Working as a counselor in a medical setting comes inbuilt with a wide array of ethical challenges, practical obstacles and emotional trials. In this context, it is incumbent upon the counselor to possess certain sensitivities, sensibilities and intuition with respect to the needs of clients. This imperative is only magnified when this clientele is facing terminal illness. Counseling patients suffering from terminal illness carries its own spectrum of complexities and only the combination of training, experience and psychological suitability for the job are sufficient to provide one with skills to perform it well. As the discussion hereafter will show, patients with terminal illness are in a unique disposition within the context of medical treatment and must therefore be shown a unique form of counsel. This will be reflected in the values demonstrated and responsibilities assumed by the attending counselor both in this discussion and in the video compiled to accompany it.
Values and Responsibilities of the Counselor:
The responsibilities of the counselor can fall within a wide range of permutations depending on the patient's specific needs. But a common role taken on by the counselor of the terminally ill, reports Daneker (2006) is participation in strategies designed to help reduce physical pain in the patient. Daneker reports that "pain management is one of the most important concerns of hospice care (National Hospice Foundation, 2001). In addition to pain medication, the use of traditional psychological interventions such as biofeedback, hypnosis, relaxation and imagery techniques are used to provide skills that increase the client's awareness and control of pain." (Danaker, p. 1) This indicates that the counselor will be responsible for bringing a host of holistic and homeopathic strategies for healing into the therapeutic relationship. Thus, the value system of the counselor of the terminally ill patient should perhaps even more so than other medical professionals be a particularly receptive one. In helping the patient to content with pain as well as to find ways of controlling fear and panic symptoms in the body, the counselor can bring a considerable amount of physiological comfort to the subject. Therefore, a willingness to incorporate and integrate myriad non-traditional strategies for pain management will constitute an important supplement to more conventional medicinal and surgical strategies.
Pain management assistance is, of course, only one responsibility of the counselor, and a secondary one relative to the role of providing emotional support to the patient. Terminally ill patients will experience an infinite range of possible emotional, philosophical and practical responses to the various stages of illness and eventual death. The counselor will become a critical support beam as the subject undergoes these stages and said counselor must be possessed in the values of compassion, patience, understanding, calm, empathy and realism, among countless other valuable characteristics. These values should serve in attending the incredibly difficult responsibility of providing words of comfort to the patient without creating unrealistic expectations, without being patronizing and without losing a certain emotional distance from the subject. And as the text by Daneker indicates, it is absolutely essential that the counselor be capable of maintaining objectivity and equanimity in the face of a torrent of potentially volatile emotions. It is necessary for the subject to endure these emotions and the counselor's responsibility to function as a static foil for the realization of these emotional stages is essential to helping ease one through this difficult period. According to Daneker, "dying individuals cope with intense emotions such as anger, fear, guilt, and grief . . . Dying individuals benefit from counseling as much as anyone and these emotions are both a normal part of the process of dying and can be alleviated by sensitive intervention . . . Addressing the anticipatory grief of the individual is critical for counselors . . . Issues of anticipatory grief include helping clients redefine life as it currently is, facilitating communication about feelings of being a burden, supporting clients as they struggle with change, encouraging the search for meaning, and allowing the client to live day-by-day." (Danaker, p. 1)
Another key responsibility area for the client will involve the patient's family and support system. Often as the patient endures the trauma of facing terminal illness, so too must the patient's spouse, parents, children, siblings or close friends. The counselor has a…