Counseling for aids patients

1. COUNSELLING FOR
AIDS PATIENTS
SUBMITTED BY :
Anchal (190111110021)
M Sc Final

2. CONTENTS :
 What is HIV/AIDS?
 Why do AIDS patients
need counseling?
 Issues of people living
with HIV AIDS
 Therapeutic
interventions applied to
counsel AIDS patients

3. WHAT IS HIV/AIDS ?
 HIV, or human immunodeficiency virus, is the virus
that causes AIDS (acquired immunodeficiency
syndrome) and can be transmitted during sexual
intercourse; by sharing syringes; or prenatally during
pregnancy, childbirth, or breastfeeding.
 HIV weakens the immune system by destroying CD4
positive (CD4+) T cells, a type of white blood cell that
is important for fighting off infections. The loss of
these cells means that people living with HIV are
more vulnerable to other infections and diseases.

4.  People living with HIV may be diagnosed with AIDS
when they have one or more opportunistic
infections (infections that occur because HIV
weakens the immune system), such as pneumonia
or tuberculosis, and have a very low number of
CD4+ T cells.
 It is an incurable and fatal disease but strict
adherence to antiretroviral regimens (ARVs) can
dramatically slow the disease’s progress and
prevent secondary infections and complications.

5. WHY DO AIDS PATIENTS NEED
COUNSELING?
 Learning of HIV- positive status is a traumatic event
for an individual that can lead to anxiety,
depression, anger and distress and these emotional
responses have clear implication for disease
progression.
 Therefore an optimism is to be developed in the
patients so that these emotional responses do not
deteriorate the psychological as well as physical
health of the patient.
 Positivity is developed and their quality of life is
improved by counseling.

6. ISSUES OF PEOPLE LIVING WITH HIV
AIDS
 Confidentiality and disclosure
 Stigma and discrimination
 Depression
 Self esteem and self criticism
 Death anxiety
 Worry about job security
 Effects on intimate or sexual life
 Substance abuse
 Insecurities regarding family
 Dilemma of HIV positive pregnant women

7. CONFIDENTIALITY AND DISCLOSURE
 People living with HIV worry about confidentiality.
Deciding who and when to tell is not easy.
 Some concerns might be:
 Should I just keep this to myself?
 How do I get help without everyone finding out my
status?
 How do I tell my loved ones?
 What can I do to assure a safe home, work and
social life?

8. STIGMA AND DISCRIMINATION
 HIV stigma is negative attitudes and beliefs about
people with HIV. It is the prejudice that comes with
labeling an individual as part of a group that is
believed to be socially unacceptable.
 While stigma refers to an attitude or belief,
discrimination is the behaviors that result from
those attitudes or beliefs. HIV discrimination is the
act of treating people living with HIV differently than
those without HIV.

9.  Here are a few examples:
 A health care professional refusing to provide care
or services to a person living with HIV
 Refusing casual contact with someone living with
HIV
 Socially isolating a member of a community
because they are HIV positive
 Referring to people as HIVers or Positives.
 Stigma can prevent people living with HIV from
seeking counseling, obtaining medical and
psychological care, and taking preventative
measures to avoid passing the virus on to
others.

10. DEPRESSION
 Depression is a mental health disorder that is
highly prevalent, and characterized by low mood,
diminished self-worth, pessimistic thoughts, poor
concentration, and biological symptoms (that of
poor appetite and sleep difficulties) and increased
withdrawal from social activities.
 Depression is more than just feeling sad or
grieving. It is more intense and lasts longer.
 Rates of depression among people living with HIV
are as high as 60%, as opposed to 5-10% of the
general population.

11. SELF ESTEEM AND SELF CRITICISM
 People with HIV/AIDS can experience a drop in self
esteem because of:
 The stigma associated with HIV being a sexually
transmitted disease.
 Beginning to see oneself as “toxic” to others.
 Discrimination or rejection also leads to lowering of
self esteem.

