Self-concept in the Relationship Between

Dental Hygienists and Clients

Self-concept

An organized network of ideas and feelings we have about ourselves Come from experiences and interactions with other peopleDynamicGeneralizations

Development of Self

Peplau’s four steps of development

First stepAppraisals are made by significant others about the self

Evaluative statementsBased on the evaluator’s expectation“Good Baby!” or “Bad!”

Second Step

Appraisals are repeated, become a pattern, and become incorporated into the self

Third step

Behavior emerges to match the appraisals

“John good!” “I ate it all up!”

Forth Step

The Self continues to develop, and is open for reappraisal

Reappraisal

Functions of Self-Concept

Help to explain behavior Provide a decision making frameworkShape expectations for future (possible selves)Provide bridges for a person to become one’s own unique self

Application: Characteristics of a Healthy Self-Concept

Satisfaction with Body Image Distinct Sense of Identity Emotional Stability; Realistic Life Goals, High Self-Esteem; Congruence between Real and Ideal Self Spiritual Well-Being Satisfaction with role performance

Functions of Body Image

Senses

An instrument for action

Expressive instrument

Mental picture of the body

Strategies for communicating with clients with alterations in body image

Provide information and opportunities for the client to ask questions

Modeling acceptance

Introducing adaptive functioning

Encourage the client to share experience with others

Enhance social support

Applications

Can you illustrate how to use some of the above strategies to communicate with the following patients?

• A 65 year old woman who suffered a stroke and half of her body became paralyzed

• a 14 year old girl who just got braces• a veteran who lost his leg during the war• a man who has a serious burn and half of the body has

contracted

Personal Identity

It includes all our psychological beliefs and attitudes: – Perception– Cognition– Emotion– Spirituality

Perception

– Transformation of sensory data into personal image of reality

– A bottom-up and top-down process

Perceptual Illusion

Perceptual Illusion

Perceptual Illusion

Perceptual biases & Self-Concept

Selective Attention

Self-fulfilling Prophecy

Communicating with Clients with Perceptual Biases

Perceptual checks1. Describe precisely the behavior of

concern

2. Offer two alternative explanations for problems

3. Request feedback

Case Example

Client: I see that you didn’t eat today. (clarify the problem) Nurse: Why? Is it because you don’t feel well, or is it because you don’t like the food? Client: I want to eat some solid food, I’m sick of having slop everyday. (alternative explanation) Nurse: oh, so that’s the problem you have. Can you tell me more about your what you like to eat? (request feedback)

Perceptual Checks Roleplay

Illustrate the 3-step process of perceptual checks. – A client has lots of cavities and doesn’t like to

use floss.

– A client just got his braces off. He is supposed to wear a mouthguard at night, but he doesn’t.

Cognition

The mind processes perceptual information and incorporates with other information in the mind to form a coherent whole

logic, stored in long-term or short-term memory

Cognitive Distortions

“All or nothing”

Overgeneralization

Mind-reading or fortune-telling

Personalizing

Acting on “should” or “ought to”

“Awfulizing”

Self-Talk

A thought process that leads to a feeling or judgment, which subsequently attaches to one’s concept of self. Example of negative self-talk“I stuttered in the interview”

“I had a terrible interview”“ I probably won’t get the job”“I will probably never be able to get a job”“I’m no good”

Communicating with Clients with Cognitive DistortionsDevelop awareness of self-talk

Challenging the client’s distortions

Social support

Recognizing Cognitive Distortions

1. I shouldn’t feel anxious about giving this presentation in class. 2. I’m boring and people don’t like to talk to me.3. I shouldn’t get upset when people don’t approve of me.4. If I hadn’t been raised in a dysfunctional family, I would be a

different person. 5. If I don’t get high grades, my family will think less of me.6. I can’t experience true satisfaction unless I do things

perfectly.

How would you challenge the above distortions?Can you give me an examples for the distortions we discussed above?What are some of your cognitive distortions and how do they affect your behavior?