This episode was prerecorded as part of a live continuing education webinar. On-demand CEUs are still available for this presentation through all CEUs. Register at allceus.com slash counselor toolbox. This episode was prerecorded as part of a live continuing education webinar. On-demand CEUs are still available for this presentation through all CEUs. Register at allceus.com slash counselor toolbox. I'd like to welcome everybody to today's presentation on 15 Principles of Client-Centered Care. Now this was originally written and based on the Registered Nurses of Ontario's Best Practices Guideline, but what was in there was so applicable to clinicians and medical providers and, you know, the like, pretty much anybody who works with clients in some way that I thought it would be really good to go over here. So we're going to start out by looking at some of the benefits of client-centered care. Client-centered care empowers the client to actively participate in his or her care and develop an understanding of the interaction between his or her environment and herself.  From a mental health clinicians perspective, we want clients, again, still to actively participate in their care, identify what they think is going to work, what they think is causing their depression, where they think it comes from, and develop an understanding of the interaction between them and their environment. So when you're depressed or when you're anxious, how does that impact your environment?   It goes away after a while, but you know, it impacts me. It's not a huge impact, but I don't like chaos. I don't like, we call it flat surfaceitis in my house where every flat surface seems to get inflamed or bigger over the course of the day. So we want to look at those things and it can be everything from colors. Whenever I move into a new house, and I've always had the walls repainted a really light yellow, it's called a straw color. I'm not big on real bright colors, but just a little hint of yellow makes it a little bit more cheerful than some of the bland colors. I try to stay away from anything that had blue undertones, because I like something a little warmer and more cheerful, and I know that impacts my mood. I know, for example, having lived in houses that are older, you know, back in the day when they were building houses, they didn't build nine, ten vaulted foot or vaulted ceilings. And if you're living in a house that has these short eight foot ceilings, you know, we didn't used to think of them as short, but now you do and you don't even realize how much it feels sort of oppressive or it can feel oppressive, especially when it's dark outside. If you're in an environment like that and you feel kind of cooped up and maybe that's just because we've gotten used to being in places that have higher ceilings. But having people look around and go, what is it about this environment that feels icky? Or what is it about this environment that you really love? I really love open spaces and bright color or brightness, you know, light and windows and those sorts of things. But not everybody, that's not everybody's cup of tea. Client centered care, when we start having clients take a look at that and say, Oh, I see how I can make some of these changes here in my environment, or I see how I'm impacting my environment. And that makes me motivated to change. So we're increasing treatment compliance. We're showing them that there are things they can do. We're giving them tools to empower them, oops, and make them feel like they can do something right away. And that's awesome. And we always talk about or I always talk about making short clients walk out of every single session, including the assessment sex session with something to do some kind of tool, some kind of information that gives them some insight or something as a direction to go towards recovery. So that improves treatment compliance. It often leads to more rapid and enduring improvements because they get that momentum going, and they just keep going, you know, think about if you've ever done one of the elliptical machines at the gym, if you can get it going and you can keep it going, you can go on centrifugal force or whatever it is that I wasn't big in physics. But the pedals will move for you. When I taught spin, I always used to tell people you're not working out effectively. If when you stop pedaling, the pedals keep moving. But you know, when we're talking about counseling, you know, if a person starts going, they start that pedal going, and it's going to stay in motion because remember, something that's in motion tends to stay in motion, some things that's at rest tends to stay at rest. So if we have them making these changes, it's going to be easier to keep them engaged and keep them making small, small changes.  We want to be able to provide the best treatment possible. We want to have a good reputation in the community. But we also got into this because we want to help people. So you know, obviously, we care about people or we wouldn't be doing this. But there's also the other benefits, you know, it makes people enjoy coming sort of coming to counseling. Some days not so much, but they see the benefit in it. So what is caring caring can be listening to and empathizing with clients points of views. And if we can get everybody in our office to do this, not just counselors, because client centered care when you really look at it, isn't just the clinician or the nurse, I mean, think about somebody in the hospital, they work with nurses and doctors and, you know, everybody comes in and out of there, even the maintenance person who's mopping the floor. So they interact with people and a client centered environment, everybody is going to care about the clients ideally. So we want to help even our front desk staff who answers the phone, who greets people when they come in, we want people to feel welcome, we don't want them to walk up to the front desk. And you know, you have that little window drawn, and the person just stands there. I had to do that last year at the doctor I was going to I had to do that. And I walked in and I stood there. And I wanted to check in and I just stood there and stood there and she was just typing on her computer and she was not about to acknowledge me until she was finished doing whatever she was typing whatever she was typing. So we want to make sure that our staff meets clients and greets clients in a way that they feel cared about. And they can listen to and empathize with clients points of view. If it's the front desk staff, they may need to empathize, you know, I'm really sorry that, you know, Dr.  You know, just working with them good customer service. It recognizes clients are unique individuals. So we recognize that because of their culture, because of their age, because of their diagnosis, because of what happened on the way to treatment today, they may present a little bit differently than anybody else that you see that day. So we want to greet people and meet people without having any predetermined notions, you know, sometimes you work with clients and my grandfather was the perfect example. You know, God bless him. He was probably in a lot of pain for many, many years. He had an injury in World War Two and ended up having to have a plate put in his head. And because he had a skull fracture. Anyway, so he probably was in a lot of pain. And, you know, he was a chronic smoker and, you know, was in law enforcement for many, many years. So on top of the war and law enforcement, there was probably some PTSD. We didn't talk about that stuff back then. And on top of all that, he had some issues with alcohol. So there was a lot of stuff going on there. And generally, he was kind of cranky to be around. But when he had his hospice nurse come in, she didn't react to him that way. She recognized him as an individual who was in pain, who was suffering, whatever. And as soon as somebody recognized that and met him with empathy and unconditional positive regard and all that stuff, it kind of changed.  I was like, oh, grandpa. But in any event, when we recognize clients as individuals, and even recognizing that how they were last Tuesday may not be how they are today. So we don't want to go, oh, not that one again. You know, we want to go, okay, this is a new day, new challenge, let's see what we got. And caring means never allowing your values to interfere with the client's right to receive care. Now, does that mean that you have to provide services to every single person? You know, the jury's out on that as far as ethics goes, but, you know, sometimes there are issues that you are either not trained to deal with, or because your personal stuff, you cannot deal with. And you know, we all have stuff here and there. But being aware of that, but also being aware that we have to refer clients out, we can't just say, well, we can't deal with that. Well, okay, maybe you and I can't deal with that because, you know, I'm not don't have the training or whatever, but the client has the right to receive care. So I need to refer him or her out to someone who can. A client centered approach is one in which clients are viewed as whole people, not just recipients of counseling services for their depression. They have physical aspects, they have social aspects, you know, that biopsychosocial thing. It's not merely about delivering services where the client is located, you know, we don't necessarily, they can come to us, we can go to them, we can do video services. That's not client centered care. That's part of it. You know, we definitely want to try to meet clients where they are physically, emotionally, yada, yada when possible. But that's only part of it. Client centered care also involves advocacy, empowerment, and respecting the client's autonomy, voice, self determination, and participation in decision making. So we want to instead of my pet peeve, which is why I bring it up a lot, we don't want to do treatment plans and hand it to the client and go here, this is what you need to do. We want to start out by saying, what's worked for you? What do you think is going to be effective? What do you think is causing your depression, your anxiety? When did this start? When you didn't have this situation? What was different? Help me learn more about you because you're the expert on yourself. And that helps the person go, Oh, you know, maybe I do know something here. And it empowers them. So after this episode, hopefully they'll have the skills to figure out what questions to ask and what research to do so they can problem solve on their own should they have a similar problem in the future. And we want to respect their autonomy. If they believe in adjunct practices, acupuncture, Tai Chi, herbs, you know, internal medicine stuff, whatever it is, if they think that needs to be part of their recovery plan, then by all means, you know, let's see how we can make referrals and make this a comprehensive treatment plan. Empowerment is another part of client centered care. And it's the participation of individuals and communities, not just the individual in a social action process. Okay, that targets both individual and community change outcomes. So empowerment isn't just about saying, Hey, John, you know, I'm glad we're working together. Why don't you tell me what you think is going to be effective. That's part of it. But empowerment is much bigger. We want to get the communities to start saying, if you're depressed, counseling can help. If you're depressed, here are some tools. If you are struggling with domestic violence, here are some resources. We want it to be a social action process that involves prevention, early intervention, as well as treatment services, because we want to reduce the prevalence of whatever that problem is in the community. And, you know, we know that an ounce of prevention is worth a pound of cure. So we can go out there and say, let's talk about this.  