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Introduction

After breakfast at 9 am, the interaction took place in the patient lounge of the cancer unit. Steve, a 58-year-old man who had just been admitted for prostate cancer, was sitting in a corner as I walked into the room. With his hands on his lap and his head lowered, he gave off the impression of being noticeably reflective. There was a weak light emanating from the closed curtains. I took my place across from him, ready for our discussion.

Two weeks earlier, Steve was diagnosed with prostate cancer, leading to his admission to the oncology hospital and the start of his adventure. He had been having symptoms like urine problems, which prompted a medical assessment and eventual diagnosis. His condition had mainly been steady during the previous two weeks. As part of his treatment, he had a prostatectomy, and the following week was reserved for radiation therapy.

When Steve was officially admitted as a voluntary (informal) patient, he was honest about his worries regarding the cancer diagnosis and how it would affect his life. He recently joined a cancer support group, and he went there for the first time last week. This was my third conversation with Steve, and we discussed how he felt about the learning of the diagnosis as well as his time spent on the oncology unit. He openly expressed his concerns about how his illness would affect his family and showed a growing readiness to discuss his feelings and anxieties.

Interaction

Heron Category

Client Reaction

Alternative Interaction and Purpose

I start the session by greeting Steve with a warm smile and a friendly tone, creating a welcoming atmosphere.

Supportive

Steve responds with a slight smile and a nod, indicating that he appreciates the friendly approach.

An alternative approach could have been confrontational to address any recent relapses or slip-ups. However, I maintained a supportive tone in this session to build trust and rapport.

I ask Steve how he has been since our last session, showing a genuine interest in his well-being.

Supportive

Steve opens up about his challenges over the past week, including cravings and depressive symptoms.

An alternative approach might involve using a confrontational style to challenge his behaviour directly. However, in this case, a supportive approach (using open end questions) allows Steve to share his struggles openly.

I employ active listening, nodding and making empathetic statements as Steve talks about his experiences and emotions.

Supportive

Steve seems more relaxed and comfortable, knowing he is being heard and understood. He was able to clearly express his everyday hardships like pain and all day activities

An alternative approach could be confrontational to address his behaviour head-on, but I choose to validate his feelings and experiences through active listening.

I use open-ended questions to encourage Steve to explore his feelings and triggers, such as, "Can you tell me more about what was going on when you had depressive thoughts?"

Supportive

Steve begins to reflect on his emotions, anxieties, and circumstances. This gain insight into his depressive triggers.

An alternative approach might involve a cathartic approach to challenge his thought patterns, but in this case, open-ended questions helps Steve explore his feelings independently.

I offer positive reinforcement for his progress, such as following a schedule for ensuring timely mediations

Supportive

Steve's face lights up, and he expresses gratitude for the recognition.

An alternative approach could be prescriptive to emphasise the need for complete abstinence, but positive reinforcement encourages continued progress.

I suggest exploring coping strategies and self-care techniques to manage discomfort and depressive symptoms.

Informative

Steve appears engaged and takes notes on the suggestions.

An alternative approach might involve a catalytic style to challenge his resistance to change, but in this session, providing information on coping strategies is more appropriate.

Analysis

In the therapeutic encounter with Steve, a supportive approach emerges as a vital and transformative element in his journey toward recovery from prostate cancer and the concurrent management of anxiety and depression. This approach provides Steve with a safe and empathetic environment and is the cornerstone of the therapeutic process. It enables him to overcome his hesitations and anxieties about sharing his current condition and mental health struggles, particularly during the initial stages of cancer treatment. Employing supportive strategies breaks down barriers, creating an atmosphere of trust and understanding that is crucial for the treatment process to be effective (Kwame & Petrucka 2021).

The significance of supportive communication techniques, such as active listening, cannot be overstated. Through active engagement with Steve's narrative, I convey genuine interest in his well-being and ensure he feels truly respected and acknowledged. This empathetic approach contributes substantially to establishing a strong therapeutic relationship (Moudatsou et al. 2020). This relationship provides the foundation for the therapeutic journey, creating a space in which Steve feels valued and heard.

Incorporating positive reinforcement into the session is another powerful aspect of the supportive approach. Steve's motivation and self-esteem are boosted when his adherence to medication schedules is recognised and celebrated. This acknowledgment is crucial to Steve's recovery because it motivates him to move toward transformation. It reaffirms that his efforts are acknowledged and valued, fostering the confidence he needs to keep improving. It gives him the knowledge and abilities to overcome his emotional and physical challenges while creating greater autonomy and authority over his healing process.

The informative strategy exhibits its benefits alongside the supportive approach. I educated Steve on coping mechanisms, self-care techniques, and his medications' dosage and side effects. He now fully comprehends how to cope with his anxiety and effectively manage depression symptoms. Establishing a therapeutic setting where Steve feels secure, appreciated, and prepared to advance in his recovery depends on this well-balanced mix of encouraging and educational tactics (Molina-Mula & Gallo-Estrada 2020). A strong therapeutic partnership must be established for Steve to feel comfortable revealing his challenges and vulnerabilities. This creates the foundation for openness and trust (Stubbe 2017). Steve was provided with the knowledge and valuable tools he needed to address his fears and concerns and deal with his depressive symptoms. This informed method simultaneously enhances the therapeutic process. This knowledge gives him more autonomy and control over his recuperation, strengthening his sense of empowerment (Vainauskienė & Vaitkienė 2021.

