Fiona is a 32-year-old white, single lady, who is a radio presenter. She is a new mom to a bouncing baby boy. On summer of 2012, she woke up with a mild headache. She took some pain killer, and then headed straight to work, hoping that the headache would vanish. At work, the headache escalated, and she started having double vision; thus, she was rushed to an emergency center. The doctor decided to make an MRI, which brought the disappointing news that she had a brain tumor. This marked the beginning of her life with cancer. She underwent surgery and radiation, and this changed her life completely. Surely, it was extremely hard for her psychologically: one moment she is a dazzling radio presenter, and the next moment she is a cancer patient. Though she took medication, she lives with the fear that the tumor might start growing again and she may not be there to see her son mature. She is not able to continue working for the long hours that she used to work before. Thus, the disease changed her way of life, as well as her son’s. She is reserved and does not talk a lot about her issues. Thus, this further complicates her problem as she has no one to lean on or who can take care of her.
The client walked into our premises wearing a smile, but from a closer look, one could tell she was struggling with something. The diagnosis of brain tumor and its suddenness caused her a lot of worries. The fact that she is a radio star keeps her in the limelight, and as soon as the news was announced, everyone has been talking about her. Fiona is used to encouraging others, wishing them well and is seen by many as a role model. Being in such a vulnerable situation has caused her a lot of distress, and she is not sure about how to handle the situation. A crisis can be defined as a situation that an individual finds stressful and the normal coping strategies are deemed insufficient to deal with it (Laguardia). The definition of a crisis is not limited to a traumatic event, but mostly focuses on the individual reaction to the situation. It can be said to be the upset of an individual equilibrium that defies all the personal intervention mechanisms. This type of crises thus can be termed as life event crises. The victim will have to adjust their lifestyle and may not be able to live as they used to before. It is a crisis as it occurred all at once and the normal intervention tactics are not able to arrest the situation.
Roosen, in his research paper on the factors that affect the crises management, noted that good judgment, available information, and effective planning are some of the key factors that determine the success of the management program. He identified the fourth factor as luck. The interplay between these factors is that successful application of the first three factors will influence the success of the fourth one. Judgment refers to the errors in the decision making during a crisis. It is, therefore, important for the person facing the crisis to be aware of the decisions that need to be made. The other factor is the lack of information on how to cope with the issue. This affects the person's ability to seek intervention before the issues escalate beyond their control. In the case of a crisis, there is the need for an effective plan on how to deal with the situation.
The above interventions factors are dependent on the individual. In our case, the patient is a white heterosexual female, who is 32 years old. She is a single mother with one kid. The fact that she works at a radio station is an important factor as it has allowed her to interact with people in similar situations and help them to make the right choices. She is an excellent communicator, and thus she will be able to talk her issues out with the professionals. Being a public figure, she attracts a lot of attention, whereas this may have some negative impacts. However, words of encouragement that she can hear from the public and colleagues may have some healing impacts and thus assist her in dealing with it. Working with media is considered to be one of the most lucrative careers; therefore, being in that elite class will accord her access to the best care available and thus facilitate speedy healing and management of the issue. Work and communication with people from diverse cultural backgrounds has opened her up. Thus, she is open to trying out different psychotherapy techniques. One more aspect is that being a single parent is devastating to the kid. However, this can act as a stimulus as she is aware of the fact that she needs to be strong for her son. Finally, one should also note that being a female is a strength as studies have shown that male members of the societies are less likely to open up about their issues. Female members, on the other hand, talk to their friends and even when it comes to talking to a professional, they are most likely to get an effective intervention session as compared to men (Wisch, Mahalik, Hayes, and Nutt; Helmes and Gallou).
