Chronic Illness

Diagnosis

The diagnosis of a chronic illness can result in both immediate and long-term psychological challenges. Diagnostic tests and ongoing treatments can be physically painful and emotionally stressful for both patients and families. Disbelief, denial, anger, and depression are common reactions to a diagnosis of chronic illness. In many cases these are understandable responses to the situation. However, patients and families may need assistance to look beyond these responses in order to adopt new ways of coping and more realistic goals regarding their lives and the future. For example, denial may be helpful in assisting patients and families to get past the initial crisis point of diagnosis. However, denial has sometimes been associated with an individual's resistance to following a medical regimen or medical advice, which can lead to negative health consequences. In general, in order to provide the most effective services, it is important for counselors to have a basic understanding of the nature of the illness, the multiple demands of the procedures involved in diagnosing and treating the illness, the potentially ongoing aspects of medical care, and the prognosis of the illness.

Chronic Illness in Adults

Once diagnosed, adults are confronted with the process of adjustment to living with a chronic illness. This process is often ongoing, depending on the nature and course of the specific illness. Adjustment is complex, often involving emotional, cognitive, behavioral, physical, and social components. Emotional adjustment can include dealing with feelings of helplessness, being overwhelmed, and fear of the future. Cognitive components may include difficulty with concentration, hypervigilant appraisals of the illness and one's condition, and decline in short-term memory functioning. Behavioral concerns include role fulfillment and role change in an individual's life and meeting the demands of the illness (e.g., doctor visits, taking medications as prescribed). Physical components of illness may include loss of mobility, physical adaptations needed [Page 79]at home or work, or not being able to drive. Finally, social concerns often focus on personal relationships, social support, the stigma of chronic illness, and social comparisons with others. The combined effects of these adjustments and changes brought on by chronic illness represent an enormous challenge to the patient at a time when most personal resources are very low. Therefore, assistance from a counselor is extremely important in order to support the individual in this process of adjustment.

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