Oh, no. Oh, no, no, no. What it does mean is we go out and we make a ton of really positive contacts who go, you know what, I made this little change that you talked about in that workshop at the library and it's been awesome. And it really helped. And then they tell their friend about the workshop that they went to with you and, you know, it just kind of spirals. You get a reputation in the community, positive one. And then people start coming to you when they can't solve the problems on their own. Those little tips and tools aren't quite enough.  Let me go talk to her. So, yes, a lot of our prevention and advocacy and outreach is not billable. But if you look at it as business development and marketing, as well as an ethical practice, it's definitely something worth doing. Empowerment is a concept that's crucial because we need to help clients identify where they are. You know, the treatment services in Trenton, Florida are very, very different than the treatment services available in Orlando, Florida. Trenton is a very, very rural town. I think the county itself has 14,000 residents in the entire county. And Orlando, we all know about Orlando. So, you know, what services are available, what empowerment needs to happen, what changes need to happen are going to be very different between those two communities. So, we need to go into the communities. We need to talk to the physicians. We need to talk to the clients. We need to talk to the mom that's picking her kid up from daycare and say, you know, what services might be helpful. And empowerment also involves an initial and ongoing assessment, not just initial, not at the beginning, not at the end, but initial and all the way through of the client's values, feelings and actions in order to figure out what's going to work. We need to know because, again, what someone in a super rural community, for example, may be willing to do, may not be the same as something it may not feel comfortable as, you know, and somebody in a more urban area may go, Oh yeah, no problem. I'll go to the 12 step meetings or support groups or, you know, I'll go to online, you know, online counseling is very suspect in a lot of rural communities, even though that's one of the best ways for them to access services. A lot of rural communities are still kind of iffy about that whole online thing. The humanistic approach kind of underscores the client centered care. It's based on knowing the client and the client's perspective through continuous dialogue. You know, think about Rogers, he said that if we clear that path and provide unconditional positive regard, we listen, we hear, we empathize, we provide paraphrasing so clients can hear what they're saying and we're really actually a sounding board. Clients can often solve their own problems. You know, they may need a little bit of a nudge one way or another or provide them a tool. But most of the time they can achieve their goals. The humanistic approach, if you remember, views the client as a whole and recognizes the interconnectedness and interrelationship between the client and the environment. If they're in a critical environment, if they're in an environment where they get conditional positive regard or where there's a lot of blockages to their growth, they're going to have difficulty. So what can we do to make this a supportive, encouraging, nurturing environment for that client? What does that look like for that client? And it focuses on restoring health, harmony and enhanced quality of life. So the nice thing about the humanistic approach is it's very human oriented. It's very interconnected. So it works well with both individualistic as well as collectivistic cultures. Participatory management is the extent to which managers involve staff in decision making regarding their work and aspects of the work environment. It's characterized by the manager seeking staff input and feedback about the work environment, involving staff in decision making about their own work and providing recognition and support and taking action on the input. Well for client centered care, who knows the clients better than Oh my gosh, the line staff. So we want to get information from line staff about what's going to help, what's taking too long. I know we went to a particular online assessment tool that I won't name at the clinic I worked at in Florida. And our assessments went from taking anywhere from 45 minutes to an hour and a half to three, four hours to get through this online assessment. And you know, the clinicians were like, I can't do that. I mean, my billables were bad before and now they're just deplorable. And the clients were also obviously getting frustrated. So clinicians or line staff are in the perfect place to say, this is what we need. This is what the clients are asking for. Front desk staff, your check in staff are also vital components because they can tell you, you know, where, where there are breakdowns in the processes, what would make life a little bit easier for clients and clinicians and the flow of things. Because a lot of times, I don't know about you, but I don't look at the flow as much as I just wanted to flow. I wanted to work and, you know, figuring out the process can get a little bit tedious. So people who are better at that can provide input. But we need as managers, if you're a manager, you need to seek input. And then you need to act on it. So participatory management allows staff, line staff, front desk staff to have a voice for the clients. So it's still client centered care, even though we're talking about staff people. But this is how we get the client's voice into management's decision making. Reflective practice is an ongoing process that the counselor utilizes in order to examine his or her own practice, evaluate strengths, and identify ways of continually improving practice to meet client needs. So reviewing your tapes, going back over sessions, looking at case notes, getting supervision every once in a while. But I would encourage you to regularly look at how are things going? Are they progressing? When you do treatment plan, reassessments or updates, whatever you call them, where you're at. You know, this is a good time to reflect and go, how are things going? Other things that you can ask is, you know, what have I learned in this process? You know, maybe you're working with a new client from a different culture that you haven't worked with before, or maybe the same culture and you're learning something new about him or her or how to interact or deal with a certain issue. Identify what's been most useful in this particular case in this process. What has been most useful with the client? And what else do I need to fully support the client in achieving his or her goals? And if I were to have a similar situation again, what would I do the same and what would I do differently? Respect. Yeah, we need it. We need to respect client's wishes, concerns, values, priorities, perspectives and strengths. Emphasis on the strengths. The others seem, in my mind, to be kind of no brainers. We would hope that an ethical therapist respects those things already. But we also need to remember to ask about strengths. One of the ways we can show respect is by asking clients, what works? What helps you or what do you think would help you? Or if they're not sure or they've never encountered this situation before, you know, in similar situations or, you know, do you know anybody who's solved a problem like this? But we want to talk to them about what their strengths are. And if you're still coming up short, you know, ask them, what are your strengths? What do you do well? And sometimes clients have a hard time coming up with these things. But it can be a good place to start with self esteem building and self efficacy building and all that kind of stuff. Clients are always the experts on their own lives. They know themselves best, or they wouldn't be in this situation. They know they're depressed, or they know they've got generalized anxiety or the anxiety we we put labels on it. They know they need help. They know they've tried to fix it and it didn't work. Okay, you know, you're the expert, you've been living in that body for 3040 years. I've known you for 3040 minutes. So let's talk and you tell me about what works, what triggers all that stuff. We need to follow the client's lead with respect to information giving, decision making, care in general and the involvement of others. Yes, insurance companies want us to involve the family. Now it can be the family of origin or the family of choice, you know, whoever they consider their supportive people, not necessarily always blood relatives. But we want to follow the client's lead, how much involvement they want with those people. Do they want them in the session with them? Do they want them to have no contact? What things do they think are important in their treatment? And have clients define the goals that coordinate the practices of the health care team. They're going to be a lot more motivated to accomplish goals they define. And you're like, but I need them to do this thing. Well, then find a way dialectically to write their goal so it accomplishes your goal. And I've used the example before when I worked with people that were on probation and parole. They just wanted to get off papers. They didn't think they had an addiction problem. They, you know, didn't want to be there, but they were stuck with me.  