Abstract

Counseling professionals within medical settings confront life events of chronic illness, death, and deal with the consequences of life decisions made by their clients, patients, families, and significant others. They must be aware of a holistic linkage between patients’ psycho-emotional choices of adjustment and their compliance with and to medical intervention. In addition, therapists have also recognized the presence of individual and family created contexts of meanings (Goldenberg & Goldenberg, 2004) and narratives. Spiritual identity and self-esteem, life evaluation, and culturally diverse health values, and healing beliefs (Van Hook & Aguilar, 2001) can strongly influence the use of positive coping devices relevant to adaptation, well-being, and patient autonomy (Goldstein, Jaffe, Sutherland, & Wilson, 1987). Consequently, today’s therapeutic encounter may typically contain concern not only for psychological, emotional, and psychosocial outcomes of intervention but for the spiritual ones as well. However, managed care systems that promote diagnostic, short-term counseling approaches, have required therapists to adjust therapeutic dialogue to center on brief experiential, client-centered and holistically focused interventions in lieu of using more traditional and often longer-term insight and psychoanalytic approaches to therapy. As a result, a collaborative partnership of mutuality and conversation must be established almost immediately between patients and counselors to confront and process together the multi-dimensional impacts of chronic illness and continuing disability on the individual’s and family’s functioning. Creating a relationship that will successfully generate an exploration of additional strength and spiritual healing factors such as are contained within family perceptions of attached meanings to the occurrence of illness, and mediating factors of spirituality may be disallowed within prescribed healthcare interventions.