Preparation for Counseling Adults With Terminal Illness: Personal and Professional Parallels

Abstract

This article presents a review of the literature on counseling adults with terminal illness, particularly the literature on the nature of preparation that counselors and other professionals who attend to the needs of adults with a terminal illness require. The authors review information and findings from philosophical, psychological, practical, and spiritual works. It is evident from these readings that a personal and professional examination of making meaning of life and death is integral to the performance and personal well-being of professionals who take this caregiving role.A review of the professional literature on counseling adults with terminal illness yields fascinating information. Almost invariably, discussions about theory and practice are preceded or intertwined with philosophical discussions about death and about how it is and how it ought to be viewed by individuals and groups. It is evident from these discussions that a personal and professional examination of how counselors make meaning of life and death is integral to preparing to counsel adults who have a terminal illness.In this article, we provide a review of pertinent literature-primarily but not exclusively from the counseling field-that shows that there are parallels between the experiences and preparations of both the counselor and the client as they seek to address the client's concerns. Starting with the philosophy of life and death and the mindfulness of meaning needed by all who are facing death, we find that the potential for increased awareness is high for both client and counselor. Recognizing this potential, we suggest that integrating spirituality and interacting fully with the client and the reality of life and death are critical in the support process through the various coping phases. Mindfulness of Death and MeaningLife and death are often juxtaposed as polar opposites. Simplistically, life is viewed as a beginning and a cause for celebration, whereas death is viewed as an end to be feared and a cause for mourning. Yalom (1998), an existential psychotherapist, offered an illuminating analysis of how this polarization develops in his writings on death anxiety, or fear of death. Yalom identified

Religious Practice and Spirituality in the Psychological Adjustment of Survivors of Breast Cancer

“…Manis and Bodenhorn (2006) have also provided instructive guidelines for counselors preparing to work with patients with terminal illnesses that focus on the clinicians' own need to make meaning of illness and mortality. Kazarian (2001) has suggested that the incorporation of spirituality is particularly important in disease prevention and health promotion for African Americans, who are affected by cancer in disproportionate numbers in the U.S. population.…”

“…Cole and Pargament (1999) have developed an intervention program, titled "Re-Creating Your Life: During and After Cancer," appropriate for patients with cancer who are "spirituality oriented" (p. 395), and others (Breitbart, Gibson, Poppito, & Berg, 2004;Gibson, Pessin, McLain, Shah, & Breitbart, 2004;Kristeller et al, 2005;Puchalski, Dorff, & Hendi, 2004) have offered similar intervention models. Manis and Bodenhorn (2006) have also provided instructive guidelines for counselors preparing to work with patients with terminal illnesses that focus on the clinicians' own need to make meaning of illness and mortality. Kazarian (2001) has suggested that the incorporation of spirituality is particularly important in disease prevention and health promotion for African Americans, who are affected by cancer in disproportionate numbers in the U.S. population.…”

End‐of‐Life Care: An Overview for Professional Counselors

“…For example, clinical trials of a meaning-centered group intervention, which was based on Frankl's ideas as well as listening to people who were dying, have demonstrated significant effects on the degree of sadness experienced by people with terminal cancer (see Greenstein & Breitbart, 2000). The counseling literature has reinforced the idea that counselors working with people facing EOL situations can learn from the experiences of, or provide assistance to, people who have faced death, are dying, or who have a chronic/terminal illness such as HIV (Buki, Kogan, Keen, & Uman, 2005;Burke & Miller, 1996;Freeman & Ward, 1998;Holt, Houg, & Romano, 1999;Ingersoll, 2000;Kinnier, Tribbensee, Rose, & Vaughan, 2001;Manis & Bodenhorn, 2006;O'Halloran & Altmaier, 1996;Shepherd Johnson, 2003;Springer & Lease, 2000;Vaughan & Kinnier, 1996).…”

“…In fact, some authors argue that they should be emphasized alongside the biological, psychological, and social dimensions, creating a "biopsychosociospiritual" framework (Kaut, 2002(Kaut, , 2006Sulmasy, 2002). The counseling literature has included some discussion of the importance of spirituality when people are near the end of life (Buki et al, 2005;Burke & Miller, 1996;Holt et al, 1999;Ingersoll, 2000;Manis & Bodenhorn, 2006;Shepherd Johnson, 2003), but much more can and should be considered when people are dying, especially for members of diverse groups (e.g., Born, Greiner, Sylvia, Butler, & Ahluwalia, 2004;Puchalski, Dorff, & Hendi, 2004). As was discussed earlier, attention has been given to existential considerations, which can be placed under the broad heading of spirituality; in general, however, the discussion of religion and nonexistential spirituality has taken place in other literatures.…”

An investigation of perceptions of two therapeutic responses for persons with a terminal illness experiencing death anxiety

“…Kübler-Ross has been credited for changing the way healthcare professionals, including therapists, view dying persons. Basically, she urged others to view death as natural, not as an illness (Manis & Bodenhorn, 2006).…”