Alternative approaches

It's crucial to recognise that the supportive and informative strategies used in Steve's instance are ideal for the initial phases of his treatment before pursuing alternative therapeutic contacts. However, there can come a time when more confrontational or catalytic methods are required to improve his progress further.

A confrontational attitude may be beneficial when dealing with probable relapses or reluctance to change. Relapses are typical during cancer treatment, and they can be crucial opportunities for development (Seiler & Jenewein 2019. A confrontational method enables the counsellor to directly question self-destructive behaviours and attitudes, whereas a supporting approach fosters a safe and empathic setting. Finding the right balance between comprehension and responsibility is crucial (Behr et al. 2020). As a result, Steve might be forced to face the repercussions of his behaviour and feel driven to return to his recovery journey by dealing with relapses and resistance to change. However, when to use an aggressive approach should be carefully examined because doing so too soon risks alienating or demoralising the client.

On the other hand, a catalytic approach can be highly beneficial in some circumstances, especially when the client is prepared to go deeper into the root causes of their concerns concerning their treatment. This strategy entails overcoming change resistance, promoting introspection, and facilitating insights (Ashwin & Wells 2023). It can be a potent technique for resolving co-occurring mental health conditions, like depression in Steve's instance, and identifying the fundamental roots of cancer treatment. A prescriptive approach entails medical practitioners making detailed, understandable therapy suggestions in accordance with their knowledge (Malykh & Rudetskiy 2018). This strategy is crucial when patients like Steve need clear direction and decision-making since cancer therapies are complicated. Furthermore, a cathartic method encourages patients like Steve to verbalise their feelings and anxieties. It gives patients a secure place to let go of suppressed feelings, which can be therapeutic and emotionally comforting. As a result, it helps patients with their medical therapy while increasing their psychological well-being (Rajhans et al. 2019).

Conclusion

In conclusion, the combination of supportive and informative approaches in this interaction proved effective in the early stages of Steve's treatment. However, as therapy progresses, it is important to remain flexible and adapt the approach to meet Steve's evolving needs, which might sometimes involve confrontational, catalytic, prescriptive, and cathartic elements. The key is maintaining a therapeutic balance that fosters growth and recovery while respecting the client's readiness for change.

References

Ashwin, C & Wells, R 2023. ‘Theories of Communication And Counselling, in Communication in Midwifery-E-Book, p.43, https://books.google.co.in/books

Behr, M, Aich, G & Scheurenbrand, C 2020, ‘Person-centered and experiential psychotherapy and transactional analysis–contributions of two humanistic approaches to challenging or confounded counselling situations’, Person-Centered & Experiential Psychotherapies, vol 19, no.4, pp.350-364, viewed 18 October 2023, https://doi.org/10.1080/14779757.2020.1748694

Kwame, A & Petrucka, PM 2021, ‘A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward’, BMC Nursing, vol 20, no.1, pp.1-10, viewed 18 October 2023, https://doi.org/10.1186/s12912-021-00684-2

Malykh, VL & Rudetskiy, SV 2018, ‘Approaches to medical decision-making based on big clinical data’, Journal of Healthcare Engineering, viewed 18 October, https://doi.org/10.1155/2018/3917659

Molina-Mula, J & Gallo-Estrada, J 2020. ‘Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making’. International Journal of Environmental Research and Public Health, vol 17, no.3, viewed 18 October 2023, https://doi.org/10.3390/ijerph17030835

Moudatsou, M, Stavropoulou, A, Philalithis, A & Koukouli, S 2020. ‘The role of empathy in health and social care professionals’. Healthcare, vol 8, no.1, viewed 18 October 2023, https://doi.org/10.3390/healthcare8010026

Rajhans, P, Hans, G, Kumar, V & Chadda, RK 2019, ‘Interpersonal psychotherapy for patients with mental disorders, Indian Journal of Psychiatry, vol 62, no. 2, p.201, viewed 18 October, https://doi.org/10.4103/psychiatry.IndianJPsychiatry_771_19

Seiler, A & Jenewein, J 2019, ‘Resilience in cancer patients’, Frontiers in Psychiatry, vol 10, viewed 18 October 2023, https://doi.org/10.3389/fpsyt.2019.00208

Stubbe, DE 2017, ‘The therapeutic alliance: the fundamental element of psychotherapy’, Focus: Journal of Life Long Learning in Psychiatry, vol 16, no.4, pp.402-403, viewed 18 October 2023, https://doi.org/10.1176/appi.focus.20180022

Vainauskienė, V & Vaitkienė, R 2021, ‘Enablers of patient knowledge empowerment for self-management of chronic disease: an integrative review’, International Journal of Environmental Research and Public Health, vol 18, no.5, viewed 18 October 2023, https://doi.org/10.3390/ijerph18052247

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