Counseling Individuals with Life-Threatening Illness

Week #1 

Chapter 1: Introduction: Counseling Individuals with Life-Threatening 

Illness   

The experience of a life-threatening illness is among the most challenging situation that a person and their families have to encounter. From the time a person suspects the presence of dangerous symptoms to the time they are diagnosed, and through the long periods of chronic illness, it leaves a permanent mark on the ill person, their families, and friends. Life-threatening illness does not only refer to a medical crisis, but it is also a spiritual, psychological, and social crisis.  

Chapter 2: Historical Perspectives on Dying and Illness 

The historical perspectives have contributed to studying the dying process in contemporary society. The development of hospice offered a way to care for the dying. It has improved the treatment of dying people and promoted research on the dying process. Hospice care has penetrated much of medicine that acknowledges that the quality of a patient's life means addressing their psychological, physical, and spiritual needs. Therefore, the growth of hospice has enabled the medical system to meet the needs of the dying from chronic illness.  

Hospice care has continued to evolve since historical times. The idea of a home-like environment was introduced to offer healthcare services within the patient's actual home. The introduction of the home care model of hospice became widespread across the United States. Technological development has further evolved hospice care, leading to a new form of care, which enables patients to receive continuous life-extending treatment while accessing palliative care provided by hospice services. Technological advancement will provide an opportunity for palliative and hospice care programs to continue evolving and enhance their public acceptance and awareness.  

Kübler-Ross provides a series of five stages that a dying person go through. These include denial, anger, bargaining, depression, and acceptance. Kübler-Ross noted that hope was a common reaction through and within these stages. Therefore, Kübler-Ross provided a powerful tool that helps provide humanistic care for the dying patient.  

According to Perhaps Weisman and Hackett's (1962), notes that denial is not always negative, as Kübler-Ross has pointed out. It is common for a patient to deny some realities regarding the illness they are diagnosed with. Denial helps to encourage a patient to take part in therapy to maintain hope. Denial functions as a defense mechanism and its absence may not encourage a patient to take part in painful therapies. The coping responses to life-threatening illnesses that help a patient and family members include: taking appropriate actions, seeking information, passive acceptance, escape, displacement, suppression, disengagement, blaming oneself or others, and compliance. Therefore, these coping strategies help a person accept death and its consequences. 

A person anticipating loss can experience grief reactions. They perceive anticipatory grief as a normal reaction to life-threatening illness. Examples of grief reactions include depression or sadness, preparation for death, and a plan to live with the effects of death. Most family members experience the challenge of continuous grief in anticipation of death may prompt them to disengage and isolate themselves from the dying person.  

Life-threatening illness can be understood based on a series of phases, including the prediagnostic phase, which is the process of seeking medical assistance. The acute phase involves the period surrounding the diagnosis of a life-threatening illness. The chronic phase refers to a person's struggle with the illness and treatment. The majority of people may recover from illness. Although recovery might occur, a person may have to adapt to the anxieties, fears, residues, and after-effects caused by illness before going back to the life they experienced. The terminal phase involves adapting to the uncertainty of the imminent death as treatment shifts to palliative. A person has to adapt to a number of tasks at each phase, which includes: handle spiritual/existential issues facilitated by the disease effectively, reserving relationships and self-concept with others in the course of the disease, to take action in coping with the reality of the disease, and responding to the physical aspects of the illness.  

Chapter 3: Effective Professional Caregivers: Seven Sensitivities 

Sensitivity is a crucial aspect of the effective functioning of caregivers. The seven sensitivity that caregivers should demonstrate include: sensitivity to treatment goals, sensitivity to the whole person, sensitivity to cultural differences, sensitivity to the problem of discomfort and pain, sensitivity to individual's needs, sensitivity to mutual, open, and honest communication, and sensitivity to individual's autonomy. These sensitivities have been put at the center of any caregiving role, including the social worker, the chaplain, the counselor, the health aide, and the physician. The combination of skill and sensitivity helps a caretaker to contribute positively towards patients struggling with a life-threatening illness.  

