Problem Background
Despite the developments that have been made in approaches that seek to address the threat posed by HIV/AIDS, it is still one of the leading killers in the globe (DiMarco & Zoline 2004, 68). The effects of HIV/AIDS on individual health cannot be quantified owing to the effect that it has in making the body susceptible to all forms of diseases. The effects of HIV/AIDS on the society especially the cost associated with its management and the burden that it places on healthcare make it one of the most costly conditions in the current generation DiMarco & Zoline 2004, 68).
The healthcare system and independent researchers have taken heed of the threat posed by HIV/AIDS to the society and have been keen at devising systems that can effectively be used in ensuring that the epidemic is well handled. Approaches to deal with stigma, preventative health and developing awareness across societies have come up as some of the systems that can be used in ensuring that the negative effects of HIV/AIDS to the society are addressed (DiMarco & Zoline 2004).
Efficiency of the approaches used in management of HIV/AIDS is important in devising an approach that is effective (Sikkema, Hansen, Meade, Kochman & Lee, 2005). The resource requirement and the time consumed by the intervention systems require that they be effective for their existence to be justified. Among the various systems that have been developed, integrative systems have come up as having the potential of ensuring a feeling of appreciation among patients while ensuring that the challenges that they face as patients and those that are unique to the environment they are in are well addressed.
Problem Definition
Though the prevalence rates of HIV/AIDS in Ireland is not as high as in third world nations, the presence of the killer condition has not been assumed (WHO 2009). HIV/AIDS is not only a problem for the effects that it has on individual health but also due to the effect that it has on individual cognition and self esteem. Research shows that people who have contracted HIV/AIDS via sex are more prone to stigmatization than those that are known to have contracted the condition via other means. Statistics by the Word Health Organisation (2009) show that there were 4419 reported cases of HIV in Ireland by the end of 2006. The number included 909 people who had already developed HIV/AIDS and 97 who had died (WHO 2009). The statistics further show that 93% of the cases are of know mode of transmission (WHO 2009). Over 63% of the infections were a result of sexual relations both heterosexual and homosexual. Use of drug and injections accounted for 32% of the known cases (WHO 2009). A comparison between statistics from Ireland and third world nations and even the US shows that HIV/AIDS is far from being considered an epidemic in this nation (WHO 2009).
Ireland is among the few nations that have effectively developed and implemented integrative health approaches with regards to management of HIV/AIDS (Cartwright & Cassidy 2002). The level of efficiency that the nations has attained in management of HIV/AIDS makes it a case for approaches that other nations can employ in ensuring that HIV/AIDS is managed effectively. Efficiency in management of HIV/AIDS is the only options that the society is left with considering that its cure appears to be an enigma (Cartwright & Cassidy 2002). Interactive psychotherapy has proven to be effective in Ireland and the only piece left of the puzzle is why?
Significance
Healthcare management is dependent on the taxpayers for its funding. A costly healthcare system directly impacts on the quality of life attainable by affecting taxes. Development of an effective system to managing a healthcare issue is important in gaining information regarding the problem and ensuring that the mechanics employed in its address are relevant to its nature. HIV/AIDS is both a healthcare issue and a social problem that can effectively be addressed by employing integrative psychotherapy. The findings of the study will be reflective of best practices in integrative psychotherapy that have contributed to effective management of HIV/HIV/AIDS in Ireland. The results will thus form a basis for further research on integrative psychotherapy and can be borrowed or directly used by healthcare systems across other nations and even regions to ensure HIV/AIDS is effectively managed. Adoption of integrative psychotherapy approaches in management of HIV/AIDS would reduce stigmatisation and encourage societies into not only developing awareness on the problem but appreciating the effects that it has on individual health and the economy.
