Section 3 of the #NCMHCE content outline https://nbcc.org/exams/ncmhce Adjustment Related to Physical Loss or Chronic Illness
#ncmhce #examreview #disabilityadjustment

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Video by Dr. Dawn Elise Snipes on integrative behavioral health approaches including counseling techniques and skills for improving mental health and reducing mental illness.
Adjustment Related to Chronic Physical Disability

NCMHCE & Addiction Counselor Exam Review
Dr. Dawn-Elise Snipes
AllCEUs Counselor Education
Objectives
 Explore common disabilities
 Identify bidirectional PACER impacts and interventions to address them
Introduction
• Approximately one in four adults (25.7%) in the United States, or 61 million people, reports living with at least one disability
• In 2018, 51.8% (129 million) of adults were diagnosed with at least 1 of 10 selected chronic conditions
• 15.9%, or 41 million individuals have autoimmune issues
Types (Not Inclusive)
 Autoimmune disorders (Chron’s, lupus, MS, RA, psoriasis)
 Lyme disease
 Chronic pain (injury, fibromyalgia)
 Amputation
 Paralysis (injury / stroke )
 Diabetes
 Dementia (stroke / Alzheimer’s / Weirneke’s Encphalopathy)
 Cardiovascular Disease (Heart disease / COPD)
 POTS
 Osteoarthritis
 HIV
 Hepatitis C / Cirrhosis
 Kidney Failure

Physical: Impacts and Interventions
 Circadian rhythms and sleep
 Chronic HPA-Axis Activation
 Alterations in the gut microbiome
 Increased pain (hyperalgesia, allodynia) and inflammation
 Medication side effects (documented and client report)
 Nutrition (dietary quality and absorption)
 Gonadal hormones
 Fatigue

Affective / Cognitive: Impacts & Interventions
 Low health literacy
 Anxiety (health, abandonment/rejection)
 Grief / Depression / Anger
 Guilt
 Concentration
 Memory (during the adaptation process)
 Hopelessness / Helplessness (disempowerment)
 Polarized thinking

Environmental: Impacts & Interventions
 Housing Instability (medical bills / job changes / home loss)
 Employment changes (STD, LTD, job changes, accommodations)
 Ergonomics and Accessibility
 Sensory Input
 Light
 Sound
 Smell
 Touch / Temperature
Relational
 Changes in self-concept, efficacy and esteem
 Altered interpersonal activities
 Need to connect with others to normalize, destigmatize, validate
 SO Reactions
 Anxiety
 Grief
 Difficulty understanding / empathizing
 Resentment
 Overprotectiveness
 Attachment Changes: CRAVES

Spiritual: Impacts & Interventions

 Sense of connectedness to others and the world
 Sources of hope
 Sense of purpose
 Ability to find meaning in events
 Belief in a higher power or universal energy
 Ability to partake in spiritual activities (i.e. church, religious rituals)

Summary
 Chronic physical conditions can impact every area of a person’s life
 Even though the behavioral health professional focuses on the affective/cognitive/relationship and sometimes spiritual dimensions, it is vital to understand the impact of these issues on the physical functioning of the individual as well as the environment and how that impacts behavioral health.

Pain and Inflammation
 Anxiety
 Depression
 Autoimmune Issues
 Thyroid Disease esp. autoimmune thyroiditis
 Low Testosterone
 Estrogen imbalance
 Opioid use

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