My goal is for you to stay clean and sober. For you to stay clean and sober, or for you to get off papers, you have to stay clean and sober. So your goal is to get off probation. Cool. My goal is in part of integral to your goal. So let's just make that happen. Let's figure out how I can help you get off probation. And we would work together that way. I wasn't going to try to convince them that they had a problem and they needed to work on their addiction because they were in pre contemplation. That wasn't the place to be right now. Identifying concerns and needs is important. Initiate discussions in order to understand the client's perspective regarding his or her health and quality of life. You know, what may be intolerable for some clients may be kind of, you know, a better day for other clients. So what is your quality of life? What are you hoping that life will look like? What does a rich and meaningful life six months from now? Or even in the next month, what are you hoping is going to improve? What does a good quality of life look like to you? Clarify the hopes, wishes, preferences, strengths again, needs and concerns of the client from his or her perspective. So sometimes clients aren't going to want to do group or maybe they don't like reading. So we need to talk to them about what types of interventions, what modes work best for them, what they want to work on first, because most of the time when clients come in, they've got multiple presenting issues. So what do we work on first? What the client wants to work on? That's where we start. And seek to build the client's capacity or their ability to reach independence based on their goals. So we want to look at, you know, whatever this is you define as a high quality of life. So let's arrange your goals to build on one another to help you reach that higher quality of life. It also represents the client's community perspectives of health, goals and life, as well as their concerns when making recommendations to others. So we want to make sure that any recommendations we consider or make reflect what the clients and communities perspective of health and goals are. And when we say community, it can be culture. So if it's independence, interdependence, you know, we want to make sure that we're helping them achieve what's right for them culturally. Follow the client's lead when providing information or teaching what the client wants with respect to his or her health, illness or situation. And document the client or community's perspective with regard to health and quality of life, goals, wishes, choices and concerns. I'm working with a client right now who is Iraqi, and her goals are actually very much independent and less collective, more individualistic and less collectivistic. And her family is very collectivistic. So her family and her community of origin have different ideas and definitions about what she should be defining as her goals. So again, talking to her, if I would have just assumed that she was, you know, wanting to fit in with her culture of origin, I would have been going down the wrong path. So it's important to open that dialogue. We want to identify priorities for change or action when we're making starting to make decisions. What are we going to do first? Identify options from the client's perspective, you know, what things are here and from the community perspective, what is available to you in your community? Again, what's available in New York or Nashville or Miami is going to be different than what's available in Gainesville or Trenton or Lebanon, Tennessee. Act as a resource for clients in deciding care strategies by clarifying and providing information and teaching clients to say what they need and to respect what they think, to respect their own values and wants and needs. And we want to support them in that. And we want to act as an advocate for the client's values and decisions. Caring and service involve mean involving the clients throughout the caring and service process.   You tell the waitress what you want to eat. Same sort of thing here. We want to listen. We want to ask. We want to figure out what we can provide to them that is going to help. We want to respect and honor client choices and decisions, though they may not be related to the illness disease process or health services. And regardless of our own values, you may not agree with what your client's going to do. You may not agree with the decisions your client wants to make. But it's your client's decision. So we need to respect and honor those choices. And even if what they're getting ready to do, you know, they say you're working with the client on PTSD issues and they announced to you that they're getting ready to quit their job and do something else. Well, that's not really directly related to the PTSD probably. However, you know, it probably is going to impact treatment and a lot of other things. But we need to respect and honor the client's choices and maybe stop and talk about what is prompting you to make this decision at this point in time. And we want to use trust building strategies to develop the counselor client relationship. We want to demonstrate respect and value for clients by listening with openness and use positive language to discuss clients. Instead of we want to eliminate depression or using negative terms like the client is always irritable or whatever. We want to use positive language. The client seems to be the client's mood seems to be improving. Instead of the client is not nearly as cranky. Put a positive spin on it, use positive language, use additive stuff instead of trying to remove a problem or adding something. What is the client working toward and use the client's own words to describe situations? That helps because then we don't have to worry about is it too jargony? You know, what is going on right now? I'm depressed. I'm anxious. I'm this or that. Okay. You know, cool. Involve family and significant others as the client wishes and ensure that the client's goals are central to the coordination, continuity and consistency of care. So again, coming back to the client's goals, your treatment center, maybe a mental health treatment center. And you're working with the client on anxiety. Okay. The client's goals are to, you know, maybe improve her relationship with her, her significant other. And but part of that is also helping her deal with her anxiety and improve her communication skills. What we're going to frame that in terms of the things I think may need to be done. How is that going to help you achieve your goals? Evaluating outcomes is also important. We can't just start throwing the kitchen sink at people and go, Well, something here's got to work. We want to know what works and use what works with that client. So engage the client in evaluating care delivery and health related outcomes throughout the process. You know, when you do things, the next week when they come back, go, How did that feel? Did that work for you? If not, let's talk about why not? You know, maybe we need to scrap it and try something else. But we want to get their input throughout the process. We don't want to wait to the end and go. So did the last 10 weeks do anything for you? We want to get it throughout. Support the client if or when goals cannot be met. Sometimes you can't completely achieve a client's goal of 100% symptom remission or something. Demonstrate an attitude of openness and willingness to change in order to improve the quality of care from the client's perspective. So if you're typically a CBT counselor, and the client really needs something that's a little bit more humanistic in nature, you know, demonstrate a willingness to back off on some of the cognitive stuff and use an approach that's more conducive to that client's recovery, demonstrate a willingness to make referrals for stuff that you're not trained for and change care plans and practice approaches in order to improve quality from a client's perspective. So if they feel like things aren't moving very fast or fast enough, we can talk about things that might improve how quickly things are going. Successful implementation of client-centered care requires organizational and managerial support, though. Everything we've talked about requires that some of your billables be probably brought down a little bit if you're going out and doing outreach and advocacy. And that the management is willing to hear and act upon recommendations from staff that are based in client needs. We need to have organizational champions who are willing to stand up and go, let's, yeah, let's just take a step back here and see what's in the best interest of the client. We need to provide education and training for counselors and pretty much everybody on staff about how to show care, empathy, communication skills and even some dbt skills because sometimes clients come in and they're already emotionally dysregulated. So how can we help someone verbally deescalate a client? And we don't want to wait till somebody is like in crisis. If somebody comes in and they're already stressed out, a few kind words from the check-in person can go a long way. We want to provide care delivery that ensures continuity of care and continuity of caregiver. Have you ever worked in one of those places where the clinicians change over every six months? That's really frustrating to clients. So we want to make sure that clients can come in, ideally see the same caregiver through their entire stay and if they come back, you know, for another episode, the same therapist is still there. Now it's not always possible, but creating a positive work environment creates a situation where people want to stay. What's the benefit? Well, aside from reduced cost of training and everything, the client comes back and sees you again and they saw you last year. They don't have to tell their whole story again. You remember because you worked with them already so they can kind of pick up where they left off. If they start with somebody new, yeah, that therapist has the notes and the chart and everything, but there's that whole process of developing the therapeutic alliance and yada, yada, yada. It just takes extra time. So it's more effective, more efficient and more compassionate. If people can see the same person and there's, you know, continuity, we want to make sure that therapists aren't calling in and, you know, maybe they're there this week. Maybe they're not. That's not helpful. Organizational and unit policies need to be congruent with client-centered care and there needs to be a positive work-life environment.  