Dr Kerryn Phelps called for businesses to ‘embrace a “wellness culture.”

 

In the ACT there are two positive, practical resources that schools can utilize to promote Teacher Wellness.

 

The ACT Department of Health has designed a proactive approach to wellness through its ‘HealthierWork’ program. This is available to organizations in the ACT that employ more than 50 staff. The service provides a free online survey to identify the unique needs of each workplace and support to design a 12 month plan.

 

Financial assistance to promote a Wellness Program is available through the MindMatters program.  MindMatters is a health initiative for secondary schools that aims to improve the mental health and wellbeing of young people and their community. As a framework MindMatters provides structure, guidance and support while enabling schools to build their own mental health strategy to suit their unique setting. Schools that complete the online course receive government funding to support their Wellness Program. The school I teach at provides a unique program for staff developed from data and feedback through HealthierWork and MindMatters. This includes free massages for staff, a student recognition program, community events, guest presenters and a healthy eating program. All of this is designed not only to help staff look after themselves, but to let them know that their dedication to meeting the needs of each individual student is recognized.

 

At the end of the 2016 National Wellness Conference I had a clear goal: to promote Teacher Wellness. I was inspired by the practitioners I spoke to and researchers I listened to and was optimistic that I could ‘make a difference’. I mentioned to one of my new conference friends that I would like to return to the US in 2018 to present on what I believe would happen in the next two years. I have optimistically called my 2018 presentation “Riding the Winds of Change”. Below is a summary of what has happened since the end of the NWC 2016 conference:

  • In July 2016 I met with senior managers within the ACT Education Directorate to talk about my presentation and what I learned while I was in the USA. This affirmed some of the information they had gathered and provided some context on a wider scale on how to promote Teacher Wellness.
  • In October 2016 I sat on an Occupational Violence (OV) reference group to analyze possible causes, impact and how to avoid OV (OV is student and/or parental violence towards teachers). This led to the design of a Risk Register to be implemented in 2017 on minimizing the risk of OV.
  • As part of that reference group I was paired with a non-teaching manager; the manager of Health, Safety and Wellbeing. We examined the Education Directorate’s current Wellbeing Framework, and noted that it was reactive, with a focus on supporting teachers who had been affected by workplace injury, stress or violence. The need for a proactive approach to Wellbeing was obvious and I was asked to participate in the design of the framework.

Our staff is currently writing the school’s 2017-2021 Strategic Plan and has placed Staff Wellbeing as one of the four priorities over the next four years.

 

What an amazing opportunity awaits me in 2017; to complete the ACT Education Directorate Wellbeing Framework and put it into practice! I look forward to measuring improvements in teacher wellness and retention rates, as well as improved student wellness and student outcomes, and presenting updates at NWC 2018.


Tabatha Kellett is an educator with over 20 years’ experience. She has taught ESL, mainstream and special needs students from pre-school to Year 12 as well as lecturing in teacher education at the University of Canberra (Australia). Tabatha has a passion for mentoring early career teachers, working with experienced teachers to develop a sustainable approach to teaching. Her experience in the fitness industry and work with social/emotional literacy provides a balanced approach to wellness. Tabatha led her workplace to becoming the first government school in Canberra recognized as a ‘Healthier Work’ environment. Tabatha is currently the Year 11 and 12 Executive Teacher at a special needs school in Canberra, Australia. 

Tags:  Australia  International Wellness 

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