A holistic approach has proved effective in hospice care, which supports the reality that life-threatening illness occurs in life. Managing pain is another crucial aspect of hospice. Caregivers have an important task of assisting patients experiencing pain to feel some degree of physical comfort. Strategies that caregivers can use to manage pain include offering a more effective pain treatment, intervening directly, or serving as advocates reminding healthcare providers about the pain concerns of a patient. Therefore, sensitivity plays a great role in helping individuals experiencing a life-threatening illness manage their pain, tend to their treatment needs, and achieve the desired goals.  

Week #2 

Chapter 4: Skilled Counselor 

Counselors working with individuals and families experiencing a life-threatening illness require skills as well. These skills include cautiously monitoring their reactions and roles while promoting effective self-care and the ability to work with families and individuals throughout the cycle of life.  

Caregiving is a shared responsibility, meaning that as much as the caregiver is struggling to help an individual, the individual and family should assist in order to achieve the desired health goal. The primary role of counselors is to assist families and individuals in recognizing issues they are experiencing, examine the dimensions of these issues, and implement effective coping mechanisms with their concerns. 

The effective communication skills applied in counseling include using open-ended questions, active listening, interpretation of nonverbal behaviors of an individual, problem-solving skills, empathic statements, theme identification, self-disclosure, perception check, techniques that attempt to comprehend the meaning of client's attitudes, behaviors, and feelings, action strategies, and affirmation.  

Caregiving to individuals experiencing life-threatening illnesses has similarities with different caregiving and counseling circumstances. However, some factors, especially in crisis contexts, makes counseling the dying unique, which include differences in goals, different rules, Countertransference can be extreme, differences in processes, an active counselor, pace-setting by an individual, and the therapist are obligated to work with families and other survivors. 

Life-threatening illness often impacts the entire family. Sensitive counseling identifies illness in the familial context. In addition, a sensitive counselor assists families in evaluating ways that illness impacts them as a family and their coping abilities with the illness. The two models that have been identified to be useful in helping families cope with the life-threatening illness include: Herr and Weakland's (1979) model of solving family problems can be implemented in various situations where families require to examine their process of problem-solving address challenges. This model encompasses the following processes, including establishing rapport and conducting an initial assessment, defining the concerns, identifying solutions utilized previously, setting goals, understanding the family system, and successful termination. The second model includes network interventions, enabling family units to utilize larger systems to address specific challenges effectively. The phases of this model include the retribalization phase, polarization phase, mobilization phase, depression phase, breakthrough phase. 

Response to care and counseling, coping with illness, and responding to the illness crisis is unique for people based on the life cycle phases, including older adults, persons with intellectual disabilities, and children and adolescents. Working with adolescents and children with life-threatening illnesses can be challenging. The counselor-child relationship is always triadic, involving dealing with a child, the guardian, or parent, which may impair trust between the counselor and the child. Caregivers should recognize that it is important to be clear about their role. It is critical to maintain open communication and hope when communicating with a child experiencing a life-threatening illness. 

The limitations, such as challenges thinking abstractly, poor short-term memory skills, limited abilities to shift skills from one point to another, and external locus of control, make it difficult for persons with intellectual disability to cope with abstract concepts. When counseling individuals with intellectual disabilities, caregivers should be clear and patient with their clients and teach them coping skills throughout the crisis. Learning can be facilitated through a four-step process including preparation, whose objective is to prepare these individuals exposed to experience. In addition, direct instruction is the second step where the counselor can teach skills that maybe be beneficial to the individual, offering continued reinforcement and reassurance. The third process is the Modeling approach that a counselor uses to model the desired behavior of the person. The fourth step is emotional support, whereby a counselor can assist persons with intellectual disabilities in understanding and expressing their emotions.  

When working with older individuals, it is important for counselors to understand that older people are not a similar group but differ just like any other age group or variables such as formal support system, family, culture, and ethnicity. In addition, counselors should have a basic comprehension of the aging process, which involves the ability to differentiate between changes resulting from normal aging and those that are illness-related or pathological. Furthermore, counselors must evaluate their feelings and beliefs regarding the aging process and older individuals.  

