The document discusses the CORE model for assessing patients with hearing loss which evaluates their Communication status, Overall emotional participation, Related personal factors, and Environmental factors. It describes the psychosocial aspects of hearing loss including how it can affect self-concept, emotional development, family concerns, and social competencies. The document emphasizes the importance of considering these psychosocial factors when providing counseling to patients with hearing loss.

1. HEARING LOSS
Psychosocial Aspects & Counseling
The use of a audiologic rehabilitation
model has been in place since the early
1980’s.
The model described in Schow, will be
used to provide a consistent description
for effective professional patient/client
interaction.
The assessment component of this
model is CORE.

2. HEARING LOSS
Psychosocial Aspects & Counseling
C.O.R.E.
C—Determine patient/client
communication status
O—Determine overall emotional
participation variables
R—Determine related personal factors
E—Determine environmental factors

3. HEARING LOSS
Psychosocial Aspects & Counseling
Communication Status
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Auditory?
Visual?
Language?
Manual?
Communication—self report?
Previous rehabilitation?
Overall communication?

4. HEARING LOSS
Psychosocial Aspects & Counseling
Overall Participation Variables
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Psychological/emotional?
Social?
Vocational?
Educational?

5. HEARING LOSS
Psychosocial Aspects & Counseling
Related Personal Factors
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Personality type?
IQ?
Age?
Race?
Gender?

6. HEARING LOSS
Psychosocial Aspects & Counseling
Environmental Factors
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Services?
Systems?
Barriers?
Facilitators?
Acoustic conditions?

7. HEARING LOSS
Psychosocial Aspects & Counseling
When attempting effective audiologic
rehabilitation, it is important to consider
how the patient/client’s hearing loss
affects their overall participation
variables i.e. their psychoemotional and
social interactions.
Of course, their related personal factors
(personality type, IQ, age) must also be
considered.

8. HEARING LOSS
Psychosocial Aspects & Counseling
Four Psychosocial Aspects
When interacting/counseling with
patient/clients (at almost any age level),
there are four fundamental aspects to
consider. They are:
1.
2.
3.
4.
Self-concept
Emotional development (or status)
Family concerns
Social competencies

9. HEARING LOSS
Psychosocial Aspects & Counseling
Self-Concept
Individuals are not born with selfconcepts.
Self-concepts are created by input,
feedback, and reactions from those
around them.
These concepts can be modified over
time as social interaction occurs.

10. HEARING LOSS
Psychosocial Aspects & Counseling
Emotional Development
An individual uses language to describe,
interpret, and understand the abstract
nature of his or her emotions.
Due to progressive hearing loss or
language deficits, limited self-expression
may create a delay in their awareness
and understanding of their own
emotions as well as those of others!

11. HEARING LOSS
Psychosocial Aspects & Counseling
Family Concerns
Often, the family as well as the patient/client
will experience the “grief cycle” of emotions
as hearing loss is encountered/revealed.
The grief cycle consists of:
• Shock
• Denial
• Depression
• Acceptance/resignation

12. HEARING LOSS
Psychosocial Aspects & Counseling
Social Competencies
Poor and/or limited communication results in
poor social competence. Social competence
often includes the following skills:
• Capacity to think independently
• Capacity for self-direction and self-control
• Understanding the feelings and needs of others
• Ability to tolerate frustration
• Ability to rely and be relied upon by others
• Maintaining healthy relationships with others

13. HEARING LOSS
Psychosocial Aspects & Counseling
It is important to understand that,
whether one is born with hearing loss, or
suffers acquired hearing loss in later
years; the patient client will encounter
these four described psychosocial
aspects of hearing loss.
Let’s cover these aspects in more detail
regarding acquired hearing loss.

14. HEARING LOSS
Psychosocial Aspects & Counseling
Those with acquired hearing loss
generally wait an average of seven
years (after becoming aware of
their communication challenges)
before attempting to access
hearing health care.

15. HEARING LOSS
Psychosocial Aspects & Counseling
Hearing loss can be a symptom of a
serious health issue—even if benign,
the permanent effects of auditory
deprivation occurs after three years
of hearing loss!

