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Psychological Perspectives in HIV Care: An Inter-Professional Approach

Features of the book An overview of the chapters Overall aims of the book The good, the bad and the ugly: how do people living with HIV experience care in the health system?Firstly At the time of diagnosis Feeling heard Empathy, authenticity and honesty HIV-related stigma Stigma in society Stigma in healthcare Healing suffering Kevin’s story Jane’s story Kevin’s story continued ...Jane’s story continued ...An inter-professional approach: working together towards meaningful change Summary References Self-awareness in HIV care Introduction Self-awareness Self Self-awareness and caring for people with HIV Developing self-awareness Interdisciplinary and team self-awareness The model as a tool for interdisciplinary working Self-awareness as a tool for caring Empathic understanding Social and emotional intelligence Utilising self-awareness Case study example: SAGE and THYME Summary References Seeing the whole person Seeing the whole person: a biopsychosocial perspective in HIV care Introduction Why do we have models in healthcare?The biomedical model Criticisms and a move away from the biomedical model The biopsychosocial model Why should medicine consider psychological and social factors?Biopsychosocial Biopsychosocial Effectiveness Economics Ethics Living with HIV: attending to the whole person Multifaceted impact on wellbeing An integrated approach Biopsychosocial care planning The impact of HIV on sense of self Narrative explorations and systemic practice in HIV The importance of considering the impact of personal values Summary Resource box References HIV diagnosis: the impact on mental health and wellbeing Telling someone they’ve got HIV: the sooner the better The 5S model Setting the scene Subject broaching Staff and service user reflection Signposting Sensitive, supportive and informal approach Stages of accepting an HIV diagnosis Identity Containing concerns and worries Mental health problems Illness-related post-traumatic stress disorder How intertwined are HIV and mental health?Risk Adherence Life outcomes Prognosis Stigma Positive relationships Conclusion References Navigating stormy waters: difficult conversations in HIV care Person-centred communication - Rogers’ core conditions The importance of empathy Creating an effective clinical encounter Barriers to effective communication Behaviours that block communication Identifying and responding to cues Responding to patients in distress Therapeutic use of self So how can healthcare practitioners develop this Supervision and reflective practice Reflection, self-awareness and teamwork Summary References Traumatic beginnings, complicated lives: attachment styles, relationships and HIV care Attachment theory and mental health Secure attachment Insecure attachment Anxious/ambivalent attachment Avoidant attachment Disorganised attachment The impact of traumatic stress Resilience: why are some people less affected by trauma?Adverse experiences: the influence on physical health Direct impact on health Indirect impact on health Lack of self-care (not worth taking care of)Self-harm: using self-injury, alcohol and/or drugs (can’t self-soothe)Stigma and shame (reliving previous abuse)Relationships and sexual choices/not choices Attachment and marginalised groups The context of care HIV teams as a ‘pseudo family’Styling services to specific attachment needs Easing high distress: proactive and consistent approaches Sometimes less is more Recognising the complexity: interdisciplinary responses The attachment style of healthcare professionals: why this matters Complicated healthcare interactions and shifting roles Addressing complex dynamics Delivering services: the provision of a secure base Recommendations From dark places, some good things can grow...Conclusion References Chemsex among men who have sex with men: a social psychological approach Introduction The prevalence of chemsex Contextualising chemsex in people’s lives Case study 1: Janies Case study 2: Juan Identity process theory Chemsex and sexual risk Why engage in chemsex? Social and psychological drivers It can be about the sex, the confidence and the connection Psychological issues: what comes first - the adversity or the chemsex?The predisposing factors When the party is over: the unwanted impact Chemsex and identity threat: a complicated, bidirectional relationship So how can we help promote wellbeing?A vulnerable starting point The complex relationship between harm and coping Understanding distress responses The impact of coping strategics How can we help reduce the risk of harm?Important aspects of a healthcare clinician’s approach Care delivery for chemsex users Conclusions Notes Useful resources References The seemingly intractable problem of HIV-related stigma: developing a framework to guide stigma interventions with young people living with HIV Introduction What is HIV-related stigma?Why is HIV stigmatised?Stigma may be a layered experience What are the mechanisms through which HIV-related stigma operate?Young people living with HIV and stigma HIV-related stigma: the impact of sociocultural context Interventions to address HIV-related stigma Interventions for young people Current situation Physical sensations Exploring the evidence base for addressing HIV-related stigma Group-based interventions Working with an individual young person Bringing the evidence together: points for clinicians Clinicians assuming responsibility Consider family-based and systemic working What is advantageous versus what is achievable?Be mindful of complex needs Summary References Multidisciplinary management of neuropathic pain in HIV care Understanding neuropathic pain What causes neuropathic pain?How do people present with neuropathic pain?How to assess someone with neuropathic pain Screening tools Medical management of HIV-associated pain Goals of medical