The five obstacles that may hinder the attempts of older people to cope with a life-threatening illness and participate in the counseling process include resistance to counseling, stereotypes of aging that may hinder an individual from seeking medical attention, limited social support, cognitive and physical impairment, and challenges with life review. A caregiver can help an older individual adhere to counseling and treatment by affirming the continuity of identity, which is usually threatened by older age with illness, allowing them to maintain self-esteem, and establish a sense of correspondence with caregiving staff, and determine a coping ability as individuals draw comfort from successful coping with earlier experiences. 

Caregiving to individuals with a life-threatening illness can be emotionally draining and stressful. It is crucial for caregivers to be sensitive to the impacts working with the severely ill and the dying have on them. Therefore, caregivers should be sensitive to their personal feelings and establish effective coping strategies.  

Week #3 

Chapter 5: Responses to Life-threatening Illness 

The manner in which a person currently responds to everyday crises often provides signs as to how the client is likely to respond to the crisis of death or illness. The following are the different ways that clients may respond to life-threatening illnesses: physical responses, cognitive, behavioral responses, spiritual responses, and emotional responses. Most people will manifest stress physically. Examples of physical responses include tingling sensations, headaches, nausea, insomnia, fatigue, and dizziness. Counselors need to inspire clients to report any physical symptoms to a healthcare practitioner so that the physician can monitor the illness.  

The cognitive responses to illness and dying include shock, denial, Egocentricity, Constriction of Interests, Changes in Body Image and Self-Esteem, sleep disturbances, suicidal thoughts, and hope. Life-threatening illness can cause tremendous stress, which may have adverse impacts on the diseases and treatment. Cognitive impairments such as poor concentration, inability to concentrate, confusion, and forgetfulness may be noticeable. Illness may trigger earlier unresolved challenges, causing stress, which may overwhelm an individual's coping abilities.   

The emotional reactions to life-threatening illness include feelings of guilt and shame, anger, jealousy and envy, fear and anxiety, grief, sadness, depression, and resignation. Behavioral responses to life-threatening illness include hypersensitivity, humor, which is one of the most basic coping mechanisms, disengagement, developing a strong feeling that their life is no longer in control, Regression and dependent behaviors, and acting out and resisting behaviors. 

Spiritual responses have gained a lot of attention and appreciation in recent years. They play an important role in spiritual care in response to and treatment of chronic illness. Holistic care in hospice acknowledges the spiritual aspect of care. The spiritual manifestation in reaction to life-threatening illness includes changes in spiritual behavior whereby life-threatening illness may cause clients to question the fairness of the world, the quality of their lives, and the nature of their faith. In addition, life-threatening illness may prompt an individual to seek a miracle, especially when medicine does not offer much beyond palliative care. Moreover, spiritual manifestation in response to chronic illness may elicit transcendent behaviors whereby the anxieties regarding the meaning of life may inspire a person to use their remaining time to achieve goals. Furthermore, the spiritual manifestation may include a search for meaning in life and developing a sense of connection and control.  

Therefore, the ability to understand their responses allows clients to feel empowered to evaluate ways in which their responses and adaptation styles impact their sense of self, facilitate or complicate the challenges with life-threatening illness, and how it impacts their relationships with others.  

Chapter 6: Understanding the Illness Experience 

A life-threatening illness is influenced by various factors, including lifestyle, heredity, culture, gender, environment, and social class. These factors influence the illness we develop, how long we live, the type of treatment we get, and the ways we react to the illness threats. The experience of illness is unique for every individual. Each illness is distinctive, influenced by its nature, the stage in life when illness occurs, and the conditions surrounding it. It is crucial to explore the distinct experience of illness to allow a person to understand and sympathize with the person's issues and challenges. Therefore, identifying the distinct, personal experience of life-threatening illness provides counselors with an understanding of each individual's responses.  