12. DEATH ANXIETY
 Thanatophobia is a form of anxiety characterized by
fear of one’s own death or the process of dying. It is
commonly referred to as death anxiety.
 As aids patients know that the disease is incurable
and sooner or later they are going to die. This
causes an extreme anxiety to them.

13. WORRY ABOUT JOB SECURITY
 Following questions comes to the mind of people
diagnosed HIV positive:
 Will I be fired if someone at work finds out?
 How do I explain calling out sick a lot?
 How do I explain not participating in the company
blood drive?
 How will I support myself and my family?

14. EFFECTS ON INTIMATE AND SEXUAL
LIFE
 Living with HIV/AIDS can be a barrier to having
intimate or sexual relationships.
 Aids patient can’t indulge in sexual activities
because if he/ she does so then the HIV will be
transmitted to the sexual partner.

15. SUBSTANCE ABUSE
 People’s coping styles also relate to adjustment
and disease progression. For example people who
take direct action to cope maintain a positive
outlook and tend to have better physical health.
 In contrast people who deny their illness and use
disengagement coping methods such as alcohol or
drug use have faster disease progression and
worse physical health.

16. INSECURITIES REGARDING FAMILY
 When an individual is diagnosed with HIV AIDS and
finds outs that the disease is incurable the he gets
worried about his family.
 He worry about :
 Who will manage the finances of the family?
 Will his children be safe if he dies?
 Who will take care of his family?

17. DILEMMA OF HIV POSITIVE PREGNANT
WOMEN
 Pregnant women face the dilemma: whether to
continue the pregnancy or not? As there is a high
risk if mother is hiv positive the foetus will also be
HIV positive.
 In such conditions duration of gestation becomes a
key issue.
 Late in pregnancy abortions are not advisable.

18. THERAPEUTIC INTERVENTIONS:
 Relaxation techniques: biofeedback
 Cognitive behavioral therapy
 Support groups and modeling
 Rational emotive therapy
 Motivational enhancement therapy
 Family therapy

19. BIOFEEDBACK
 Biofeedback, sometimes
called biofeedback training, is used to help
manage many physical and mental health issues,
including: Anxiety or stress.
 During a biofeedback session, the therapist
attaches electrodes to the patient’s skin, and these
send information to a monitoring box.
 The therapist views the measurements on the
monitor, and, through trial and error, identifies a
range of mental activities and relaxation techniques
that can help regulate the patient’s bodily
processes.
 Eventually, patients learn how to control these
processes without the need for monitoring.

20. COGNITIVE BEHAVIORAL THERAPY
 CBT for adherence and depression (CBT-AD) is an
effective treatment for improving depressive
symptoms and medication adherence in the context
of various chronic health conditions, including
diabetes and HIV-infection.
 CBT is based on several core principles:
 Psychological problems are based in part, on faulty
or unhelpful ways of thinking.
 Psychological problems are based , in part on
learned patterns of unhelpful behavior . people
suffering from psychological problems can learn
better ways of coping with them.

21. SUPPORT GROUPS AND MODELING
 Support groups bring together people who are
going through or have gone through similar
experiences. A support group provides an
opportunity for people to share personal
experiences and feelings, coping strategies, or
firsthand information about disease and treatments.
 In support groups people do not have fear of being
evaluated and judged by others.
 In support groups modeling also becomes effective.
When new members see that how a person already
suffering from aids is able to manage his life
adequately, he also gets encouraged to do so.

22. RATIONAL EMOTIVE THERAPY
 Rational emotive therapy introduced by Albert Ellis
in 1950s is an approach that helps the client to
identify irrational beliefs and negative thought
patterns that may lead to emotional or behavioral
issues.

23. MOTIVATIONAL ENHANCEMENT
THERAPY
 It is a directive, person centered approach to
therapy that focuses on improving an individual’s
motivation to change those who engage in self
destructive behaviors may often be ambivalent or
have little motivation to change such behaviors,
despite acknowledging the negative impact of said
behaviors on health , family life or social life.

24. FAMILY THERAPY
 Family therapy can help the individual’s family to
know the do’s and don'ts to make the home
environment suitable or better adjustable for the
individual.

25. THANK YOU