Counseling Clients in the Chronic Phase of Illness

The period between diagnosis and the outcome of the illness is a long chronic period in which there are challenges with the demands, the daily functioning of living, the symptoms of the disease, and the side effects of treatment. The early part of this chronic phase is referred to as accommodation and mitigation. The major challenge in this chronic phase is to accommodate the disease using the previous coping roles and skills and the crisis caused by the diagnosis is usually mitigated by this time. The person is simply focusing on finding ways that will him/her live with the continued presence of the illness with the aim of maintaining health and adapt/prevent decline in health. The major change in life threatening illness is the presence and longevity of the chronic phase. The chronic phase comprises of various similar issues and challenges that are common to all chronic diseases. In the chronic phase, the quality of life is likely to be extremely influenced by nature and symptoms of the illness and the pattern or trajectory that the disease takes. These factors often influence the experience of the chronic phase. 

Throughout the course of the chronic period, individuals and families often face substantial challenges and changes. The series of tasks that individuals have to confront include: managing symptoms and side effects, conducting medical regimens, managing and preventing medical crises, evaluating coping and managing stress, optimizing social support and reducing social isolation, stabilizing life in the face of illness, dealing with financial issues, maintaining self-concept, redefining relationships with others, examining fears and feelings, and find meaning in uncertainty, suffering, decline, or chronicity.

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These tasks can contribute to possible resolutions in the chronic phase. The treatment process can contribute towards total recovery in some cases. Some people may achieve partial recovery. In other cases, the condition of the illness can stabilize causing a person to experience elongated period chronic disease and residual disability, or ongoing uncertainty. Some may face continue decline, where the type of care they receive becomes exclusively palliative. Therefore, chronic phase is a difficult, uncertain, and long period both for individuals and their families. On the other hand, chronic period offers opportunities for growth for an individual to live and experience life, fighting to regain health, and make the best of the remaining time that a person has.


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