The three critical factors that influence life-threatening illness include an individual's lifestyle and personality, the time in the life cycle when the illness strikes, and life-threatening disease or condition. The disease-related factors include the nature of the illness. How and where the disease occurs is often crucial. Another factor is the symptoms, whereby diverse symptoms will impact the experience of chronic illness. Predictability of the disease course helps determine specific life expectancy and influences the ability to cope with illness. Psychological effects whereby the disease manifestation can vary in psychological discomfort they can cause in a person. Social consequences whereby different diseases have distinct social consequences. Another critical factor is the disease's pattern or trajectory, which may be a long and slow decline, a rapid decline, changing patterns of remission, relapse, and recovery, considerable uncertainty of disease characteristics, and vulnerability to both succeeding recurrences and death. Treatment differences are also an important factor, which has a profound effect on a person's experience of life-threatening illness. The important factors about treatment include the nature of the treatment regimen, the type of treatment, and the side and after-effects of treatment. 

The experiences of life-threatening illnesses are also influenced by the time in life when an illness strikes. Life-threatening illnesses may impact young and school-aged children in various ways. The separation periods and the ever-changing environment may impair the child's ability to bond and develop trust. Learning to cope with illness within a school environment may pose many challenges to the child. A child may experience stigmatization, isolation, and impaired self-concept, which may hinder intellectual development. Life-threatening illness may pose distinct threats to the key developmental aspects of adolescence, which include their identity, independence, and intimacy. Young adulthood is when a person is beginning a career or family, which means life-threatening illness can significantly impact their ability to complete tasks in the life cycle. It may affect the independence and ability to establish relationships. Life-threatening illness can destabilize all the life patterns of a middle-aged adult. Individuals in this phase mostly have stabilized friendship, family, careers, and jobs, which may be unsettled by illness. Life-threatening illnesses may impact the coping abilities of older adults, causing psychic shock on them.  

Our experience and response to illness can be influenced by different psychological and social factors, including formal support, informal support (importance of confidantes, friends, and family), coping skills, personality, and will to live, the meaning of illness, intellectual ability, prior experience, and education, and characteristics such as income, social class, ethnicity and culture, race, and gender.  

Week #4 

Chapter 7: The Prediagnostic Phase: Understanding the Road Before 

The beginning phase of life-threatening illness often starts before the diagnosis. An individual may have prior knowledge of illness when a person is struggling with suspicion of illness. This is known as the prediagnostic phase. Making the decision to seek health is a difficult process, which often determines how a client will respond to an illness crisis. Understanding the process of how to seek health offers chances for growth. Observing behavior before a diagnosis can demonstrate the client's sources of support, coping mechanisms, and fears and anxieties.  

Seeking treatment for a life-threatening illness is a complex process that is impacted by various factors. These factors include symptom-related factors, psychological and physical factors, situational factors, and social factors. The nature of the symptoms is a key aspect influencing the decision of an individual to seek medical attention. The symptoms-related variables include: how disruptive the symptom is, how serious, recognizable, and apparent the symptom is, and the frequency and persistence of the symptom. 

Physical and psychological factors impact the symptoms evaluation and decision making whether to seek health. Examples of these factors include tolerance level to pain and discomfort, the level of anxiety generated by the symptom, and the basic belief systems and knowledge to seek medical help such as the belief that the condition of the illness is harmful to health, one is vulnerable to disease, and that medical assistance and interventions can help. Personality characteristics such as how trusting one is, how extroverted a person is, or an individual's willingness to share information about themselves are other physical factors influencing seeking medical help. Another physical factor is childhood experiences that a key role in examining symptoms. Early experiences may cause one to become more sensitive to symptoms and more aware of physical feelings.  

Situational factors that influence the decision of a person to seek medical attention include social context such as health campaigns may provide the public with awareness of certain diseases and thus pay more attention to the symptoms. Competing in another situational factor, whereby if there are several competing needs that require an individual's attention, only the serious and most sustained need will receive the attention. Another factor is the availability of help access to friends and family, and accessibility to medical assistance promotes the health-seeking process. Social factors such as education, culture, age, social class, age, and gender indirectly impact seeking medical assistance. 

