Therapist's Guide to Clinical Intervention - Sigmund Freud

138 2. Assessing Special Circumstances
C. Chronic/acute pain
D. Physical limitations
E. Continued medical treatment with associated physical recovery
1. Invasive procedure(s)
2. Experimental procedure(s)
3. Rehabilitation
F. Time that it takes to achieve stability where further procedures are
not anticipated and the person is in a state of true adjustment in the
recovery process
G. Time that it takes to heal (often someone who is released from
medical treatment is in the initial stages of healing; healing can take
a long time)
H. Effects/risks of medications
1. Dependence
2. Used as the only intervention for pain and acute anxiety
management
2. Physical status affecting emotional and psychological
functioning
A. Depression/anxiety/stress may be associated with the following:
1. Losses
2. Changes
3. Adjustment
4. Chronic pain
5. Continuing medical treatment
6. Medical instability
7. Rehabilitation
8. Decompensation (feared or predicted)
B. The body may be depressed just because of what it is going through and
continuing to endure resulting in
1. Fatigue
2. Low tolerance
3. Stress/difficulty/pain associated with normal movement
4. Decreased stamina
C. Ongoing medical treatment may present the following issues:
1. How functional will the person be?
2. Will the physical integrity of the person's body be maintained?
3. Identity issues: "How have I been changed"
a. Self-awareness
b. Other's reflecting a change in personality/mood
3. Role of depression and PTSD
A. Depression
1. Decreased energy/fatigue
2. Sleep disturbance
3. Mood vulnerability
4. Increased potential for illness (people who are depressed are ill more
often)
* Recovery is a lot of work. Depression slows the process, but it is also a normal part of
adjustment.