Document 0657
 DOCN  M94A0657
 TI    Counselling for difficult patient.
 DT    9412
 AU    Waters B; Department of Psychiatric Services, St. Vincent's Hospital,;
       Sydney.
 SO    Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:54 (abstract no. SP4).
       Unique Identifier : AIDSLINE ASHM5/94348998
 AB    HIV has not afflicted a representative cross section of the community.
       IDU's have a greatly increased risk of having pre-existing personality
       disorder and/or unstable interpersonal relationships. HIV+ male
       homosexuals are more likely than their HIV-counterparts to have a
       history of prior mental health interventions, personality disorder and
       interpersonal problems. For these reasons, counsellors are often called
       on to assist with more than a simple adjustment reaction to HIV and its
       consequences. Moreover, as health deteriorates, the early signs of AIDS
       related psychiatric disorders--mania, organic personality change and
       organic depression--may attract counselling assistance. Counselling
       these more difficult patients requires a different focus such as more
       limited goals, a more directive approach and a preparedness to consider,
       and protect, if necessary, others in the patients life. Lack of
       recognition of the nature of the problems can lead to self imposed sense
       of failure in counsellors and can contribute to burn out. The back-up of
       experienced clinical psychologists or psychiatrist is necessary for
       counselling services.
 DE    Adjustment Disorders/*PSYCHOLOGY  Adult  AIDS Dementia
       Complex/*PSYCHOLOGY  Burnout, Professional/PSYCHOLOGY
       *Counseling/METHODS  Goals  Homosexuality/PSYCHOLOGY  Human  HIV
       Seropositivity/*PSYCHOLOGY  Male  *Sick Role  MEETING ABSTRACT

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