Chapter 8: Counseling Clients through the Crisis of Diagnosis 

The diagnosis of life-threatening illness often comes as a blow to a person because it is always regarded as a death sentence. The diagnosis period is usually defined as a turning point when an individual's orientation towards life shifts. This encounter with the possibility of death is often overwhelming, causing a person to experience numbness and shock. The diagnosis of life-threatening illness has been identified as the second major cause of stress because the knowledge of dying is scary. However, some people may utilize the crisis as a growth opportunity such as enhanced spirituality, reordered priorities, experiencing a sense of personal strength, and renewed relationships.  

Diagnosis of a life-threatening illness is characterized by uncertain nature, and it is beyond one's control. The diagnosis builds a deep crisis coupled with various interpersonal and personal issues, strong emotional reactions, and anxiety. Therefore, an individual must learn ways to cope with the diagnosis effectively or risk experiencing extreme anxiety and personal disorganization. The consequences of a life-threatening illness that impact every aspect of an individual's life, including school, work, financial decisions, friends, and family.  

Various tasks have been suggested to help an individual cope with the diagnosis. These tasks include understanding the illness, evaluating and optimizing lifestyle and health, optimizing an individual's limiting weaknesses ad coping strengths, establishing strategies to handle concerns facilitated by disease, identifying the impact of disease on an individual's sense of self and relationship with other people, examining fears and feelings, and integrating the current reality of diagnosis into an individual's sense of past and future.  

The end of the diagnostic or acute phase is extremely nature self-limiting. In rare incidents, the event when a person precipitates the diagnosis may lead to death or rapid decline into the terminal stage of disease, which forces survivors to face diagnosis and death simultaneously. In other cases, the disease may advance so dramatically, or the disability from a stroke can be found to be so severe and irreversible, causing the individual and family to grieve the extreme losses that have happened and prepare the individual for possible death. In situations where recovery is determined as complete in cases such as stroke or heart attack, people may experience different recurrence risks. Despite the recovery, a person may encounter after-effects of life-threatening illness such as discrimination in employment, psychological impairment, fears of relapse, and physical scars. Also, full recovery may leave financial, psychological, emotional, social, physical scars. 

Week #5 

Chapter 9: Counseling Clients in the Chronic Phase of Illness 

The period between diagnosis and the outcome of the illness is a long chronic period in which there are challenges with the demands, the daily functioning of living, the symptoms of the disease, and the side effects of treatment. The early part of this chronic phase is referred to as accommodation and mitigation. The major challenge in this chronic phase is to accommodate the disease using the previous coping roles and skills, and the crisis caused by the diagnosis is usually mitigated by this time. The person is simply focusing on finding ways that will help them live with the continued presence of the illness with the aim of maintaining health and adapting/preventing a decline in health. The major change in life-threatening illness is the presence and longevity of the chronic phase. The chronic phase comprises various similar issues and challenges common to all chronic diseases. In the chronic phase, the quality of life is likely to be extremely influenced by the nature and symptoms of the illness and the pattern or trajectory that the disease takes. These factors often influence the experience of the chronic phase.  

Individuals and families often face substantial challenges and changes throughout the chronic period. The series of tasks that individuals have to confront include managing symptoms and side effects, conducting medical regimens, managing and preventing medical crises, evaluating coping and managing stress, optimizing social support and reducing social isolation, stabilizing life in the face of illness, dealing with financial issues, maintaining self-concept, redefining relationships with others, examining fears and feelings, and find meaning in uncertainty, suffering, decline, or chronicity. 

These tasks can contribute to possible resolutions in the chronic phase. The treatment process can contribute to total recovery in some cases, while others may achieve partial recovery. In other cases, the condition of the illness can stabilize, causing a person to experience elongated period chronic disease and residual disability, or ongoing uncertainty. Some may face continuing decline, where the care they receive becomes exclusively palliative. Therefore, the chronic phase is a difficult, uncertain, and long period for individuals and their families. On the other hand, a chronic period offers opportunities for growth for an individual to live and experience life, fighting to regain health and make the best of the remaining time that a person has. 

Chapter 10: Counseling Clients in Recovery 

Partial or full recovery may occur at any stage in life-threatening illness. Counseling clients in recovery is crucial because a person may be experiencing psychological injures, physical scars, and diminished abilities. Recovery may leave issues that should be examined, and certain tasks completed as clients make an effort to move on with life. Examples of these tasks include redefining relationships with caregivers, dealing with spiritual, physical, financial, psychological, and social scars of illness, examining lifestyle issues and life and rebuilding one's life, and coping with the existing anxieties and fears.  

