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HIV: Therapeutic Strategies for Guilt, Uncertainty, Taking Control
On this track and the next track, we will discuss managing emotions. Clearly, your HIV positive client may be emotionally upset in some of the same ways as Chad. Some of the emotions Chad, age 28, experienced were anger, depression, fear, guilt, and uncertainty. Chad had contracted HIV through anal sex with another man. The reasons for Chad’s emotions were clear to me without much explanation. As you listen to this track, consider how traditional emotional management techniques can be changed to apply to HIV positive clients.
Think of your Chad. Does your HIV positive client find it easier to feel anger than shame, guilt, resentment, or sadness? I stated to Chad, "Anger may not feel as bad as some other emotions like resentment, guilt, or sadness. You can yell and scream at others and it somehow becomes someone else’s problem." Clearly, anger is a justifiable response to an HIV infection. Chad benefited from allowing himself to be angry, but redirecting his anger became the goal.
-- I stated to Chad, "First, try to separate the anger from the erroneous or wrong target." Chad had targeted himself and people that were close to him. Chad stated, "I’m not really mad at anyone in particular. I guess I’m actually mad at the disease and the circumstances."
Some clients benefit from exercise, meditation, or talking to family members and close friends. Chad began jogging initially, but as his HIV progressed, Chad began to tire easily. Chad then began a journal in which he could write out his anger. Could your HIV positive client benefit from an anger journal? What other alternatives could you suggest.
To help Chad deal with his depression, I stated, "Mild depression as a natural response to HIV infection usually runs its course within days or weeks, and then goes away. For some clients, depression goes away without intervention. However, activity can help dispel mild depression. Physical activity like boating or fishing works. Also, mental activities like reading or theater can help take the edge off your depression."
Think of your Chad. Could activity help your client with depression? I realize this is a common treatment for depression, but some times I know I need to be reminded of the obvious.
Though using activities and accomplishments to redirect a client’s attention away from internal problems and HIV may be sufficient for treating mild depression, your client may experience more severe depression. Obviously if your diagnose your HIV positive client as being clinically depressed, the previously techniques may need to be substituted for more aggressive treatment measures such as medication. Would you agree?
Also, as you know, if certain medication treatments for HIV or AIDS related dementia causes your client’s depression, changes in dosage or additional medications are available. Does your client experience anger or mild depression as a result of an HIV infection? Could the techniques on this track be adapted to benefit your client in dealing with depression or anger?
On this track we have discussed managing emotions. Two emotions commonly experienced by HIV positive clients are anger and depression.
On the next track we will continue our discussion on managing emotions. Three additional emotions we will discuss are fear, guilt, and uncertainty.
Protecting the Civil Rights and Health Information Privacy of People
- Office for Civil Rights. (2016). Protecting the Civil Rights and Health Information Privacy of People Living with HIV/AIDS. U.S. Department of Health and Human Services.
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