That communicates an aura or an energy to the clients that says, these people are miserable. What can they do for me? So we want to encourage clinicians to recharge, to rebalance, to have a positive work-life balance. So when they come to work, they're energized and they're enthusiastic and they're compassionate, not burnt out. And we want to make sure that the organization uses outcomes evaluation. Yes, Jane may not have had as many billables as Susie, but how many of Jane's clients came out, graduated, completed successfully, and what was her client evaluation rating compared to Susie's? Were they the same or were they different? Maybe Jane spent a little more time and did more client-centered care. Key elements of a client-centered system include making your clients feel respected, making sure that they feel caregivers value their personal expertise. So we need to ask, what works for you? Do clients say they're listened to? And is there evidence of the clients or the community's view in the plan of care? And this is, if you're Jacob or Car for credited, most of this is probably already there. Humanizing the physical environment routines and the language of caregiving is also important to create a more humane and home-like environment. Let them have personal items and pictures and demystify routines if you're in residential. Let them have a little corner around their bed, for example, where they can have personal items. When they walk into your office, have pictures up. Don't have sterile walls where it looks, feels like they're walking into a cell. You want them to feel like they're walking in basically to a living room. So humanize the physical environment and provide freedom to choose the type of therapists they work with. Maybe they prefer to work with somebody of a different gender, you know, allow them the freedom to choose and maybe even where they sit. Not all clients are comfortable sitting like right across from you. Not all clients. So ask them what would make you comfortable. Values and beliefs of client-centered care include respect, human dignity, clients being the expert for their own lives, clients as leaders, not followers, continuity and consistency of care and caregiver, timeliness of care. So we don't want to do an assessment and go, okay, well, you can get started six weeks from Tuesday. That's not timely. And responsiveness and universal access. So when they start having problems, if they do, can we make referrals to other providers to help them meet their needs for medications or pain management or whatever it is. Core processes include identifying concerns and needs, allowing the client to make decisions and involving the client in caring and service.  Hopefully you don't have to fake that. If you do, you're probably already feeling burnt out. Decisional coaching means monitoring decisional conflict, which is uncertainty about the course of action and related modifiable deficits in knowledge, values, clarity and support. So we want to look at making sure the client knows where we're going and what we're doing and why we're doing it. And if they start going, I'm not sure what why are we doing this again? That's decisional conflict. We want to monitor that and go, Okay, let's step back and see the big picture. What's the function of this? How is it going to benefit you? We need to tailor decision support, tailor decisions to support needs. So whatever decision we make about the treatment processes that we're going to implement, obviously those are going to be designed around whatever the client needs. And if it's a client, for example, who lives in a rural area, you know, they may need access to some telemental health, because they can't get into the clinic every single, every single week or something. They may need written handouts so they can process it. They may need written stuff that is in bigger font or on the computer so they can blow up the font because they have some visual problems. So we need to look at what types of things we're going to do and what the client needs in order to implement those activities. And we wanted to monitor progress in decision making and decision quality with the goal being to help clients improve the decision making process and quality. So we want to monitor when we ask them to do something, they try it, we say, how did that work? Did it help us move forward towards our goals? If not, let's look at why. Let's adjust so we don't make that same mistake again. I don't want to keep giving you cognitive exercises if cognitive exercises aren't working for you. So we may need to change directions. We don't want to, you know, keep making the same mistake. Patient decision aids can be used to help clients figure out, okay, what tools do I want to use to work towards my goal? What's going to work best for me? So we want to use evidence based tools designed to prepare clients to participate in making specific and deliberative choices among healthcare options in the ways that they prefer. So they may want to go to counseling, but in what way? In group, in individual, by telehealth, what is it that they hope that they can achieve? So we want to use methods to help them make these decisions. We want to provide the information to them so they can make a reasonable informed choice. We want to provide information about whatever condition they have, the options for treatment, associated benefits, harms, probabilities, and any uncertainties. And this all goes in your informed consent. So that should be kind of a no brainer there. And help clients recognize the values sensitive nature of the decision they're making. You know, I can't make this decision for you. What recovery looks like for you, what happiness looks like for you is yours. So, you know, it involves your values, what's important to you, not necessarily what's important to me. And we want to clarify the value they place on the benefits, harms, and potential uncertainties of any treatments. So maybe they want to try acupuncture or massage therapy or EMDR or whatever. And all of those have a fair amount of research supporting their efficacy. And we want to figure out, are you willing to try those things? And does that fit with your values? Do you think that that will help you more effectively meet your goals? Other strategies we can use include describing options in enough detail that clients can imagine what it's like to experience that treatment. So if we're referring to acupuncture, you know, we want to help them understand what that might be like, because some people think acupuncture and they're like, oh, no, no, no. And other people are like, cool, let's try it. But we want to be able to explain to them what it might be like. And the cool thing with digital technology now is a lot of times you can have a video or, you know, something from a practitioner that shows them what a typical session in acupuncture looks like and answers some common questions. We can guide clients to consider which benefits and harms are most important to them. Is it more important to deal with this problem right now? And, you know, if we're looking at the benefits, one treatment may be less expensive, but it takes longer. And another treatment is more expensive, but you're going to get the benefits like right away.  And then we can provide structured guidance and the steps of decision making and communication of their decision with others that are involved in the process. So, you know, once they make their decision, how do we tell family? You know, is there something that we need to do? We need to role play this. So key concepts that we went over today, identifying concerns and needs for individualized, culturally sensitive and trauma informed care. We want to make sure that, and we're going to talk about trauma informed in a couple of weeks.  But we're also looking at cultural issues that may impact treatment, what they need, what we need in the environment to make them feel comfortable. But we also need to consider the fact that clients may have been traumatized. So we do want to be able to provide trauma informed care. So client centered care really involves, really necessitates being aware of the impact of that trauma can have on clients. Now, do all clients have trauma? No. Do all clients who have experienced situation experience it as a trauma? No. But we do need to be aware of it and sensitive to it. I worked with one clinician who at the end of what one of the groups that he did one of his groups, he always turned out the lights, lit a candle and played some music and encouraged clients to meditate. It was very ritualistic, which was problematic for a couple of clients who had had situations that that that triggered a prior trauma. One was ritualistic abuse and one was a rape episode. So we needed to talk about what modifications can you make? But being aware that prior traumas may be triggered and the client may not be willing or ready to work on it or even really acknowledge that trauma is impacting them right now and that's okay. But we don't want to retraumatize them. And another way we can retraumatize them is by telling them what to do by not having care and compassion by leading them around. So they come in and we're just like, okay, we will tell you what to do. We're in control now. You have no control. And that's traumatizing to people who have been victimized before. We want to seek to clarify the hope's wishes, preferences, strengths, needs and concerns of the client from his or her perspective. So, you know, we can make all kinds of assumptions. Remember when we talked about cultural competence, being aware of different cultures provides you a lot of generalizations and a starting point. But you don't know how a culture aided or bicultural anybody is. So you have an idea so you can understand some of the concepts that you talk about. But in order to understand the client's perspective, you have to ask. We want to seek to build the client's capacity to reach independence based on their goals. So whatever a rich and meaningful life looks like to them and how can we help them achieve the goals that will get them there. We want to clarify the client's wishes and follow his or her lead in determining the involvement of others in their health care and represent the client and communities perspective of health, goals in life, as well as their concerns when making recommendations. So knowing what's available in the community, knowing what the community usually responds well to. Making sure that your lobby and your practices represent the community where you operate is really important. Follow the client's lead when providing information or teaching that the client wants with respect with his or her health, illness and situation. So if they want to tell their family a bunch of stuff, well, great, you know, let me help you facilitate that if they don't want people to really know much. All right, we're going to follow the client's lead. Same thing with accessing referral resources. They may be gung-ho and ready to contact everybody and his brother or they may be like, yeah, I know those resources are out there, but I'm just not ready to take on one more thing right now. That's okay, you know, let's follow their lead. And we want to teach clients in ways that are relevant to his or her personal reality.  