Adult Treatment Planner

Objectives and Interventions

• Describe history, symptoms, and treatment of the medical condition.
  • Gather a history of the facts regarding the client's medical condition, including symptoms, treatment, and prognosis.
  • With the client's informed consent, contact treating physician and family members for additional medical information regarding the client's diagnosis, treatment, and prognosis.
• Identify feelings associated with the medical condition.
  • Assist the client in identifying, sorting through, and verbalizing the various feelings generated by his/her medical condition.
• Family members share with each other feelings that are triggered by the client's medical condition.
  • Meet with family members to facilitate their clarifying and sharing possible feelings of guilt, anger, helplessness, and/or sibling attention jealousy associated with the client's medical condition.
• Identify the losses or limitations that have been experienced due to the medical condition.
  • Ask the client to list the changes, losses, or limitations that have resulted from the medical condition.
• Verbalize an increased understanding of the steps to grieving the losses brought on by the medical condition.
  • Educate the client on the stages of the grieving process and answer any questions that he/she may have.
  • Suggest that the client read a book on grief and loss (e.g., Good Grief by Westberg; How Can It Be Right When Everything Is All Wrong? by Smedes; When Bad Things Happen to Good People by Kushner).
• Verbalize feelings associated with the losses related to the medical condition.
  • Assist the client in identifying, sorting through, and verbalizing the various feelings generated by his/her medical condition.
  • Assign the client to keep a daily grief journal to be shared in therapy sessions.
• Decrease time spent focusing on the negative aspects of the medical condition.
  • Suggest that the client set aside a specific time-limited period each day to focus on mourning his/her medical condition. After each day's time period has elapsed, the client will resume regular activities and put off grieving thoughts until the next scheduled time. For example, mourning times could include putting on dark clothing and/or sad music; the clothing would be changed when the allotted time has ended.
  • Challenge the client to focus his/her thoughts on the positive aspects of life rather than on the losses associated with his/her medical condition; reinforce instances of such a positive focus.
• Implement faith-based activities as a source of comfort and hope.
  • Encourage the client to rely upon his/her spiritual faith promises, activities (e.g., prayer, meditation, worship, music), and fellowship as sources of support.
• Verbalize acceptance of the reality of the medical condition and the need for treatment.
  • Gently confront the client's denial of the seriousness of his/her condition and need for compliance with medical treatment procedures; reinforce the client's acceptance of his/her medical condition and compliance with treatment.
  • Explore and process the client's fears associated with medical treatment, deterioration of physical health, and subsequent death.
  • Normalize the client's feelings of grief, sadness, or anxiety associated with medical condition; encourage verbal expression of these emotions to significant others and medical personnel.
  • Assess the client for and treat his/her depression and anxiety (see Depression and Anxiety chapters in this Planner).
• Attend a support group of others diagnosed with a similar illness.
  • Refer the client to a support group of others living with a similar medical condition.
• Partner and family members attend a support group.
  • Refer family members to a community-based support group associated with the client's medical condition.
• Comply with the medication regimen and necessary medical procedures, reporting any side effects or problems to physicians or therapists.
  • With the client's informed consent, contact treating physician and family members for additional medical information regarding the client's diagnosis, treatment, and prognosis.
  • Monitor and reinforce the client's compliance with medical treatment regimen.
  • Explore and address the client's misconceptions, fears, and situational factors that interfere with medical treatment compliance.
  • Confront any manipulative, passive-aggressive, and denial mechanisms that block the client's compliance with the medical treatment regimen.
• Engage in social, productive, and recreational activities that are possible in spite of medical condition.
  • Sort out with the client activities that he/she can still enjoy either alone or with others.
  • Solicit a commitment from the client to increase his/her activity level by engaging in enjoyable and challenging activities; reinforce such engagement.
• Implement behavioral stress-reduction skills to terminate exacerbation of medical condition due to tension.
  • To reduce tension and stress, teach the client deep muscle relaxation and deep-breathing methods along with positive imagery.
  • Utilize electromyograph (EMG) biofeedback to monitor, increase, and reinforce the client's depth of relaxation.
  • Develop and encourage a routine of physical exercise for the client.
• Identify and replace negative self-talk and catastrophizing that is associated with the medical condition.
  • Assist the client in identifying the cognitive distortions and negative automatic thoughts that contribute to his/her negative attitude and hopeless feelings associated with the medical condition.
  • Generate with the client a list of positive, realistic self-talk that can replace the cognitive distortions and catastrophizing regarding his/her medical condition and its treatment.
• Implement positive imagery as a means of triggering peace of mind and reducing tension.
  • Teach the client the use of positive, relaxing, healing imagery to reduce stress and promote peace of mind.
  • Encourage the client to rely on faith-based promises of God's love, presence, caring, and support to bring peace of mind.
• Verbalize increased factual understanding of medical condition.
  • Provide the client with accurate information regarding the symptoms, causes, treatment, and prognosis for his/her medical condition.
  • Refer the client and his/her family to reading material and reliable Internet resources for accurate information regarding the medical condition.
• Identify the sources of emotional support that have been beneficial and additional sources that could be tapped.
  • Probe and evaluate the client's and family members' resources of emotional support.
  • Encourage the client and his/her family members to reach out for support from church leaders, extended family, hospital social services, community support groups, and God.
• Client's partner and family members verbalize their fears regarding the client's severely disabled life or possible death.
  • Draw out from the client's partner and family members their unspoken fears about his/her possible death; empathize with their feelings of panic, helpless frustration, and anxiety. Reassure them of God's presence as the giver and supporter of life.
• Maintain a life of sobriety that supports recovery from medical condition.
  • Explore and assess the role of chemical abuse on the client's medical condition.
  • Recommend that the client pursue treatment for his/her chemical dependence (see Chemical Dependence chapter in this Planner).
• Acknowledge any high-risk behaviors associated with sexually transmitted disease (STD).
  • Assess the client's behavior for the presence of high-risk behaviors (e.g., IV drug use, unprotected sex, gay lifestyle, promiscuity) related to STD and HIV.
• Accept the presence of an STD or HIV and follow through with medical treatment.
  • Refer the client to public health or a physician for STD and/or HIV testing, education, and treatment.
  • Encourage and monitor the client's follow-through on pursuing medical treatment for STD and HIV at a specialized treatment program, if necessary.
• Identify sources of emotional distress that could have a negative impact on physical health.
  • Teach the client how lifestyle and emotional distress can have negative impacts on medical condition; review his/her lifestyle and emotional status to identify negative factors for physical health.
  • Assign the client to make a list of lifestyle changes he/she could make to help maintain physical health; process list.