When planning the intervention program, the planner should pay attention to the fact that the patient is a mother, and thus the welfare of the child should be put into consideration. Therefore, instead of in-house sessions, the patient should be allowed to visit the professional in regular periods and, at the same time, get sufficient time to spend with the kid. The patient is a well-known radio presenter, so her case is likely to attract a lot of public attention. This is why the planner should consider privacy issues even more carefully than usually. After finishing her chemotherapy, she was accorded an extended medical leave to facilitate her healing process. This extended free time allowed her mind to realize everything, and she started thinking about the future. She is concerned that the tumor might regenerate and that she may not be there to cater for her kid. She and her husband are separated, and thus she cannot count on him to care for the kid. This is causing her distress as she is unsure of what might happen if she is not there to care for her son. Now, she is seen withdrawn and often in deep thoughts. She forgets easily about things and has lost interest in activities she used to enjoy before the diagnosis. She no longer spends quality time with the son, and she is not even keen to get back to work. If the condition escalates, it may affect the son, so it needs to be treated before it gets beyond control.
A professional needs to employ the following intervention program in dealing with the situation:
- Evaluation of the extent of the situation
A prompt bio-psychological assessment is necessary to identify the extent to which the condition has escalated and device an appropriate response. This should cover the environment and stressors, medication and any external self-treatment that the patient might have indulged in. Examples include anxiety drugs, alcohol and any other non-prescribed solution that the patient might have resorted to. The session should also cover the inquiries as to whether the patient has any suicidal thoughts. This will help to determine the seriousness of the condition and assist the professional in coming up with an appropriate response. Besides, the session will help to assess the patient's mental strength in coping with the issue and investigate if the patient or the family has a history of suicide thoughts and attempts. For a professional, interviewing skills are important in this session as the information will be taken from the unfolding story rather than intensively questioning the patient.
- Building rapport with the patient
The counselor should demonstrate genuineness and respect in dealing with the patient. At this stage, the counselor character traits and behavior towards the patient allow building of a good counselor-patient relationship. They include the normal interaction skills, such as nonjudgmental, positive and encouraging attitude, proper eye contact, etc. (Mental Health Academy).
- Identifying the major issue
At this stage, the professional will seek to understand the major underlying issue that is affecting the patient. In our case, the cancer diagnosis in itself is an issue, but it has been managed so far. The patient suffered crisis after leaving the hospital during the long extended sick leave. The counselor should thus seek to understand the patients coping tactics and the exact underlying issue.
- Dealing with the feelings
At this stage, the counselor already understands the situation that is overwhelming the patient. He/she may employ a listening tactic and allow the patient to talk the issue that is bothering her out. Through such a conversation, the patient can think through the issue and be able to minimize the impacts. Through talking, they can reason together on the best course of action.
- Exploring the alternatives
After confronting the issue, and talking it through with the patient, this step allows the counselor to explore the alternatives to the situation at hand. It is important for the counselor to initiate the discussion and choose the ideal option. However, the patient should be content with the chosen program and be able to follow it. This will determine the success or failure of the program.
- Action plan
After understanding the situation at hand and exploring all the available options and agreeing with the patient on the best way forward, the final stage is the implementation of the prescribed solution. The implementation should consider the fact that the patient has a kid and the reputation as a radio presenter. The counselor should schedule future communication timelines that will allow updates on development and keeping them in touch with the patients. If the condition is acute and involves symptoms like sleep loss, the counselor can recommend some medication, isolation and/or hospitalization. These steps are aimed at restoring a psychological balance of the patient.
The crisis worker should schedule follow-up sessions to allow evaluation of the patient's post-crisis status. The evaluation can be physical, cognitive, evaluation of overall functioning, current stressing issues and need for possible referrals.
In each of the above sessions, the counselor should ensure a debriefing session is held (Hillman).
The aim of the counselor is to understand the main issue that is causing the crises and be able to talk it through with the patient. This will allow discussing and narrowing down the ideal course of action. Implementation and follow-up sessions should be included. To avoid burning out in the session, the focus should be on training the patient how to rise above the situation, leading them to the program that will prevent even the future crisis.