In redefining relationships with caregivers, it is advised for caregivers and families to avoid sudden goodbyes to their recovered clients. Clients often form close relationships with caregivers throughout the disease. It may be challenging for clients to redefine or say goodbye to these relationships. Therefore, it is important for the caregivers to discuss their feelings regarding the relationship and termination.  

Various changes occur during the illness, and an individual cannot simply go back to the previous life patterns. Instead, a client can build a new lifestyle with a new perspective on the sense of normalcy. Counseling can help individuals develop positive responses to the after-effects of life-threatening illnesses. It offers an opportunity for individuals to evaluate the remaining issues, such as dealing with spiritual, financial, social, psychological, and physical residues.  

It is natural and normal for individuals to have continuous feelings of depression and a strong sense of anxiety, among other reactions, following experience with a life-threatening illness. The different coping strategies that can help a person deal with fears and anxieties include counseling, where a therapist challenges a client to share these anxieties with others. In addition, counselors can help clients evaluate preventive health behaviors and lifestyle changes that may reduce the chances of recurrence. These changes may offer the client an improved sense of control, which minimizes feelings of vulnerability. In addition, meditation and imagery have been useful in helping an individual reaffirm personal well-being, manage stress, and reduce anxiety. Furthermore, self-help groups may offer opportunities to share and evaluate concerns in an accepting and trusting environment. 

Week #6 

Chapter 11:    Counseling Clients in the Terminal Phase 

The terminal phase usually begins when the medical goal shifts from maintaining a person's remission or curing them to offering comfort or palliative-oriented care. Here, the chances of remission or recovery are slim, and death seems predictable and imminent. The practitioner modifies the definition of a patient from sick to dying based on tests, condition of symptoms, and response to treatment. Often, dying individuals are aware of the changes they are experiencing and sense their imminent death.  

In the discussion about death, open communication is a crucial element. The key guidelines that should be recognized by caregivers when communicating with a dying person include: allowing the individual to set the tone of the conversation, listening and reflecting in the client's shared fears and feeling surrounding death, remembering your own such as being an advocate and provide a practitioner with the needs of patients or assisting them in finding ways to resolve their issues, communicate through nonverbal actions such as expression and paraverbal factors such as cadence, loudness, and tone, and always allow hope when responding to a dying person.  

Decision-making in the terminal phase on whether a patient should go into a hospice program or when interventions should be ended can affect the quality of the remaining time in a patient's life and ways that families adjust after death. According to    Doka (2013), motivational interviewing can be beneficial as a counseling approach in helping such decision-making. This approach involves a counselor establishing a therapeutic partnership to help clients work through the inconsistencies between their behaviors and values.  

At the end of life, patients, their families, and surrogates should make ethical decisions such as whether to donate body organs, whether a patient should die through physician-assisted suicide, accept palliative sedation, or whether medical interventions should be implemented.  

Counselors play an important role in supporting clients with these ethical concerns. For instance, they can offer information and help in clarifying choices and options. In addition, they can encourage clients to undertake a deliberate and inclusive process.  

The tasks in the terminal phase that help to reflect to reflect on the transition from curing illness or maintaining life to offering comfort include managing incapacitation, symptoms, pain, and discomfort, managing institutional and health procedures, examining coping and managing stress, working effectively with caregivers, preparing for death, maintaining self-concept, maintain relationships with friends and family, examining fears and feelings, and finding meaning in life and death. 

Chapter 12: Counseling Families during a Life-Threatening Illness 

It is evident that life-threatening illness is a family illness, and they take part in each phase of their illness. Family involvement with illness starts before the diagnostic period. Families may recognize and evaluate symptoms or advice a loved one to carry out diagnostic tests. They may also be consulted as an individual makes the decision on the course of action to take, such as seeking or delaying medical assistance. Families may have to cope with a substantial amount of uncertainty and anxiety in the prediagnostic period. In the diagnostic period, families may face possible threats of the family member's illness and even imminent death. The diagnosis may impact adversely on the individual life of each family member. The chronic phase is always a very challenging period for family members. The family members have to conform to the new demands, stresses, and responsibilities in their daily routines. In the terminal phase, family members and close networks to the dying individual will rally around the dying individual. 