We want to help them learn in ways. We want to give them examples. We want to help them apply the stuff that they're learning to things that are relevant in their life. Document the client's perspective with regard to health, quality of life, goals, wishes, choices regarding information and concerns. So this again should go in the informed consent and the orientation process. We want to make the client the key decision maker in planning care and services. They are the one who decides this is what we're going to do here. We can provide a menu of options, but the responsibility is on their shoulders for making the decision. The responsibility is for them to identify priorities for change or action. And they may not know which ones they may be like, I don't know where to start. So we can provide insight. We can be the catalyst. We can help them figure out. But ultimately they need to decide what the priorities are. We want to clarify and provide information or teaching that clients want and say they need with respect to their health illness situation or possible health strategies. And one example, when you're working with somebody who has an eating disorder, a lot of well meaning clinicians may start out by trying to educate the client about why eating a certain number of calories is so important and, you know, different nutritional strategies and yada, yada, yada. And the client's just totally tuning them out because that's not what they want to hear right now. So we want to figure out what does the client think they need? What kind of information do they need from us? We don't want to just assume that they have a knowledge deficit or that they want knowledge about something. We want to acknowledge the client's expertise and encourage clients to share their knowledge and skills. We want to demonstrate respect and value for clients by listening with openness and use strengths-based positive language and the client's own words to describe situations when you're writing that integrated summary as well as when you're doing the treatment planning. So try not to get it too jargony, try to put it in the client's words. One of the things I do with my clients is I actually have them write their own treatment plan. So we do the assessment, we identify kind of what their overall goal is and maybe the three things or four things that they think they need to work on to achieve that goal. And then for homework, I have them brainstorm what it is they know about each one of those sub-goals, what information they still need, what skills or tools might help them achieve that sub-goal. And when they bring that back, you know, that becomes part of the treatment plan. And, you know, in that way, not only is it in the client's own words, but it's in the client's own handwriting. And then at the end of each week, we do treatment plan reassessments and I have them look over their treatment plan and identify which sub-goals they've accomplished or what they've done for whatever they've worked on and identify any changes that may need to be made. And then we talk about that. So again, they're doing a lot of the writing there because I want them to learn how to set goals and achieve them. And it's also when you're doing IOP treatment and you've got to do 16 treatment plan reassessments every week. It's also just a time thing, but it does empower and involve the client more. We want to engage the client in evaluating care delivery and health related outcomes by using specific processes and evaluations that provide continuous feedback from the client's perspective about the quality of care. So each week, how's it going? Do you think we're making progress? Where are you on a scale of one to five? You know, whatever it is so you can feel, get a sense of where the client feels they are because if they don't feel like they're making progress, their motivation is going to start to go down. Once their motivation starts to go down, their engagement goes down and before you know it, they've dropped out. So if we notice that they feel like they're stuck or they've hit a plateau or something like that, if we're continuously monitoring, we catch that early and we say, okay, what can we do to ramp this motivation back up and kick this puppy back in gear? And we want to demonstrate an attitude of openness and a willingness to change in order to improve the quality of care from the client's perspective. So we may need to learn. You know, if you have a client that comes in and they're from a different background, and that's okay. You know, it's at this point, you can say, you know, I'm really unfamiliar with your culture. Can you educate me? Yeah, like when I worked with the Hare Krishnas, I was very upfront with the people that came in. I'm like, I know very little about the Hare Krishna religion. Can you help me learn what's important in your life, what values are important and, you know, learn a little bit more about your religion and spirituality. And, you know, so that demonstrated that willingness for me to change, for me to use new tools that I hadn't accessed before, or new approaches in order to provide culturally responsive, culturally responsive client centered care. Okay, so real quickly, because we still have a couple minutes here. Let me see, can I make this get bigger? So client centered care is an approach in which clients are viewed as whole persons, not merely delivering services where the client's located, and it involves advocacy, empowerment, and respecting the client's autonomy, voice, self determination, and participation and decision making. Reflective practice, just to review, is an ongoing process that the counselor utilizes in order to examine his or her own practice, evaluate strengths, and identify ways of continually improving practice to meet client needs. Things that you can do is question what you learned, what practices you can share with others, what's been most useful in this particular scenario. Caring and service includes all of the following, involving clients throughout the caring and service process, acknowledging clients expertise, respecting and honoring client choices and decisions, even if they're not related to the illness or disease, or ones you would particularly make. Use trust building strategies to develop the counselor-client relationship, demonstrate respect and value for clients by listening with openness, use positive language to discuss issues with clients, and use the client's own words to describe situations, involve the family and significant others, and assure that clients' goals are central to the coordination, continuity, and consistency of care. Core processes of client-centered care include identifying concerns and needs, allowing the client to make decisions, involving the client in caring and service, and an emphasis on the evaluation of outcomes throughout the process. We want to make sure we're being effective. Decision coaching is used alone or in combination with patient decision aids, and the strategies can include monitoring decisional conflict, remember when the client is starting to go, why are we doing this again? They're having conflict about making the decision to implement or go through with a certain strategy. Tailoring decisions to support client needs, and monitoring progress in decision making and decision quality. So even after you make that decision, going back and looking at are we still motivated, was it the right decision, and are we headed in the right direction? Evaluating outcomes includes engaging the client in evaluating care delivery throughout the process, supporting the client if or when goals cannot be met, utilizing specific processes throughout treatment that provide feedback from the client's perspective, demonstrating an attitude of openness and willingness to change, and changing care plans and practice approaches in order to improve the quality from the client's perspective. So we need to be flexible. Identifying concerns and needs includes initiating discussions or strategies in order to understand the client's perspective regarding his or her health and quality of life. If you're working in a community, you can even do focus groups here to understand what the community values. Seek to clarify the hopes, wishes, preferences, strengths, needs and concerns of the client from his or her perspective, and build the client's capacity based on their goals. Clarify the realities of the illness or condition with the client and motivate him or her to take the lead, clients taking the lead again in determining the involvement of others in their health care. Represent the client's perspective of health, goals and life, as well as their concerns when making recommendations. Follow the client's lead when providing information or teaching regarding what the client wants with respect to his or her situation, and document the client's perspective with regard to health and quality of life. Key elements of a client centered style or system, do clients feel respected? Do they think caregivers value their expertise? Do they feel listened to? And is there evidence of their view in the plan or program of care? Making decisions includes having the client be the key decision maker, identifying priorities for change, identifying options from the client's perspective, acting as a resource for clients and acting as an advocate for clients in the community. And finally, patient decision aids include providing providing evidence-based information about a health condition, the options associated benefits, harms, probabilities and scientific uncertainties, so you're informed consent. Helping clients recognize the values, sensitive nature of the decision and clarify the value they place on the benefits, harms and scientific uncertainties and providing structured guidance in the steps of decision making. So providing information about the treatment that we're looking at, helping clients look at their values and does it fit with this treatment decision we're getting ready to make? And then helping clients figure out how to make that decision, you know, how do I figure out if this is right for me? All right, thank you for being with me today. Are there any questions on that note? I will see you guys tomorrow, same time, same station. If you enjoy this podcast, please like and subscribe either in your podcast player or on YouTube. You can attend and participate in our live webinars with Dr. Snipes by subscribing at allceus.com slash counselor toolbox. This episode has been brought to you in part by allceus.com providing 24-7 multimedia continuing education and pre-certification training to counselors, therapists and nurses since 2006.


