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Managing Chronic Illness Using the Four-Phase Treatment Approach
A Mental Health Professional's Guide to Helping Chronically Ill People
Patricia A. Fennell (Author)
9780471462774, Wiley
Hardback, published 7 November 2003
464 pages
26.2 x 18.5 x 3.7 cm, 0.992 kg
A pioneering book to help maximize the quality of life for chronically ill patients
Written by a leading authority on chronic illness treatment and management, Managing Chronic Illness Using the Four-Phase Treatment Approach provides evidence-based practice guidelines for clinicians to help their clients with debilitating health problems embrace a new "normal," understand the cyclical nature of their illness, and function at the highest level possible.
Patricia Fennell's groundbreaking model for understanding chronic illness identifies and describes four broad phases experienced by the chronically ill: crisis, stabilization, resolution, and integration. Using a broad array of case histories, Fennell vividly illustrates what clients need at each phase and how to assess and respond to them compassionately. Fennell also suggests how clinicians may best use their own changing experiences in their work to help clients transition through the four phases.
The goal of the "Four-Phase Model" is to maximize a client's quality of life without offering false hope for a cure, making it an effective treatment strategy for diverse client populations, including people with physiological diseases; patients whose lives are being prolonged by modern medicine; and people who suffer from addiction, post-traumatic stress syndrome, intractable pain, and post-rape and abuse conditions.
Complete with detailed treatment protocols for documenting a client's symptoms and quality of life at each phase, Managing Chronic Illness Using the Four-Phase Treatment Approach is a highly practical book for everyone working with chronically ill clients.
Preface xi Part I Conceptual Overview 1 A New Model for Treating the Chronically Ill 3 Necessary Paradigm Shifts 4 The Four-Phase Model and Other Phase Theories 5 Underlying Assumptions of the Model 13 Conceptual Dichotomies 16 The Phenomenon of Chronicity 23 Traumatization of the Chronically Ill 28 The Integration Assumption 35 Palliation 35 Patient and Clinician Together 36 2 The Cultural Context of Chronic Illness 39 The Primary Cultural Context: The Health Care System 39 Levels of Discourse 47 Sociocultural Inf luences in Chronic Illness and Their Traumagenic Effects 59 Potentially Traumagenic Sociocultural Factors 60 3 Introduction to the Four Phases: Betty’s Story 73 A Note on Developmental Life Processes 73 Betty’s Story 74 Part II The Four Phases 4 Phase 1: Crisis 97 Identifying Phase 1 Patients 99 Assessment: Physical/Behavioral Domain 105 Assessment: Psychological Domain 113 Assessment: Social/Interactive Domain 118 Clinical Goal and Treatment Issues in Phase 1 121 Treatment: Physical/Behavioral Domain 122 Treatment: Psychological Domain 130 Treatment: Social/Interactive Domain 149 Countertransference 160 Transformative Steps over the Four Phases 162 Countertransference in Phase 1 164 Clinical Stance in Phase 1 170 Spiritual/Philosophical Perspective in Phase 1 174 5 Phase 2: Stabilization 181 Personal Energy Process and Activity Categories 181 Identifying Phase 2 Patients 186 Assessment: Physical/Behavioral Domain 192 Assessment: Psychological Domain 196 Assessment: Social/Interactive Domain 199 Clinical Goal and Treatment Issues in Phase 2 206 Treatment: Physical/Behavioral Domain 207 Treatment: Psychological Domain 216 Treatment: Social/Interactive Domain 229 Countertransference in Phase 2 239 Transformation Steps in Phase 2 243 Clinical Stance in Phase 2 244 Spiritual/Philosophical Perspective in Phase 2 247 6 Phase 3: Resolution 253 Development of Meaning 253 Identifying Phase 3 Patients 256 Assessment: Physical/Behavioral Domain 263 Assessment: Psychological Domain 268 Assessment: Social/Interactive Domain 269 Clinical Goal and Treatment Issues in Phase 3 273 Treatment: Physical/Behavioral Domain 274 Treatment: Psychological Domain 276 Treatment: Social/Interactive Domain 294 Countertransference in Phase 3 298 Transformation Steps in Phase 3 301 Clinical Stance in Phase 3 303 Spiritual/Philosophical Perspective in Phase 3 304 7 Phase 4: Integration 315 Identifying Phase 4 Patients 316 Assessment: Physical/Behavioral Domain 322 Assessment: Psychological Domain 323 Assessment: Social/Interactive Domain 325 Clinical Goal and Treatment Issues in Phase 4 329 Treatment: Physical/Behavioral Domain 329 Treatment: Psychological Domain 331 Treatment: Social/Interactive Domain 335 Countertransference in Phase 4 337 Transformation Steps in Phase 4 338 Clinical Stance in Phase 4 340 Spiritual/Philosophical Perspective in Phase 4 341 Part III Future Directions 8 A Paradigm Shift 347 Chronicity and Ambiguity 347 Systems Inclusiveness 347 Distinctive Features of the Four-Phase Model 348 Umbrella Paradigm 351 Cyclic Pattern of Chronic Illness 353 Conceptual Dichotomies 354 Ongoing Trauma 357 Countertransference 358 Necessity for Teamwork 361 Meaning Development 362 Public Policy and Chronic Illness 363 Research Considerations 364 Bibliography 379 Author Index 415 Subject Index 425
Subject Areas: Psychology [JM]
