Week 5 - Fatigue - Counselling and Phenomenology PDF

Week 5: Phenomenology of hypothyroidism and nonorganic fatigue and counselling the patient with chronic fatigue (i.e., whether due to hypothyroidism or idiopathic) Part 1 - Counselling: The Cultural Climate and the Therapeutic Relationship Differences Make a Difference Importan...

Week 5: Phenomenology of hypothyroidism and nonorganic fatigue and counselling the patient with chronic fatigue (i.e., whether due to hypothyroidism or idiopathic) Part 1 - Counselling: The Cultural Climate and the Therapeutic Relationship Differences Make a Difference Importance of cultural competency. Mismatch between client and helper. How can you become culturally competent? What is culture? Acculturated and multiple heritage. Skills for Helping Someone Who is Culturally Different Tutorial stance: by listening. Tapping cultural support systems. Achieving credibility and trust. Tailoring your approach to the client. Acknowledging differences by broaching. Skills for Dealing with Gender Issues Address gender in the assessment process. Discuss gender issues that surface to avoid misunderstanding. Utilize supervision. Awareness of how gender affects attitudes, family roles, and family violence. Be self-aware of your own gender stereotypes. Part 2 - Phenomenology of Hypothyroidism and Nonorganic Fatigue  Older Patients’ Experience of Primary Hypothyroidism CC BY-SA 4.0 DEED; Link to license: https://commons.w ikimedia.org/wiki/Fi le:%E6%96%B0%E 5%BB%BA%E9%A 1%B9%E7%9B%AE.jpg. Nothing has been altered in this figure. Older Patients’ Experience of Primary Hypothyroidism General lack of knowledge about the symptoms. ○ Confusing symptoms happened prior to diagnosis (e.g., falling asleep, losing it, etc). ○ Unclear relationship between symptoms and hypothyroidism (e.g., thinning hair). (Ingoe at al, 2017, pp.630-632) Older Patients’ Experience of Primary Hypothyroidism Hypothyroidism and medication. ○ Dose adjustments. ○ Believed increases in medication would have direct effects on health benefits (e.g., lose weight, increase in wellbeing, etc). ○ Doubting the diagnosis and treatment. (Ingoe at al, 2017, pp.630-632) Older Patients’ Experience of Primary Hypothyroidism Hypothyroidism and ongoing management. ○ Appointments, regular monitoring, and dose adjustments. ○ Lack of feedback resulted in anxiety or frustration. ○ Lack of information sharing. ○ Trust in their physicians despite feeling vulnerable (i.e., “passive acceptance of the status quo”). (Ingoe at al, 2017, pp.630-632) Chronic Fatigue and Burnout CFS described in somatic terms whereas burnout described in psychological terms (p.4). Lack of energy. People depicted or afflicted are seen as “hard working, dedicated, active people” (p.6). (Leone et al, 2011) Chronic Fatigue and Burnout Overload. External attributions (i.e., cause in burnout is known, but in CFS the cause or causes are unknown). Recognition. (Leone et al, 2011) Part 3 - Counselling the Patient with CFS Chronic Fatigue Syndrome/ME Treatment is somatic. Recognizing and validating post-exertional malaise (PEM)=Severe health breakdown (“crash”) with diverse symptoms (p.3). Counselling relies on tailored approach to pacing. ○ Introducing the concept of pacing. ○ Patient resistance to the often severe constraints that it imposes. ○ Negative attributions and reactions to pacing. ○ Existential themes. (Grande et al, 2023).