Therapist's Guide to Clinical Intervention - Sigmund Freud

D. Feelings of low self-esteem and unworthiness can lead to withdrawal and refusal of
invitations to be with other people and being involved socially.
This issue is just as important for the caregiver as the chronically ill individual. Their world
has been radically decreased. Therefore facilitate development and utilization of a support
system. Also, facilitate identification of options and the setting of realistic goals. Lastly, recognize
that isolation and withdrawal may be a consequence of depression, fear, or rejection
(real or perceived).
8. Death
A. Facilitate acceptance.
B. Recognize that the individual may vacillate between grief stages.
C. Emphasize being in the here and now to maximize quality of life.
D. Facilitate the individual to concentrate on living the life they have. Initiate
conversations/discussions about life to promote living life to its fullest.
E. Support the individual in accomplishing important and necessary tasks and to talk
to family members/partner and other significant people in their life.
F. Facilitate problem solving and resolution of practical issues which can
contribute to their investment in living and decreasing a preoccupation with
death.
G. Facilitate clarification of priorities and values:
1. Identifying the most meaningful aspects of life
2. How does the individual want to be remembered.
3. What is important for them to take care of.
4. What are they able to let go of.
5. Facilitate exploration of beliefs about death and life.
6. Clarify philosophical and spiritual beliefs and resources.
7. Facilitate clarification of what gives them both strength and comfort.
8. Facilitate and support grieving.
This has been adapted and summarized from I. Pollin & S.B. Kannan (1995). Medical
Crisis Counseling, New York: Norton.
DEALING WITH THE CHALLENGES OF
LONG-TERM ILLNESS
1. Confronting your medical crisis: Recognize that you are not alone
A. Learn skills to help you effectively cope. Instead of the goal to be cured, how do
you learn to live with it and improve your quality of life.
B. By confronting the illness and associated fears, you acknowledge what is
happening and how it affects you. This is the path necessary for problem-solving
how you will live with the illness. Every experience you have becomes a part
of you.
1. Acknowledge it
2. Accept it
3. Learn how to cope with how it changes your life.
4. Learn to cope with how it has changed and is still changing you
Dealing with the Challenges o] Long-Term Illness 151