management of neuropathic pain The use of physiotherapy in managing neuropathic pain Treatment Physical exercise Goal-setting and pacing The use of psychological therapies in managing neuropathic pain Cognitive-behavioural therapy Acceptance and commitment therapy Compassion-focused therapy Pain management programmes Summary References The psychological impact of ageing with HIV Introduction: defining ageing and old age Psychological impact of ageing with HIV The history of ageing with HIV Accelerated versus accentuated ageing Biographic age versus chronological Voyage into the unknown Emotional wellbeing Cognition Personality Isolation Stigma Successful ageing with HIV Individualised care Conclusion References Neurocognitive issues for adults in HIV care HIV and HIV-associatcd ncurocognitive disorder (HAND)Chronic Acute Defining HAND Antiretroviral medication Prevalence of HAND Risk factors HAND and neurological change HAND and neurocognitive change HAND and functional change Neuropsychological assessment Presentation/screening Screening questions Clinical history Neurocognitive assessment Screening tests Full neurocognitive assessment Computerised testing Repeat assessments Functional assessment Differential diagnosis Ageing Discussing the results Neurorehabilitation General principals Rehabilitation interventions Metacognitive strategy instruction Distraction minimisation Verbal self-instruction Group-based neurocognitive rehabilitation Reducing other risk factors Utilising the learning Summary References

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Seeing the whole person: a biopsychosocial perspective in HIV care
Chapter description People are made up of interrelating, multifactorial complex sets of phenomena. This chapter acknowledges the uniqueness that an individual brings to the care setting and provides an overview of the biopsychosocial approach to care delivery. The chapter highlights that this...
(Psychological Perspectives in HIV Care: An Inter-Professional Approach)
RELIGIOUS PERSPECTIVES ON ADVANCE CARE PLANNING AND ADVANCE DIRECTIVES
While ADs are intended for individuals to record their wishes for health care should they be unable to communicate them when they are extremely sick or unconscious, that is, to indicate when to discontinue (or not initiate) life-support technologies, ADs have also emerged to ensure that religiously sanctioned...
(Advance Care Planning)
THE WIDER PSYCHOLOGICAL PERSPECTIVE
Learned helplessness The control dimension of mental toughness is closely related to learned helplessness. Learned helplessness refers to the expectation, based on previous experience, where one's actions cannot possibly lead to success. This important idea was proposed by Seligman (1975). When...
(Developing mental toughness in young people)
A psychological perspective on goal setting
Most of the research into goal setting has been focused on how to maximise the technique. Much less attention has been paid to the underpinning psychology. What we can say is: • Goal setting works better for some people. Certain personalities are drawn to it; others find it limiting and stifling. Everyone...
(Developing mental toughness in young people)
Evolutionary Psychological Perspectives on Violence
Human violence is not a novel phenomenon. Evidence indicates that violence has been a part of human life throughout our evolutionary history. Archeological evidence of violent deaths among early humans, such as indicators of clubbing (Ferguson, 1997), arrowheads and barbs (Smith, 2007), and mass killings...
(The Evolution of Morality)
Gratitude from a Philosophical and Psychological Perspective
Gratitude is currently exciting both philosophers and psychologists. Research into the beneficial influence of gratitude has boosted interest in positive psychology. The results of empirical inquiry have provoked philosophers to look again at emotions and reconsider such ideas as free will, intention,...
(The Theological Roots of Christian Gratitude)
Task Shifting in HIV Care in sub-Saharan Africa
As stated above, in HIV care in sub-Saharan Africa, nurses and/or community health workers can successfully perform tasks such as provision and management of HIV medication, and counseling and screening to facilitate enrollment of HIV- infected patients eligible for treatment [21-23]. For instance, nurses...
(The Massachusetts General Hospital Handbook of Behavioral Medicine: A Clinician Guide to Evidence-based Psychosocial Interventions for Individuals with Medical Illness)
Applications of Task Shifting for Behavioral Medicine Interventions in HIV Care in sub-Saharan Africa
In addition to the behavioral health needs related to managing HIV/AIDS, such as HIV medication adherence and retention in care, comorbid psychiatric conditions are also common among HIV-infected individuals in sub-Saharan Africa. Two of the most common psychiatric disorders among individuals living...
(The Massachusetts General Hospital Handbook of Behavioral Medicine: A Clinician Guide to Evidence-based Psychosocial Interventions for Individuals with Medical Illness)
Psychological perspectives on reflective coaching, learning and change
I want to share some psychological perspectives developed during my career so that I can link them to my newer, and ever-developing perspectives - and also to show how they link to reflective coaching, learning and change. In the 1970s I joined a team working in a specialist cognitive and behavioural...
(Emerging Conversations in Coaching and Coaching Psychology)
Social psychology perspective on terrorism
After World War II, psychologists began to acknowledge that an individual’s interaction and behaviour arc influenced by people around them. Today, social psychology focuses on how an individual’s thoughts, feelings, and behaviour are influenced by the people around them, in both actuality and imaginary...
(Civil Society Organizations against Terrorism: Case Studies from Asia)