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Facing Life & Facing Death – Counselling for Cancer and other life threatening illness. Presented by Stephen Quinlan And Juliette Kalifa. Stages and cycles. Diagnosis Treatment Recurrence Recovery Palliation Bereavement. DIAGNOSIS: “This could kill me.”. How / when May be a process

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facing life facing death counselling for cancer and other life threatening illness

Facing Life & Facing Death – Counselling for Cancer and other life threatening illness.

Presented by

Stephen Quinlan

And

Juliette Kalifa

stages and cycles
Stages and cycles
  • Diagnosis
  • Treatment
  • Recurrence
  • Recovery
  • Palliation
  • Bereavement
diagnosis this could kill me
DIAGNOSIS: “This could kill me.”
  • How / when
  • May be a process
  • Shock
  • A line is crossed
diagnosis client tasks doka
Diagnosis: Client tasks - Doka
  • Understanding the disease
  • Examining / maximising health, lifestyle
  • Maximising strengths /limiting weaknesses
  • Developing coping strategies
  • Exploring effect on self & others
  • Ventilating fears /feelings
  • Accepting / incorporating present reality
diagnosis 3 stages holland
Diagnosis: 3 stages - Holland

1. Denial , Disbelief

2. Turmoil

3. Doing

diagnosis therapy aspects
Diagnosis: Therapy aspects
  • Helping client’s struggle with uncertainty, anxiety, ambiguity.
  • A problem to be solved.
  • Explore coping styles.
  • Identify supports.
  • Clarify client choices.
  • Develop strategies for dealing with changed self image / interpersonals.
treatment
Treatment
  • For most, there is neither quick recovery nor rapid deterioration.
  • Struggles with treatments, side effects, daily business of living.
  • Chronicity – weariness, fatigue
  • What else is going on...?
treatment client tasks doka
Treatment – client tasks: Doka
  • Managing symptoms, side effects
  • Compliance – medical regimes
  • Preventing / managing medical crises
  • Managing stress / coping
  • S social support, social isolation
  • Normalising life in face of illness
  • Finances
  • Preserving self concept
  • Redefining relationships
  • Ventilating feelings / fears
  • Finding meaning
treatment therapy aspects
Treatment: Therapy aspects
  • What can you address? (eg, pain vs psyche)
  • Strategies, eg, mindfulness; one day at a time; imagery; guided meditation; relaxation exercises; support groups.
  • Reality testing
  • ? Surprises
  • Role play
  • Sexuality
  • Being non-judgmental; no assumptions
treatment therapy aspects cont
Treatment: Therapy aspects (cont)
  • Q.’s that help client find meaning in the experience, eg, How has this experience changed you? What have you learned from this experience?
  • Choices “within” even if not “about”.
treatment outcome
Treatment: outcome

Recovery?

Remission?

Recurrence?

treatment recovery remission
Treatment: Recovery/Remission
  • Client Tasks - Doka:

1. Dealing with the physical, psychological, social, financial and spiritual residues of illness

2. Coping with fears / anxieties, esp fear of recurrence

3. Reconstructing life

4. Redefining relationships, esp with carergivers

recovery remission therapy aspects
Recovery/Remission: Therapy aspects
  • Grief and loss
  • Guilts: survivor, behaviours
  • Fears: commitment, “damaged goods”
  • Venting
  • Validation and exploration
  • Normalising and the “new normal”
recovery remission therapy aspects cont
Recovery/Remission: Therapy aspects (cont)

Q’s: - What will you leave behind from this experience?

What will you keep of this illness experience?

What will you add?

  • Fear of Recurrence
  • Extremely prevalent
  • How to manage: Information/education; mindful distraction; reality acceptance; recognising triggers; explore the fear
treatment recurrence
Treatment - Recurrence
  • May or may not lead to palliation
  • Revisiting the land of Malady
  • “I have done this before – I can do it again.”
  • The goals of hope change
treatment palliation
Treatment - Palliation
  • Change of goals
  • Client tasks – Doka
  • Managing physical symptoms
  • Managing health and institutional procedures
  • Managing stress ,fears and anxieties
  • Preparing for death / saying goodbye
  • Preserving self concept and relationships
  • Finding meaning in life and death
palliation therapy aspects
Palliation: Therapy aspects
  • Conversations about death
  • Open communication – let the client lead you
  • The client sets the tone
  • Remember: “Hope should not expire before the person.”
  • ? What does a dying person need?
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