Parkinson's Disease and Counseling

Parkinson's disease, as with many chronic illnesses, will affect you both physically and mentally. It is important to realize that you are not alone. If you need help coping with Parkinson's disease, consider seeking counseling.

The decision to seek counseling is an important step. Too often, people don't get help because they feel guilt, shame, or embarrassment. By deciding to get help, you have made a choice to feel better and to improve your life. Counseling services should be chosen with care to meet your needs. By working with a trained mental health care provider and your doctor, you can develop the right treatment plan.

Where Do I Start?

First, you and your doctor should review how you and those around you are coping with your illness. It is very important to realize that the physical symptoms and disabilities caused by Parkinson's disease can have a major impact on your mental outlook and health as well as the mental health of those around you.

The biochemical changes occurring in the brain with Parkinson's disease can lead to depression. Depression is a real part of the disease as much as tremor or slowness of movement. In some people, medical treatment of the depression is necessary.

If you are feeling depressed, your doctor may refer you to a mental health provider who will conduct an assessment, or a review of your mental health. Mental health specialists include family therapists, social workers, psychologists, psychiatrists, and other professionals.

The assessment is used to diagnose the problem and determine the best treatment. You will be asked to describe any symptoms you have had (emotional, mental, and physical) and your medical history. You may be given a question-and-answer survey.

What Happens After the Assessment?

Once you complete the assessment, a treatment plan can be chosen. At this time, you and your counselor can discuss:

• The best type of counseling.
• The best setting for counseling (counselor's office, outpatient clinic, hospital, residential treatment center).
• Who will be included in your treatment (you alone, family members, others with similar problems).
• How often you should go to counseling.
• How long counseling may last.
• Any medications that will be needed.

What Types of Counseling Are Available?

The following list briefly describes common types of counseling. These can be used together or alone, depending on your treatment plan.

Crisis intervention counseling. In cases of emergency (such as initial despair over diagnosis), the counselor will help you get through the crisis and refer you to further counseling or medical care, if needed. These services are provided by community health agencies, helplines, and hotlines.

Individual counseling. This is where you meet one-on-one with a counselor. Counseling often takes place in the privacy of the counselor's office. This type of counseling works well when problems come mainly from you and your thinking patterns and behaviors. Also, some problems are very personal and difficult to confront with others present. If you are experiencing depression, anxiety, or grief in dealing with your Parkinson's this type of counseling may be appropriate.

Family therapy. A diagnosis of Parkinson's disease can affect the entire family. If you are the primary provider in the home, there can be financial strain. If you are the homemaker, there may need to be adjustments in the distribution of chores. These everyday strains combined with the emotional effects of dealing with a chronic illness have an enormous impact on the family dynamic.

Family therapy can help family members resolve issues among each other. It can also help them adopt ways to help another family member cope better. Family members can learn how actions and ways of communicating can worsen problems. With help, new and improved ways of communicating can be explored and practiced.

Group therapy. In group therapy, you join a group to discuss problems together. A counselor guides the session. Members in the group often share the same problem, but not always. The group session provides a place where people can confide with others who understand their struggles. They also can learn how they see themselves and how others see them. Members gain strength in knowing that they are not alone with their problems.

Residential treatment. With this type of therapy, you would live at a treatment center. The length of stay can vary, depending on the treatment program and progress of therapy. A program can last more than a year or just a week or two. Settings include hospitals, home-like structures, and clinics.

Focus is mainly on your problems and getting well. Other activities, such as work, family, and hobbies, take a backseat to treatment. In most programs, you receive counseling daily and participate in regular group therapy. Additional counseling after residential treatment has ended may be needed.

Self-help and support groups. These include a network of people with similar problems. These groups usually meet regularly without a therapist or counselor.

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