Medical Crisis Intervention Essay Example

Medical Crisis Intervention Essay Example Medical Crisis Intervention Paper Medical Crisis Intervention Paper The person’s ability to cope with anxiety or stress associated with life-threatening illness is considered a significant component in the healing process. This is one of the issues that medical experts is looking into in order to help the patient acquire the ability to alter his or her health control belief. This control belief influences the behavior of an individual in the process of treatment. Williams and Koocher puts it, â€Å"Loss of control is a common and often overwhelming source of psychological stress among patients and family members confronting chronic or life-threatening illness† (p.  325). In effect, they noted, â€Å"Control beliefs can direct the individual’s response to an illness as well as the healthcare system† (Williams Koocher, p. 326). Control beliefs as well as the coping mechanisms vary among patients. This discrepancy causes differences in behavioral responses of the patients towards self and the illness. At this point, it is assumed that physicians understand exactly the need to establish an appropriate control belief among the patients because as McDaniel, et. al noted â€Å"†¦ the individual or family can develop ways to limit the intrusiveness of the illness. Putting the illness in its place allows for establishing boundaries and regaining a sense of control† (cited in Williams Koocher, p. 329). Thus, the patients’ responses to life-threatening illness are influenced by governing factors in which among them are age, gender, situation, health history, previous experiences and many others. Likewise, these responses affect the way the patient perceives the treatment process as well as its outcome. To this effect, medical interventions through psychotherapy are seen to affect the control loss of a patient suffering from life-threatening illness. Responses to loss of control and in chronic and life-threatening illness Williams and Koocher presented in their articles four responses to control loss in which a patient may experience depending on the occurrence and stages of the disease. According to them, each category has both negative and positive implications. The four responses are known as passivity or no overt response, vicarious control, action-oriented responses, and cognitive adaptations (p. 328). Passive-oriented response appears during the early sign of the disease in which the patient experiences depression and the tendency for him is simply to remain passive until he learns to control his responses. As indicated, â€Å"Laying low and keeping one’s eyes open in an unresponsive situation may be an adaptive way of coping with control loss at such times† (qtd. Peterson, Maier, Seligman, 1993 in Williams Koocher, p. 329). Action-Oriented Response is another response that occurs when a patient is feeling threatened because of the existence of the disease. In this case, he would seek medical advises, read a lot of information about the nature of the disease and the ways to cope with it. It is action oriented because he assumes the responsibility to deal with the disease. Vicarious control comes when the patient is losing control and turning over the control to someone he sees as powerful and influential such as the physician or surgeon, or any health giver. Cognitive adaptation is a response in which a person after realizing that the ‘powerful other’ cannot do something to control the disease, he adapts the so-called â€Å"internal mental processes. † This is a response that allows the mind to take control of self when everything is out of control. It is also manifested in the presence of denial or defensive attitude because the patient still try to find meaning for his existence amidst the threat of death. Compare and contrast the components of action-oriented responses, cognitive adaptations, vicarious control, and passive-oriented responses. Passive-oriented response is the opposite of action-oriented response because the former manifests a feeling of helplessness and depression while the latter signifies that the patient is actively initiating actions to help him find cure for his disease. Patients having passive-oriented response does not believe that there is still cure for their illness thus, they refuse to seek doctors’ advises and that staying unresponsive as a way of coping with emotion. In contrary, patients having action-oriented response look for ways to cure the disease. On the other hand, Passive-Oriented Response is similar to Action-Oriented Response in a sense that they do not seek outside help in dealing with the disease. Action-Oriented Response is similar with Vicarious Control because both responses acknowledge that an illness needs treatment. However, they are also different in some ways because the latter recognizes ‘the powerful other’ to initiate the treatment process unlike the former in which the response is associated with the individual’s reliance on himself in providing treatment to his illness. Patient having vicarious control complies with medical advises because he has no control over his condition. Vicarious control is a contrast of cognitive adaptation in terms of reliance to medical experts. Cognitive adaptation recognizes one’s responsibility in the absence of control loss. The person knows that life-threatening illness is out of control and therefore he shifts his focus from the illness to his own attitude, which for him is something that he has control of. The manifestation of denial and defensive mechanism is the person’s strategy to create hope for himself under the cognitive adaptation. Patient then does not dwell on negative attitude. Vicarious control on the other hand, believes that other people could do something for him and entrust himself to these people for medical advises. Cognitive adaptation also recognizes medical advises and carefully follow the instruction and medication in order to cope with control loss similar to the responses of vicarious control. The adaptation is known as defensive because the patient instead of dwelling on negative thought, he recognizes that he has to take charge of his own illness (Williams Koocher, p. 329). Cognitive adaptation is almost similar to passive-oriented response in a sense that the patient gain inner strength in dealing with the illness. The only difference is that, the passive-oriented response dwells solely on negative connotation rather than the constructive ones. Both acknowledges that acceptance of death is necessary to avoid fear. Cognitive adaptation has some similarity with action-oriented disease because both responses realize that personal knowledge or familiarity of the disease is necessary, which is why, patients having these responses seek a lot of information about it and continue to follow the guidelines given by medical experts. Address the pros and cons of each All the responses are good basis for analyzing the kind of counseling a person needs in a certain circumstance. However, it is required that health giver understand the pros and cons of each of the responses to effectively address the anxiety or psychological stress that a patient experiences. Passive-Oriented