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Counseling Clients with Chronic Illness or Pain

by | Jul 17, 2017

More than half of Americans are living with a chronic condition. That number is higher among people seeking help for mood issues. Learn how chronic pain can cause anxiety, depression, guilt and grief and how to help people work through their issues to live a high quality, meaningful life.

Earn counseling continuing education credits about working with clients with chronic pain here:Ā  2 Hour Counseling CE Course Ā  or hereĀ  10 Hour Counseling CE Course based on the videos and TIP 54 from SAMHSA

Chronic Illness May Be The New Normal

About half of all American adults have a chronic illness according to the National Health Council http://www.nationalhealthcouncil.org/sites/default/files/NHC_Files/Pdf_Files/AboutChronicDisease.pdf

Chronic Illnesses include (but are not limited to:

  • Asthma
  • Cancer
  • Chronic pain
  • Diabetes
  • Fibromyalgia
  • Heart disease or high blood pressure
  • Lupus
  • Lyme Disease
  • Mental Illness (Anxiety, depression, PTSD)

Effects of Pain and Chronic Illness

  • Depression
    • Fatigue
    • Sleep Disturbances
    • Hopelessness/Helplessness
    • Negative thoughts -> Stress -> Serotonin -> Pain
  • Ā Interventions
    • Mindfulness to become more aware of what is draining your energy and making a determined effort to do those things that can help reduce fatigue.
    • Good sleep habits
    • Circadian rhythm maintenance
    • Identify the things you CAN control and that are GOOD
    • Eat healthfully to support Serotonin functioning
  • Anxiety about…
    • Things wont get better
    • It is getting worse
    • Consequences of pain (lost job, relationships, fitnessā€¦)
  • Interventions
    • Avoid caffeine and nicotine
    • Educate yourself about the disorder and the PROBABILITY things will get worse
    • Keep a log of the good and bad days
    • Practice distress tolerance skills
    • Use the Challenging Questions Worksheet to address anxiety provoking thoughts
  • Guilt in the form of self anger for not being able to do what you used to or what you want to.Ā  This guilt can cause you to lash out at othersā€”push them away so you donā€™t disappoint them like you disappointed yourself.
  • Interventions
    • Think about how you would want your child or best friend to feel if they were in your position
    • Get rid of the shoulds
    • Focus on the things that you CAN do
    • Decide whether it is worth using your energy to be mad at yourself (and the world)
  • Grief over the loss of functioning, energy, dreams, freedom, self-concept….Ā  Remember the stages of grief are: Denial, Anger, Bargaining, Depression, Acceptance
  • Interventions–No quick fix here.
    • Work through the stages of grief for each of the losses because of the pain (Physical, self-concept, job, freedom (driving/mobility), dreamsā€¦)
  • Self-Esteem or self concept can also he altered because you may not be able to do all of the things you used to.
  • Interventions
    • Make a list of the positive things about you
    • Identify 1 or 2 goals you can work toward
    • Celebrate small things
    • Silence the inner critic