Family members have to cope with various feelings and reactions throughout the terminal phase. The common examples of these feelings and reactions include depression, sadness, anger, and guilt. In addition, family members may experience difficulty interacting and communicating with the person they are not sure how to react or behave. They may feel drained due to the demanding responsibilities to care for the physical and emotional needs of the dying individual. Family members may experience confusion, rejection, and hurt as the dying person's health deteriorates and begins to withdraw and disengage. A broad range of personal variables such as relationship influences reaction to the illness of a loved one with the person, personality, knowledge of experiences with diseases and death, coping abilities, gender, age and maturity, mental and physical health, fears, and formal and informal support. In addition, family reactions to illness and death are influenced by the unique characteristics and structure of the family, such as interactional patterns, patterns of independence and dependence, developmental states, communication, expectations, norms, values, and beliefs, resources and strengths, and problem-solving abilities and coping styles.  

Factors that promote the ability of the family system to cope with life-threatening illness effectively includes training on how to offer effective care in the course of illness, understanding of the symptoms and the possible cycle of illness, the ability to take part in caring for the ill person, availability of informal and formal support systems, social and economic resources, positive relationships between family members, and quality of good care. 

Other factors that may hinder the ability of a family to adjust to life-threatening illness include poor quality of medical care, stigmatization of diseases, ineffectiveness or unavailability of formal and informal systems, dysfunctional patterns on family communication, interactions, relationships, and problem-solving, and lack of economic or social resources. 

Prompts 

My most defining experience with grief was when I understood the stages of grief and found healthy ways of coping with the pain. Examples of the coping techniques that I used include allowing myself to feel angry, sad, and even cry. I used social media resources such as support groups that helped me through the grief process. I looked after my emotional and physical needs through exercising regularly, getting adequate sleep, and eating a healthy diet.  

I feel that the stages of grief impact the mourner positively on their path through the mourning process. It helps an individual frame and recognizes what they may be feeling. Understanding these stages provides a pathway for comprehending the numerous intense and complicated emotions a person is experiencing. Therefore, they help take an individual to a place where they can live with the loss in a healthy manner.  

I feel that stages of grief vary based on the knowledge of terminal illness being present. For example, a person who has died from AIDS will be grieved differently due to the nature of the diseases and social stigma and rejection. These factors may hinder the person from grieving through the five stages of grief. A person who has died from stroke or cancer will be grieved differently, and mourners will experience denial, anger, bargaining, depression, and acceptance. 

The presence of spiritual enlightenment impacts the griever positively because it helps an individual believe in the power of their faith to get healing, helps them understand the foundation of existence, and makes a person feel open to more truths in life. Spiritual needs are linked to social, emotional, and physical needs, thus helping individuals progressively resolve their grief. 

My experience in societal toleration when a person is diagnosed with a terminal illness is that they face isolation. Most people in society are not ready to care for the terminally ill person, which can be draining emotionally and physically. Although they may receive support to some extent, the level of societal toleration to terminal illness is low.  

I feel that the approach in supporting the terminally ill changes based on the age of the patients because of the level of understanding of the illness, the coping abilities, and the needs of an individual in the phase of the life cycle, and the support systems. For instance, a child with a terminal illness will be approached differently compared to an older adult or adolescent. A young child has no understanding of terminal illness, unlike an older adult who understands terminal illness.  

My personal experiences with the topics covered have been informative and insightful. They have shaped my understanding of the impact of life-threatening illness on individuals and families, how counseling plays a profound role in helping individuals and families cope with the situation and the importance of sensitivity in counseling individuals with life-threatening illnesses. The information has contributed significantly to knowledge both professionally and personally. 

Reference 

Doka, K. J. (2013).  Counseling individuals with life threatening illness . Springer Publishing Company.