Sunday, January 22, 2012

Therapy During Catastrophic Illness

by Zachary on October 11, 2011 at 11:00pm

After much prompting from my wife, I decided to post this paper that I wrote for my counseling class.


October 11, 2011

            Ellen Pulleyblank Coffey wrote an article concerning family therapy during catastrophic illness. Her article discusses how to counsel with families during prognosis and illness. It also details death and moving forward. This subject has become especially interesting and in fact applicable to me in my life. My wife and I delivered our second child, Peter, October 3, 2011. Peter has been diagnosed with Trisomy 18, a genetic illness which has a median life expectancy of 14.5 days. It became apparent to me that many parents would need counseling if they were involved in similar situations. I was also interested in how to approach the subject if clients and therapists have differing spiritual views.

            Coffey first suggests different conversations that need to happen during the first stages of illness. Families need to carefully plan how they are to manage care, time and other resources during these illnesses. Families should learn to draw from larger community resources. Families should educate themselves and learn how to move forward through actions of medical treatment. The last conversation discusses the idea that often we may think of medical establishments having a responsibility to extend life for as long as possible. Depending on an individual’s spiritual beliefs and other considerations, there may be times when it is better to end life earlier to maintain better quality of life.

            The end of the article involves how families handle grief associated with terminal illnesses, the death event and moving forward. There are factors to consider when counseling with clients through this process, such as associated depression or denial. Children may have post traumatic stress and families may have a hard time rebuilding after the death of a loved one.

            I have been trained to be disciplined and level headed, but I have also been trained that there are stages of grief associated with any traumatic event. Throughout this first week of Peter’s life, I have shed many tears as I realized the severity of his illness. Friends and family have been very supportive; some even suggesting that he will overcome this. This could be a sign of denial or could be considered blissfully optimistic. My wife and I had many conversations regarding things we need to put in order while Peter is with us, and the steps we will take after he passes away.
My wife and I heard concerns during the first trimester that Peter had features of Trisomy 18. After consulting with a specialist over the next months, it was determined that he did not have this illness. We were taken by surprise at his birth when it was determined he had Trisomy 18. My wife and I consider ourselves lucky that we had some degree of time to emotionally prepare for this possibility. We also feel it was beneficial that we did not know the full prognosis as this would have added stress to the entire pregnancy. Some individuals may have harbored negative feelings towards doctors who give an inaccurate diagnosis, but I realize that medical science is not complete. Individual doctors and specialists are qualified and try to present the most accurate picture they can assess.

            My wife and I are Christians and this has certainly been our guiding support throughout this event. Specifically, the belief that Peter will be resurrected and reunited with us after we die is comforting to us. My wife and I ponder how people without such beliefs could find any comfort through an event such as this. Coffey suggests that therapists can discuss different spiritual beliefs with their clients. This was an interesting insight to me. I may have felt as if a therapist was to avoid “pushing” their spiritual beliefs. In fact they should be careful of that, but a therapist would do well to have a resource page that discusses many different beliefs regarding death. Clients could scan this information and find a belief that fits their worldview. Clients could then become actively involved in support groups.

            It is important to us that family and friends have been associated with this event. We discuss Peter’s status daily through newsletters and have had family travel some distance to see him. My wife said, “Family being here makes it seem like Peter is real.” As one can imagine, these traumatic events can shake concepts of reality and mortality. Understanding personal needs is crucial as families move forward in these circumstances.

            There are many lessons that can be learned from an event like this, such as developing spiritual concepts, understanding personal and family needs, discussing difficult situations effectively and working with medical professionals. It is also important for individuals to understand when to reach out to friends and communities for help. Capable families may feel like they can handle circumstances on their own, but there is a binding and satisfying experience that comes from giving and receiving service. This experience has helped me understand how to counsel with individuals experiencing grief and a hard time. My wife and I are nearing a time when we would be “ready” for Peter to pass on. We enjoy each day we have with him and will continue to enjoy them as long as he decides to stay here on earth. 

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