Hi everybody it's Sam from Mixed Up Craft, thank you for watching today so I need to start making some gift bags for Christmas. I've already done the pop-up one with the pop-up piece on the front but I want some bigger gift bags so I do like to make these. So I've got this one here which is a slightly different size to what I've done on the channel before. I always try and make sure there's some kind of difference in the sizes but I have a whole playlist up here of gift bags and specifically flat pack ones which is what this one can be. So I've used my new papers which I'll show you in a moment and I've just already tied it together there with the bow around the handles but yeah just to show you really how it will come together but I'll show that when we do the make the next one but they're gorgeous papers. It's a really nice style, I like the handle with this one as well and yeah that's all there is to say so let's start making it. Okay so I just thought I'd show these stamps again because I shared these in my last what did I get these are bi-simply created which is part of craft label and they're only a pound they've got lots on their website so it's all linked below but that's what I've used I've got that one underneath the paper pad for the tag and these ones are slightly bigger ones and that's the one I used on the recent selection boxes I've made and these are only £1.25 now I do have a discount code as well so by the time you add that they're an absolute bargain so have a look check it out it's a great website there's loads of other really good things on there and they've actually got a big clearance section as well at the moment so I've got my ribbon that's the one I'm using today it's actually the droid to the world I used the piece on earth and then the droid to the world I'm using this one in bossing powder and it's the rose gold and then I've already got my handles because I need to die cut one more which I'll show you in a moment so I'll give you the measurements for those but these are the card making magic a5 oval dies really handy ones to have on your and then this is the paper pad so it's the winter sparkle and it's beautiful and I've chosen so I've got that paper on this bag you see the some of the stars got glitter on them for this one I'm using two sheets here so you do need 12 by 12 to make this bag but you could take the design of this bag and put it into the I don't know I think I've got about probably 30 plus gift bags you know so you can lots of people go on to the playlist take bits from the tutorial they've watched and then kind of mix them with other things so check that out but you'll see there I've already heat embossed the droid to the world and these tags so I've taken this one as well again this is what I shared it's also part of that collection and you get 12 printed tags and I just use those so everything matches so let's start scoring and then I can go through these bits with you in a moment so it's a deconstructed one which is what I like to do when I make bigger gift bags so here I have two pieces now that the slightly one side is slightly shorter than 12 so it's 12 inches wide so if you've got directional paper this is gorgeous this one just make sure it's the right way up at this point so that's your 12 inch width then when you pop it on its side mine's 11 and 5 8 now the reason I've done it at 11 and 5 8 is because I wanted to cut it so it finished with the top of these this strip of words here because it kind of had a bit of just some you know like a quarter it was like that on the top and I just think it didn't look so good so I've just trimmed that off so that's why mine's that height yours can be any height you want so if you want it to be the full 12 keep it at 12 but you will have to change the side pieces but you can come down as short as you want so you know you could do 9 8 so if you've got something specific to go in the bag this is when you can change the height I'm gonna score it 3 inches because that's my that's going to be the width of the bag so 3 inches is the base so when we fold this so you can get more of an understanding that's now the front of the bag that's the base that's what I mean this height you can reduce down or slightly increase it you might even have a 3 or you know bigger that's how you would do it so you want to do that on two pieces so again I've already scored this one three inches down the side there now if you do change the height of yours then you'd need to change it on these pieces as well but you want to keep the width the same so these are two pieces of 4 by 11 and 5 8 ok along the 4 inch side you want to score it half an inch and at 3 and a half and that's our tabs that we're going to be using to stick them to the main front and back so again half an inch and three and a half and then you're just scoring along the long side again at 3 but whatever height you've decided here you know yours might be obviously shorter so two pieces of that size two pieces of the 12 by 12 then for the handles I'm using these dies here I just give you the measurements so the this is to make the frame but also to cut my handle but once you see what I'm doing you can use it you can do any size you could also do square circular triangular if you wanted to it's in telepathy but the middle one is four and three quarters and then the outer one is five and three eight and the height is two and a half and then about three inches okay now I'll actually die cut them top one is in the rose gold and I die cut two more in white I'm starting to get these in the cloud loose that's a nice strong handle so that's what I'll do in a moment is I'll cut that one and then I'll cut two more in white cards starting to stick them together okay so that is all of the scoring and now you just want to burnish those score lines okay so with these two pieces here you just want to do a little bit of cutting so along the bottom here you want to cut up both the score lines and then remove it but take a little you know wedge off the next piece so you just cut in on an angle there like so you'll also want to take a wedge out of that so now I've shown you that one I can just come into this one slightly off there and just don't matter if they're even a bit wonky it all gets hidden but by taking a bit off the outer edge it just stops any of that hanging out the sides and then I'm also just going to take a little bit off of the top like so same as you know same way I do all my gift bags and then again I'm just going to do this one okay so we've got our two side pieces and then we've got our front and our back if you are going to put heavier things in I always say reinforce the bases with some heavier weight cardstock or even some like grey board just to really give it some strength now we just want to start putting it all together so I'm going to grab one of my side pieces here I'm going to use the calau so take a little bit slightly longer to dry just because I'm using this shiny surface card or this coated is probably a better word but I'm just going to pop it down there and then it does give me that wiggle room always line up your base score line when you're doing your gift bags because you can always trim if anything's a little bit off at the top you'll see there that lines up nicely and I'm just bringing it right up to the score line so that when I go to fold it this will all still look nice it's not going to bend or anything okay so that's that one there I'm going to just carefully flip mine over like so and then I'm just going to fold that bit back over if you do that while the glue is still a bit wet you can see that I've got a really nice side to the bag and that's obviously what everyone's going to see then I can move along to this one and again I'm just going to run my glue all down that tab and then again I'm going to focus on that base score line at the bottom of this side piece here I like doing deconstructed bags even if I'm making a smaller bag and I can fit the side and the front all on one piece of cardstock I still like to sometimes deconstruct it because I like to have the contrast of like the cardstock and then the pattern paper or maybe two patterns that kind of clash but still work well so yeah it's always a fun way to do it and you'll see all them on that playlist okay so now we want to do the handles because I have to rise off forget and I'll carry on so you can do this on these pieces before you attach them to this but it really doesn't matter either way but with the smaller of the oval shape here so actually I'm just going to I'm going to just die cut my two I'm going to die cut the handles quickly because then I can take this apart and I don't need to worry about matching it up perfectly again so I'm going to get these all die cut so one in mirrored card and then if you want to make it stronger to the white okay so I've just done that one then I can take that smaller off whatever size you're using you just want the smaller one and I'm just going to use this now to draw around so I'm just going to pencil and I want to pop it in the middle of this 12 inch width piece here so I'm just going to bring in my rude I think I write that it was roughly three and five eighths from each side so I'm just going to bring that one over a little bit that way three and three about there I'm kind of happy with that I think I'm okay so and then I want to make sure that I've got kind of