Literature Review
Psychotherapy is a wide field that seeks to develop a better understanding of the human person. Psychology can be considered one of the oldest disciplines in academics and its fusion into therapy which is a recent development adds little to the existing knowledge except for integration of medical terms and theories. Put simply, psychotherapy has been traversed by theorists and scientists as a proper understanding of the human brain and how it works was sought (Bolognesi 2006, 626). Cognitive, affective, behavioural and physiological theories and systems have been developed and applied to societies in bids to address challenges communities are faced with. While individual systems have their own advantages and cons, integration of different theories has come up as one of the most effective approaches to ensuring that direct factors that contribute to overall well-being are addressed. Integrative psychotherapy is therefore a system where elements of different theories that make up psychotherapy are drawn from in both practice and theory (Joe, Carmack, Garcia-Buñuel, Kelly & Chester 2000, 273). The result is a discipline or a practice that is largely appreciative of diversity and strength of each of the theories while addressing weaknesses that are inherent of individual systems. It is generally appreciated that no one theory can fully explain the human person thus the need to integrate and not just draw from other theories.
Sigmund Freud may be considered the father of modern psychoanalysis for he came up with the basics of the talking cure or psychoanalysis (Cartwright & Cassidy 2002). A number of developments have since been recorded with different variations coming up in seeking to ensure effective grasp of human cognition and behaviour (Rubenstein & Sorrentino 2008). Person centred, transactional, gestalt, family systems and existential therapies are just but some of the examples that have been developed (Richardson, Morgan, Vielhauer, Cuevas, Buondonno & Keane 2005, 1017). Owing to the interest that man has in understanding his own nature a number of theories have been developed and practised by psychotherapists. Though an understanding of what works in addressing a social problem is important, developing a strong theoretical basis for success is often important in replicating success in other cases. An understanding of why a system works is the main goal in integrative psychology that draws from multiple theories to explain success or even failures.
Application of integrative psychotherapy in management of illnesses is not a recent development and has widely been tipped as one of the most effective approaches to ensuring that psychological aspect of care is addressed. The role of the environment and frame or mind that a patient is in plays a critical role in determining the rate of recovery thus the levels of efficiency that can be managed in provision of care. The WHO recognises the essential role played by overall well-being of an individual in determining rate of recovery (Marvel, Rowe, Colon-Perez, Diclemente & Liddle 2009). Psychotherapy has proven to be quite important in appreciation of positive living among HIV patients, ensuring that the society is appreciative of the problem thus reduction of stigma and generally making sure that the society is in a frame of mind that is relevant to effective management of HIV/HIV/AIDS.
Gap
Though a lot has been done on individual therapies and their relevance to not just HIV/AIDS but also ensuring effective healthcare management, there are a number of issues with respect to practical integrative psychotherapy that are yet to be addressed. The theory involved in integrative psychotherapy borrows elements from other existing theories to develop an understanding of a conditions, its practical application is however a nightmare that few researchers manage to deal with. The multitude of theories that one can chose from, the effects of culture and existing systems and the underlying effect of the healthcare systems are all factors that affect integrative psychotherapy practice. Researches have done little to address this issue that affects practical integrative psychotherapy mainly due to its need for specificity to communities and even nations (Pobuda, Crothers, Goldblum, Dilley & Koopman 2008, 565).
Research Methodology
The methodology used in any given research or study affects the accuracy and relevance of findings and is therefore a factor that affects the integrity of a research. It is important that the approach be of relevance to objectives and nature of a problem to develop results that can be of use to the society. The literature review points to a gap that exists in research on practical integrative psychotherapy to medical cases. This presents a case where primary data should be sought. A look at the theory that is beneath integrative psychotherapy shows that there are multiple approaches and theories that can be adopted in trying to develop an understanding of any phenomenon. This presents a theoretical situation that is defined by a large number of well researched theories. It is thus apparent that a qualitative research that involves analysis of existing theories and collection of first hand data would be appropriate for the research.