Response The passivity of the patient upon knowing about her illness provides him the opportunity to accept his condition and the realization that the illness is still curable. The passive attitude is a response to the shocking effect of the illness; however, by allowing the mind to intervene a little later may help the person by entertaining positive thoughts. The feeling of helplessness is simply an initial reaction, which may also be replaced by optimistic viewpoint coming from people surrounding him. As Williams and Koocher noted, this attitude may be an â€Å"adaptive way of coping with control loss† (p. 329). On the other hand, this response is basically negative because of the feeling of hopelessness and depression that govern a person. If remain uncorrected, the patient’s condition will worsen because the right treatment for the disease is withheld. Active-Oriented Response This type of response has positive implication considering the fact that the patient instead of mourning over his condition would take initial actions to find cure for his illness. The attitude therefore is characterized by a strong control response and the person out of this drive will explore every possibility to address his condition. At this time, he is not yet ready to seek a physician’s advice, but he is receptive to suggestions that will be gathered through his own initiative and effort. Though amenable in nature, yet the person’s response is associated only with the outcome. Williams and Koocher referring to action-oriented responses stated that it is â€Å"†¦ maladaptive if the environment is unresponsive† (p. 329). The receptivity of the person is limited to his expected outcome in his environment; for instance, the availability of information in the internet. The unresponsiveness may only increase his â€Å"feelings of control loss† (ibid). Vicarious Control The attitude of a person having vicarious control connotes positive action because at the loss of his control he turns to an expert or professional to take charge of his situation. The transfer is actually a delegation of responsibility to someone who is more knowledgeable and more expert in the field. The patient is more open to medical advices and carefully follows each instruction that results to positive outcome. Its only disadvantage is the negative adjustment that a patient may experience at the result of poor prognosis. The patient will keep believing the ‘powerful others’ because he has already lost his control. Negative adjustment may include inconveniences brought by series of laboratory tests or in the event that more than one physician will examine the patient. Cognitive Adaptations At the loss of control and perhaps when the circumstance is inevitable, the only resort a person would have is to control his own responses by allowing his cognition to dictate his mind or simply called â€Å"inner control† (p. 329). It is highly constructive because when a person learns to control his own self, the possibility is that he will no longer be affected by internal or external factors. He can easily divert his mind from negative to positive and the acceptance of reality is highly probable with less resistance. The patient may learn to appreciate life better by accepting good vibrations or thoughts. They may even show cooperation at the process of treatment because of their positive outlook; however, they may become either adaptive or maladaptive as it gets worse. Similar to other responses, cognitive adaptations have disadvantages. Since it is associated with denial or defensive mechanism, patients normally resort to illusions that the reality does not exist at all. The denial and defensive mechanism may be effective at the onset but not when the condition becomes severe and uncontrollable. Williams and Kooper stated, â€Å"Denial can be maladaptive when it interferes with proven medical treatment†¦Ã¢â‚¬  (ibid). The worse is when a person out of his denial syndrome may delay or intentionally refuse to seek medical help. Furthermore, the person’s ability to use his cognition in controlling his responses depends on age, gender, and emotional maturity. How can these issues be addressed in counseling This information is very important for medical practitioners because the science recognizes that the patient’s psychological condition affects greatly in the treatment process. The loss of control particularly is one of the worst conditions that a person undergoing a treatment may experience. In fact, medical counseling is also given as an intervention to help the patient restore the fervor to live. A psychologist or a psychotherapist on the basis of responses can develop a strategy through which he can address the problem of control loss. Stage by stage of an illness, the patient may need different approaches because the manifestation of loss of control though not permanent yet consistent at given circumstances such as when a person needs confinement or surgery, or any event when he feels he is not in control of his situation. Understanding of the nature of responses helps the doctors and counselors to determine the type of counseling needed. Furthermore, since the goal of psychotherapist is to influence individual health control beliefs and behavior towards the course of disease treatment process, the key players can make use of the responses in assessing those control beliefs contrary to health control beliefs because the two may differ at a given disease or situation according to Lefcourt (qtd. William Koocher, p. 330). Understanding of the patients’ responses to control loss as influenced by his cultural beliefs and medical history can help the hospital institutions to design a â€Å"medical setting that is responsive to issues of control loss† (p. 332) of individual patients with different needs. The environment along with strategic approaches of medical personnel will be appropriate to the needs of the patients as manifested in their responses. Several models have been presented to assist the hospitals in the administration of interventions aimed at increasing the perceived control of the patients having life-threatening illness. In particular, the MCC model (p. 333) provides a structure that will guide the medical providers in dealing with patients in a step-by-step process. Conclusion Loss of control is one issue in medical practice that requires intervention. The intervention is viewed as psychological because this involves the changing behavior of the patients caused by anxiety or stress because in case of life-threatening illness, he may feel that he is no longer in control of his situation. This scenario is crucial in the management of treatment program because the patient may not show cooperation and willingness to survive that greatly affect the treatment process. Using the responses of the patients, medical practitioners and psychotherapist may develop right approaches to help these patients restore their self-efficacy and control. Due to these factors, many hospital institutions today develop right environment for patients experiencing control loss. Reference Williams, J. Koocher, G. (Fall 1998) Addressing Loss of Control in Chronic Illness: Theory and Practice. Psychotherapy 35 (3) 325 – 335.