Rebecca Gray Toby Newton-John Jamie Lee Claire Ralfs From person to patient, and partner to carer: the transitions and transformations of couples affected by chronic illness – and how counsellors can help them
Overview • Background • Literature Review • Practice Recommendations • Tools and resources
Background • Chronic pain and relationships (Toby Newtown-John) • Expansion to chronic illness (Medtronic Philanthropic Funding) • Collaboration with RASA (Practitioner consultation) • Tools and resources (Website)
Definitions Chronic illnesses are long-term conditions characterized by complex causes; multiple risks; long periods of latency; and impairment or disability. Examples include coronary heart disease or hepatitis C. Long-term mental health illnesses are also considered chronic illnesses, such as, depression, schizophrenia and bipolar disorder.
Definitions Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or experienced in terms of such damage. Chronic pain refers to pain that has persisted for a period longer than three months. This form of pain is now considered to be a disease and rather than just being a symptom of some other condition, as it is often experienced despite attempts to treat it with medications and other therapies.
Literature Review • Bad relationships are bad for you • Bad relationships make it harder to manage health issues • The ability of the partner to be supportive erodes over time • Caring for someone with chronic illness affects the carer’s wellbeing • Improving the relationship can improve their health
Practice recommendation • People with chronic illness may be vulnerable in relationships; or may be acting out their illness • Loss of intimacy or couple distress may be masking power imbalances in relationships • Screen for power imbalances in the couple relationship and wider family relationships before using these tools • In particular, domestic and family violence may prevent therapeutic work or escalate after therapeutic work
Website materials Therapist Patient Partner Pre-session Self-guided Wellbeing ‘fridge background couples magnets’ briefing conversation In-session guided Living with therapeutic chronic illness tip Partner tip sheet conversation sheet In-session Living with relationship chronic illness Partner video checklist videos Other chronic illness resources (podcasts, books, websites)
Website materials Therapist Patient Partner In-session Self-guided Wellbeing ‘fridge background couples magnets’ briefing conversation In-session guided Living with therapeutic chronic illness tip Partner tip sheet conversation sheet In-session Living with relationship chronic illness Partner video checklist videos Other chronic illness resources (podcasts, books, websites)
Website materials Therapist Patient Partner In-session (or Self-guided Wellbeing ‘fridge pre-session) couples magnets’ briefing conversation In-session guided Living with therapeutic chronic illness tip Partner tip sheet conversation sheet In-session Living with relationship chronic illness Partner video checklist videos Provides background on ‘reasonable hope’ (Weingarten, 2010) • Contrasts ‘reasonable hope’ from ‘unrealistic hope’ • Suitable for therapist and client in-session •
Website materials Therapist Patient Partner In-session (or Self-guided Wellbeing ‘fridge pre-session) couples magnets’ briefing conversation In-session guided Living with therapeutic chronic illness tip Partner tip sheet conversation sheet In-session Living with relationship chronic illness Partner video Provides a guided narrative therapy influenced externalisation • checklist videos of ‘the illness and its effects’ Promotes conversation about a difficult topic • Suitable for therapist and client in-session •
Website materials Therapist Patient Partner In-session (or Self-guided Wellbeing ‘fridge pre-session) couples magnets’ briefing conversation In-session guided Living with therapeutic chronic illness tip Partner tip sheet conversation sheet In-session Living with relationship chronic illness Partner video Normalises distress with checklist of common couple issues • checklist videos (adapted from ‘Gottman 19’ checklist) Uses ‘the miracle question’ to dreams for the future • Suitable for therapist and client in-session •
Website materials Therapist Patient Partner Pre-session Self-guided Wellbeing ‘fridge background couples magnets’ briefing conversation In-session guided Living with therapeutic chronic illness tip Partner tip sheet conversation sheet Provides indirect means to show effects of • chronic illness on patient’s mood In-session Living with Deliberately irreverent tone • relationship chronic illness Partner video Suitable as therapist handout or client • checklist videos download Other chronic illness resources (podcasts, books, websites)
Website materials Therapist Patient Partner Pre-session Self-guided Wellbeing ‘fridge background couples magnets’ briefing conversation In-session guided Living with therapeutic chronic illness tip Partner tip sheet conversation sheet Basic psychoeducation on chronic illness and • relationships; tips for a culture of appreciation In-session Living with Drawn from Gottman Institute materials • relationship chronic illness Partner video Suitable as therapist handout or client • checklist videos download Other chronic illness resources (podcasts, books, websites)
Website materials Therapist Patient Partner Pre-session Self-guided Wellbeing ‘fridge background couples magnets’ briefing conversation In-session guided Living with therapeutic chronic illness tip Partner tip sheet conversation sheet Actor and clinician talking about common issues • of chronic illness and relationships In-session Living with Based on interviews with chronic illness • relationship chronic illness Partner video sufferers and research evidence checklist videos Suitable for client streaming at home • Other chronic illness resources (podcasts, books, websites)
Website materials Therapist Partner Pre-session Self-guided Wellbeing ‘fridge background couples magnets’ briefing conversation In-session guided Living with therapeutic chronic illness tip Partner tip sheet conversation sheet Scaffolded questions to explore how chronic • illness is impacting on a couple relationship In-session Living with relationship chronic illness Partner video Based on narrative reauthoring conversation • checklist videos Suitable for couple download at home • Other chronic illness resources (podcasts, books, websites)
Website materials Therapist Patient Partner Partner Pre-session Self-guided Wellbeing ‘fridge Self-guided background couples magnets’ couples briefing conversation conversation In-session guided Living with therapeutic chronic illness tip Partner tip sheet Partner tip sheet conversation sheet Basic psychoeducation on chronic illness and • relationships; tips for a culture of appreciation In-session Living with Drawn from Gottman Institute materials • relationship chronic illness Partner video Suitable as therapist handout or client Partner video • checklist videos download Other chronic illness resources (podcasts, books, websites)
Website materials Therapist Patient Partner Pre-session Self-guided Wellbeing ‘fridge background couples magnets’ briefing conversation In-session guided Living with therapeutic chronic illness tip Partner tip sheet conversation sheet Actor and clinician talking about common issues • of chronic illness and relationships In-session Living with Based on interviews with chronic illness • relationship chronic illness Partner video sufferers and research evidence checklist videos Suitable for client streaming at home • Other chronic illness resources (podcasts, books, websites)
Let’s talk about Reas asonab able Hop ope .
What about hope? What comes to mind when The usual. you think of hope? ‘A butterfly, a rainbow, an undemanding bird that perches in one’s soul’ Those are common images (Weingarten, 2010, p. 7) and very ‘uplifting’, but would Chronic Illness let anyone stay uplifted like Fair point. that for long? And the higher you fly, the further you fall… That’s where Reasonable Hope comes in. It’s far more down to earth. Think sweaty track pants Ok. Tell us more… and worn out sneakers. Based on the work of Kaethe Weingarten
Research and Dr It’s assumed Google confirm ‘It’s knowledge that good for people should relationships where share feelings with couples share their partner. feelings’. Here’s a good place to start… Frustration builds But chronic Illness Couples hide the triggers powerful, feelings and then difficult and feel guilty about socially hiding their undesirable feelings. feelings in couples Is the relationship strong enough to share even those ose feelings? Are couples even allowed to feel these feelings?
Recommend
More recommend