Approach
Ireland is one of the nations that have efficiently employed integrative psychotherapy in management of HIV/AIDS. Observation of psychotherapist working with couples and individual that have contracted HIV/AIDS via sex will be the main mode of data collection. To ensure that data collected is enough the research will be done for a period of 15 months to reduce any bias that may be a result of seasonal or individual practices. Selection of Ireland is mainly due to its effective use of integrative psychotherapy and seeking physiotherapists that work with individuals who have contracted HIV/AIDS through sex is out of the realisation that such people face high levels of stigma and are more likely to take on degenerate practices. Observation as a qualitative data collection mechanism is associated with high levels of accuracy and information intensity. These variables are important in ensuring that the information captured is relevant to the complex unexplored practices that define integrative psychotherapy application to HIV management.
Analysis
Data collected from observation of physiotherapists will be explored and with the input of additional research on existing theories in psychoanalysis and manifestation of HIV/AIDS analysed to determine factors that have been central to successful implementation of integrative psychotherapy. The research is qualitative thus the objectivity of the researcher and internal checks to determine that every assertion is justified by an observation or existing literature will play a part in ensuring analysis is carried out without biases.
Rea liability and Validity
The research approach has been defined in a manner that is appreciative of integrative psychotherapy and dynamics that define behaviour towards people suffering from HIV/AIDS. The reliability of the findings is developed by breadth of the research and use of both existing theoretical knowledge and observations in developing a picture of best practices in integrative psychotherapy. The theory beneath a practice rarely changes irrespective of the actual mechanisms. The study is mainly aimed at seeking why integrative physiotherapy is a success in Ireland thus the information is relevant to any society irrespective of the underlying systems and values.
References
Bolognesi, N 2006. AIDS in Africa: A question of trust. Nature, 1443(7112), 626-627
Cartwright, D & Cassidy, M 2002. Working with HIV/AIDS Sufferers: “When Good Enough Is Not Enough”. American Journal of Psychotherapy, 56 (2), 149.
DiMarco, M & Zoline, S 2004. Duty to Warn in the Context of HIV/AIDS- Related Psychotherapy: Decision Making Among Psychologists. Counseling & Clinical Psychology Journal, 1(2), 68-85.
Joe, E, Carmack, A, Garcia-Buñuel, E, Kelly & Chester, J 2000. Implementation of Guidelines for HIV Counseling and Voluntary HIV Testing of Pregnant Women. American Journal of Public Health, 90(2), 273-276
Marvel, F, Rowe, C, Colon-Perez, L, Diclemente, R & Liddle, H. 2009. A Multidimensional Family Therapy HIV/STD Risk-Reduction Intervention: An Integrative Family-Based Model for Drug-Involved Juvenile Offenders. Family Process, 48(1), 69-84.
Pobuda, T, Crothers, L, Goldblum, P, Dilley, J & Koopman, C 2008. Effects of Time-Limited Dynamic Psychotherapy on Distress Among HIV-Seropositive Men Who Have Sex with Men. AIDS Patient Care & STDs, 22(7), 561-567.
Richardson, MA, Morgan, EE, Vielhauer, MJ, Cuevas, CA, Buondonno, LM & Keane, TM 2005. Utility of the HIV dementia scale in assessing risk for significant HIV-related cognitive-motor deficits in a high-risk urban adult sample. AIDS Care, 17(8), 1013-1021.
Rubenstein, D & Sorrentino, D 2008. Psychotherapy with HIV/AIDS Patients: Assessment and Treatment Plan Development. American Journal of Psychotherapy, 62(4), 365-375.
Sikkema, KJ, Hansen, NB, Meade, CS, Kochman, A & Lee, RS 2005. Improvements in health-related quality of life following a group intervention for coping with AIDS-bereavement among HIV-infected men and women. Quality of Life Research, 14(4), 991-1005.
WHO (2009). Ireland-HIV-AIDS Country Profile [Internet]. Available: <http://www.euro.who.int/aids/ctryinfo/overview/20060118_21> [Accessed 16 June 2009]
Appendix
Gantt Chart
Task
Duration
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Pre-study
2
Collection of Data
8
Analysis of theories
2
Compilation
2
Review
1