halfway or half of the oval in this side here the other half out you could come up higher if you want totally you know I'm shooting normal so you come in a much much lower as well and then I'm just drawing around the inside there now you could come you know and do your handle quite far in so just have a little play around now I'm just going to cut this one you don't need to worry about the other one because you will use this as a template for that next piece so just then scissors and don't worry if you're not too neat you're gonna hide it it really yeah just don't worry yourself because I said it's all gonna get hidden so I'm just going to be carefully so and then I'm just going to get my other one just lay it underneath and just line it all up perfectly that didn't just sit it in that section there quite nicely and then just going to draw around it again but that way you know they're both gonna line up and then just cut that second one out okay so now we can carry on sticking it all together and then we can have the handles you have the handles now if you want once you see how I do it but I'm just gonna do it all together so I'm gonna add my glue now to this side again just line up that base score line just line up that and then all I'm gonna do is fold that piece over bring this one and add your glue by doing it this way you can ensure it's gonna lie flat as well because if you don't want them to be fold flat and you want them to stay as a you know a solid kind of gift bag but you maybe want to make a few and store them away as I say in a lot of my videos don't stick the bottom down when I go to do it and just leave it like this with the handles on and you can see how easy they would be to store away because you know you might want to start making bags for birthdays next year and things like that or you might be planning for with all the time that a lot of us have had now to be prepping all of your craft fair things for next year so there we go now I'm gonna add the handles and all you want to do because you've got the larger one on the handle to make the handle it will sit over the piece that you've cut perfectly that's what you want to do is just line it up I need to bring it up just remember do you want to cut on the the outside not the inside so you can see there where I've cut around the inside you actually wanted to do the outside so I'm just lining my back up and I'm just going to draw around outside now when we lie that down you see it will stick over like so I'm just going to trim a little bit away there but you want to be cutting on the outside and I'll put a little or draw around the outside so I'll put a little thing up when I get to that bit so just to keep mine tidy and it just shows you can still cut this bit away even when the bags together but I'm just going to just cut that piece out okay so just done that now I can grab my glue and I'm just going to put a bead of glue that's the width of your handle okay so just and then you can sit your handle and the inside will match perfectly with the curve of the inside which is what I should have done so it all makes sense if you want to flip it over you can see inside there it all lines up perfectly so you could have a thicker handle as well I mean you don't have to do it just by using the next size up you might want to go up a few so you've got a much thicker handle like I said I like the delicate look of the thinner ones and I'm not going to be kind of carrying this a long way it is more of a decorative feature rather than a practical feature but you can easily make it wider okay then I'm just going to do the other one on the back okay so that's that all done now if you wanted to you can cut another one which I may well do in white and then stick it on the inside here so it covers up that join and it will also just add a little bit more strength so I'm just to cover up so if you are you know worried that maybe yours is a little bit messy then that's a good way to disguise it all but that's all done so then you want to decide on the front and the back maybe I'll go for that one yeah we'll do this one is the front so I'm going to pull this up this one's going to be the back so this one's going to go down first and what I might do actually is just take I just fold that one inside so you can see what I'm doing I'm just going to take a little wedge off so whatever one you decide to be the back just take a piece off of either side there just so they all fold in I always like to put my side tabs in between the back and the front and then I'm just going to cover it now this glue as you all know if you use the Kalao clear or purpose it dries very very stiff so it becomes it just strengthens everything so although this is a paper by the time this has the glue it will feel like a card stock but this is a good time to reinforce it now by adding some grayboard in between these two pieces so I'm just going to stick that one down and that one so I'm just going to add a bit more glue like I said the good thing with this glue as well you do have time and you can reposition as well so there's some glues once you kind of you know they stick together that's it you're locked in it's not the case of the clouds it's a really nice glue and because it's a solvent base it doesn't warp your card stock either so you can cover large areas and then I'm just going to go inside there and just make sure that's all stuck down okay so I said paper is perfect if you're adding clothing lightweight things if you're going to start using maybe bottles you know small beer bottles things like that I would definitely recommend this to be more of a card stock but now to make it full flat I'm not scoring this I do have lots of full flat gift bags I've got a playlist just for fold flat where I do the scoring but because this is quite well it's still a card stock but it's not too too thick I'm just going to push the sides in and then I can just work my way down so like so pushing in keeping everything all lined up you can see it all lines up still on the front and you'll get to a point where you'll meet down here see the triangle and then you can just fold it away from you it's just a quick cheat way to make a full flat gift bag as long as everything lines up and you stuck everything down but that again that's completely optional you don't need to do that but if you do want to make them stick them down you can still store them away now you can see and then you can just go in and kind of burnish you know those kind of pieces if you pop your school bent folder inside there so you go on the top and burnish you might get marks on your nice card stock but if you go in there it will just help it to all kind of fold like so and then I'm just going to add my lovely ribbon here again I can't remember where this is from I always kind of pinch ribbons from other kind of packaging that people give me or it could be the end of a roll that I had but I'm just going to tie off a knot there and then with this one so I've got one in the gold or the rose gold of my double-sided tape and I'm just going to because I want to have them kind of overlapping each other but I want you to be able to see a little bit of each of the colors so I'm going to line up the hole there and then lift it slightly so you see a little bit of that gold there and then I've just cut this one using my oval dies and I'm going to have it so you can see it along the bottom there so that one I used a little bit of foam just to add a bit of dimension so I'm going to pop a bit of foam just on the top half there just line up the hole a little bit of showing on the bottom and you've got plenty of room there to be able to write something on the back and now I can just thread it through here so this is all ready for me to add my gift I will just wrap it in some probably try and see if I can get hold of some cream tissue paper and now I can just tie a nice big bow and then another little extra is I just cut this circle here if you want to get a similar size to me this is about two and a half and then I'm just going to eyeball this but because I've got the scallops I can kind of work it out I'm going to cut it in half and then I'm going to cut it in half again so I've got four kind of quarters there segments and then I'm going to stick them you can do it on the back as well but I'm just doing on the front on each of the corners so I'm going to stick one there one there one there and one there again completely optional but it does just add a little bit more of a luxurious feel to the gift bag okay there's the finished bag I need to kind of position that a bit more so it's kind of in the bag space rather than sticking out but it gives you an idea anyway and then if I just pop my bag in there I can just pop that back out you can see there it looks lovely really really yeah very good so check out the playlist I have loads of other gift bags on there and that you'll start to see a lot more kind of packaging ideas now because I need them so I only try to really share things I genuinely use myself and that I need I think that's also good for you guys because you know that they are going to work so hopefully you enjoy all the future ones if you haven't subscribed I'd really appreciate it if you did just click on my face that should come up here and along with some other tutorials I'll put the playlist for the fold flat in case you missed it so it'll probably be here just click on that one and then I'll put another nice bag of some kind there as well so thanks for watching and I'll see you all again very soon bye