16. HEARING LOSS
Psychosocial Aspects & Counseling
The psychoemotional reactions to
revealed hearing loss can involve
stress, anxiety, insecurity and anger.
Let’s review page #254 in Schow for
additional psychoemotional
reactions.
Let’s also review Case #7.2 on that
page.

17. HEARING LOSS
Psychosocial Aspects & Counseling
It is interesting to note, that family
members take the brunt of the stress
while the person with the hearing
loss is attempting to accept the fact
that their communication abilities
are changing.
Often, the family members are
blamed by the individual suffering
the hearing loss.

18. HEARING LOSS
Psychosocial Aspects & Counseling
The affected individual usually does not
realize the burden their hearing loss
places upon their spouse or significant
other.
This often results in a downward spiral to
even long term relationships.
Hearing loss is insidious and family
concerns are often encountered before
the hearing loss has been defined.

19. HEARING LOSS
Psychosocial Aspects & Counseling
The psychosocial aspects of late on-set
hearing loss can result in past life-style
modifications.
• No longer regularly attend church
• No longer engage in jokes or humor
• Only short “to-the-point” comments
• Other modifications?

20. HEARING LOSS
Psychosocial Aspects & Counseling
This psychosocial withdrawal has
been shown to lead to depression.
It has been commonly found when
adults begin to modify or change
lifestyles, that gradual hearing loss
may be a contributing factor.

21. HEARING LOSS
Psychosocial Aspects & Counseling
Several studies have noted that the
more severe the hearing loss—the
more severe the psychosocial and
emotional problems can be!

22. HEARING LOSS
Psychosocial Aspects & Counseling
Psychosocial Aspects of Deafness
Should hearing babies be born to
deaf couples?
Let’s review page#257 in Schow to
begin this discussion regarding the
deaf culture.

23. HEARING LOSS
Psychosocial Aspects & Counseling
COUNSELING BASICS
Now that we recognize more
regarding hearing loss and its
psychosocial aspects, let’s better
understand important distinctions for
both effective counseling and
proper referral to other healthcare
professionals.

24. HEARING LOSS
Psychosocial Aspects & Counseling
Counseling is designed to help people
develop “here-and-now” strategies for
coping with lifestyle modifications,
decision making, and current social or
health problems.
There are two forums for counseling:
1. professional, 2. non-professional

25. HEARING LOSS
Psychosocial Aspects & Counseling
Counseling events fall into two
fundamental categories, they are:
1. Informational counseling
2. Personal adjustment counseling

26. HEARING LOSS
Psychosocial Aspects & Counseling
INFORMATIONAL COUNSELING
This form of counseling is often used by
non-professional counselors, it is
commonly use by audiologists and
hearing instrument specialists.
It is easily recognized when the
professional finds that he or she is doing
most of the talking i.e. one-way
communication.

27. HEARING LOSS
Psychosocial Aspects & Counseling
PERSONAL ADJUSTMENT COUNSELING
This type of counseling involves more
two-way communication. In fact,
counselors call it facilitative
communication.
This approach allows patient/clients an
opportunity to express how they feel—
often revealing their communication
goals.

28. HEARING LOSS
Psychosocial Aspects & Counseling
PERSONAL ADJUSTMENT COUNSELING
There are three steps involved to facilitate
this type of counseling process.
They are:
1. Help patient/clients tell their “story”
2. Help patient/clients “clarify” their
problems.
3. Help patient/clients take responsibility
for their communication problems

29. HEARING LOSS
Psychosocial Aspects & Counseling
PERSONAL ADJUSTMENT COUNSELING
Let’s review page #260 in Schow for better
definition of this process.
Note: pages 261—263 provide more
detail regarding integration of this form of
counseling into audiologic rehabilitation.

30. HEARING LOSS
Psychosocial Aspects & Counseling
The C.O.R.E. model of assessment
considers patient/client attitudes—
including readiness for change.
An empathetic, non-judgmental attitude
can help patient/clients face their fears
and consider “treatment”.

31. HEARING LOSS
Psychosocial Aspects & Counseling
Patient/clients can present with a variety
of psychosocial problems.
When attempting non-professional
counseling and you feel like the
counseling may be going beyond your
comfort level, always immediately refer
the patient/client to an appropriate
healthcare professional.