Medical Crisis Counseling in Health Maintenance Organizations

Preventive intervention measures provide helpful coping skills for medical crises sufferers and presents challenges to therapists to take on a myriad of roles to reduce client distress. Those who were recently diagnosed with cancer, adult-onset diabetes, and first time heart attacks were found by Koocher, Curtiss, Pollin & Patton to report significant positive attributions to healthcare providers and more support from families after being part of a medical crisis counseling study.

The researchers concluded that the psychopathology perspective did not properly take medical concerns into account and that a better preventative therapy model would also be cost effective in deterring medical crisis patients from later, costlier counseling. More importantly this research illustrated that the study’s steps taken within stages of treatment helped sufferers to more positively respond to healthcare providers and others in their support system (i. e. family).

Increasing social activity for these clients while improving perceptions of helpfulness and care by others toward the client is the most important intervention outcome, as it will improve quality of life for clients while helping to unburden the medical and psychological community due to implementation of these simple, short term steps. This short term approach aimed to help client’s avoid the stigma that is many times associated with mental health issues by focusing on medical issues and reactions.

This type of approach required that the therapist not only assist with the client’s coping capabilities, but also that the therapist focused on being a health educator. This required both empathy and education while the patient was being guided through the understanding that the distress that accompanied a diagnosis was a normal reaction and in no way pathological. Questions that attempted to draw on the exact nature of the diagnostic experience helped to keep the focus on the medical condition and clients’ reactions to their conditions were queried in a narrative form.

Simple who, what, when, where, why, and how questions were posed to assist the client in forming a basis for their own sense of control over their experience. Researchers asked what the patient knew about their condition, who told them, and how he or she communicated with care givers. Steps were then formed with this information to intermediate sessions. The intermediate sessions addressed coping strategies that could be utilized by the client in the form of; journaling, homework assignments, modifying existing coping strategies, and obtaining medical information.

Most importantly, activating social support systems and improving communication with family, medical care providers, and others were introduced as affirmative measures toward a more positive sense of emotional wellness. The process was fairly short in duration with up to 10 sessions offered, goals were finalized and progress was noted with scoring completed by the Customer Reported Outcomes and Satisfaction Scales (CROSS). Outcomes were weighed and the validity of the measured health status does seem solid due to the fact that the participants had no previous pathology or history of psychiatric treatment.

The only downfall of this study was that the elapsed time from diagnoses to study was 92 days. The researchers admit that “with a more rapid initiation of intervention, the outcome would potentially address symptoms of emotional distress more quickly” (57). The conclusion can be made then that the efficacy of the research could be further improved and that the best outcomes and methods in the time period allotted should be further expanded upon.

The most important strategies of dealing with expanding on social support and helping foster and facilitate better communication seem to have created a higher client satisfaction rate with cardiac patients as they self-reported higher levels of social activity and seemed happier with their health care providers. Cancer clients similarly reported a greater sense of support from friends and family in comparison with the control group. These most important findings and frameworks in which they were created are important from both a client and cost-effective standpoint.

Viewing the client as a consumer is part of the study and as such these consumers that participated in the study showed more satisfaction with health care providers with would theoretically lead them to increased motivation to follow medical protocol. This would lead to saving on the healthcare spectrum, as would the burden of excessive therapy in patients who did not perceive to have support from their social networks. It is only commonsense that preventative counseling is better for the holistic wellness of a newly diagnosed patient and this prevents a load on the system that would otherwise be burdened.

This is important not only from the client as a consumer perspective, but in realizing that time wasted on counseling and unnecessary health maintenance can harm others in need of service. In closing, the research done by Koocher, Curtiss, Pollin & Patton is exceptional in that it shows how intervention can prevent negative holistic health outcomes in CROSS reporting. Early therapy from a non psychopathological perspective helps to relieve diagnosis stigma and hones in client goals.

The most important measure is that of social support expansion as well as facilitation of better communication between clients and medical personnel. This does put the therapist in a unique role of both educator and counselor, but the outcomes both in terms of cost and client wellness are quite worth it and should be policy in each and every medical facility. Reference Koocher, Curtiss, Pollin & Patton. (2001). “Medical Crisis Counseling in a Health Maintenance Organization: Preventive Intervention” in Professional Psychology: Research and Practice. Vol 32, No. 1. pp 52-58

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