What's up everybody? Jason here for JasperJasperace.com. 20-22 tops, gilded collection baseball, just sold out three box breaks, sorry. Number five. And again guys, third total spots, all teams in, everybody gets a random team in MLB. Here we go guys. Roll. You got a four and a six for 10 times, good luck. One, two, three, four, five, six, seven, eight, six, seven, eight, nine, 10. 10. Arthur, Donna Harry. 10 times. One, two, three, four, five, six, seven, eight, nine, 10. Marlon's down in the Guardians. All right, so 10 times, 10 times. Arthur the Marlins, Robert the Red Sox, Anthony the Angels, Steve Law with the Royals, Mark with the Pirates, Yankees, Rob with the Rays, Mark with the Giants, Rob with the A's, DMACC, the Cubs, Dan with the Rangers, Robert Mancini with the Twins, Mark, Dodgers, Phillies, Braves, Anthony with the Orioles, Mark with the Astros, Harry with the Blue Jays, Mark with the Tigers, Harry with the Rockies, Mark with the Poggers, Devon with the Mets, Michael with the Cardinals, Robert with the Nationals, Michael with the Diamondbacks, Mark with the Mariners, Rob with the Reds, Chad with the Brewers, Rob with the White Sox, and Harry with the Cleveland Guardians. All right, if anybody wants to trade, trade windows open, and then let me choose the last stack we're gonna use here. Randomize this 10 times. One, two, three, four, five, six, seven, eight, nine, 10. We're gonna go with two. Stack two is what we're gonna use here. Three will be for the last one. All right, so this is Brew for Trade, O's in the Block, Marlon's for Trade, Guardians, Rockies, Blue Jays up. If anybody wants to trade amongst each other, because like I said, I mean, unless there's a specific team you want, if you don't see it listed, it's most likely not being traded. That's pretty nice. All right, you wanna accept that trade, Harry? If not, I'm gonna close it. All right, guys, no trading. Stick to what you got. All right, here we go, guys. And again, this was stack two. Three is the last one there for number five, or number six, I should say. I think this one has an extra card, too. All right, Tom Glover in the 99. Boba Shet to 99. Ernie Clement, blue to 50. And a Jake Berger for the White Sox. So Rob with the White Sox, Cleveland, Harry. Try to trade, couldn't trade Mojo. And then Ernie Banks for the Cubs, going to DMACC to 50. And the Big Herb, Frank Tom is 65 out of 90. White Sox going to Rob. No, Charles. The Chasing History LeBron James is just a repack product. And I think some of them are autoed, some of them are not for the Instagram, if you're talking for the personals. But if you look at the sell sheet, you'll notice some of them are autographed, some of them are graded, some of them are raw. But not all of them, buddy, no. I think the main chaser out of that product run is basically a huge LeBron. I think it's out of 23 autographs to my 2012 product upper deck. But there's like a Curri Auto in there that's not graded, that's pretty big, you know. There's a Karim 101 Limited that's non-graded, but not everything is graded, man. It's a mixture of graded and non-graded. And some of them are auto, some of them are not as well. All right, Charlie Blackman, Edward Cabrera, and Whit Merrifield for the Kansas City Royals with a Josh Lowe for Tampa Bay, gonna rob. That's number to 25. KC, though, that is Steve Locke. Yeah, it's a fun product, man. I mean, I didn't get to rib any yesterday, but I think for the most part, since it is a Sapphire edition, you know, the probably least amount of heat you'd probably get out of there is like a $250 card, maybe $200, at least. Some of the bigger cards are probably like $1,500 to $2,000, so definitely worth it. 10 out of 10, Mike Schmidt for the Philadelphia Phillies. Going to Mark. Last one here, folks. Come on, UC. There it is. Ozzie Smith, Stan Musil, Eloy Hemenez, and Ereddy Jackson to 10. Another one for the White Sox, Rob. All right, last one here, folks. Good luck. And is that another Mike Schmidt? Wow, it is. Out of 99 this time. Look at that. And there you go, guys. Another one of the books. Number six is in the store, pretty much sold out. We'll run it back as soon, guys. Jaspy'sCaseBricks.com.


Here's Ugarkovic, Bakus with Troisi, who lines it up and drills it into the bottom right-hand corner. Barely four minutes on the clock.  No pressure on Troisi, time to receive, turn, set the ball and balance. And there is no saving that. It's a ripper from Troisi and a good start for the Wanderers. Straight into the feet of Ugarkovic again. A little touch, they're in behind them here, Rodwell. And that's two. And Rodwell gets his first goal in A-League football. And they're doing it without the ball, but they're doing it in style. The Western Sydney Wanderers, two goals in eight minutes, and they have stunned Melbourne City here. Delightful from Petrados. Raspin finished from Rodwell. It's a brilliant start for the Wanderers. Down the left-hand side, dangerous ball in. And Galloway is there, but I think it's an own goal. Jimmy Petrados may have had the final touch. Galloway not celebrating three goals in 15 minutes. And the shootout at High Noon is on at Amy Park. Light blue pylon in front of the Wanderers goal. And two-one, this could be anything today. Happy New Year. Emerson's ball in the head-up. Who continues his incredible goal-scoring record against Western Sydney. McLaren is back. And we're all square at Amy Park. Melbourne City, two. Western Sydney Wanderers, two. McLaren's third of the campaign. Immediately, right up the other end with Ogawa. He hit the post in the first half. He shoots. It's a great save from Glover. And Rostin Griffiths turns it behind. It didn't look like it was all that promising as his tillio. On the left foot! What a strike from Marco Tillio. It's like reversing doors from the first half, where Western Sydney Wanderers taking the game to Melbourne City. But half a chance at the other end. And the home side are in front for the first time this afternoon. And Hemed coming into the game. That's brilliant experience coming in. Look at this. It's Ogawa. With the finish. And the flag has stayed down by the looks of things. Melbourne City can't quite believe it. And Kajiro Ogawa has his first goal in a league football. And it was all so simple.


Hello and welcome back to the craft box. My name is brain and today we are in the arena Which only means one thing. It's a bit. No, it's not a PvP video We are going to be doing some more Beast Moon completionist series today We're gonna start off by upgrading our tier of balance cyclops to tier number two Which means we get two max battle cards, which is dope Actually wait no wait. We're in tier two three max battle cards. So yeah, that that's what we get We're not gonna upgrade the levels, but we also get a badge for that as well Hopefully should be cyclops tier two technically or cyclops to yep balance cyclops to boom. There we go We are also going to go over here Craft not one of those we're gonna buy The only problem is I don't have enough Lunari to do all of this So, um, you know, we are gonna craft a couple of these we're gonna get the morbid one Which is the start of the death Death tree for crafting these and I think we can get the simmering which is obviously fire We're gonna get steady which is balance. We might as well just get all of the first tier ones I think it's probably the best. I think that is it because what we had I Don't know. I don't know is that it could be it may not be I could be missing one am I missing one? Let's find out is brain missing one. It doesn't look like it No, unless it's on the first page devastating deathly that one. No, no, we didn't miss one. Good job Let's go craft these up. I've also got 36 Lunari left.  I need to remember which one we've already got life. We've got Storm we've got ice we've got And myth we've got as well, which is that one morbid is one that we're creating boom. There's morbid, which is the death obviously What else what else is there there's simmering, which is the fire one and Steady, which is the balance one and that means we've got all of the first tier ones, which is dope So if we go into our backpack, obviously, we have The blooming which is life blustery which is storm brisk, which is ice. We have the Morbid which is death the first death one looks pretty cool already like not gonna lie looks pretty dope We also have the simmering and the steady and we also have the Other one which is The infamous which is there that's Smith one. So yeah, that is where we're gonna end off today We will be getting some more. There was a stream as always When the Beast Moon of Hunters out, I always do a stream of the Beast Moon hunts So if you missed that go and check that out because we had a lot of fun did a lot of stuff We got a couple wins couple losses, but you know, that's all that matters. We got them wins badge check We're currently at seven of six sixty. Sorry. We've got two Cyclops, which we got one today two Ninja pigs And then we're currently up to 16 of 25 matches one So we're kind of slowly getting there. Um, but yeah anyway Thank you for watching remember to like and subscribe before we subscribe press the little bell So you know exactly when I post another video and remember to craft outside box