Psychological Perspectives in HIV Care: An Inter-Professional Approach

Features of the bookAn overview of the chaptersOverall aims of the bookThe good, the bad and the ugly: how do people living with HIV experience care in the health system?FirstlyAt the time of diagnosisFeeling heardEmpathy, authenticity and honestyHIV-related stigmaStigma in societyStigma in healthcareHealing sufferingKevin’s storyJane’s storyKevin’s story continued ...Jane’s story continued ...An inter-professional approach: working together towards meaningful changeSummaryReferencesSelf-awareness in HIV careIntroductionSelf-awarenessSelfSelf-awareness and caring for people with HIVDeveloping self-awarenessInterdisciplinary and team self-awarenessThe model as a tool for interdisciplinary workingSelf-awareness as a tool for caringEmpathic understandingSocial and emotional intelligenceUtilising self-awarenessCase study example: SAGE and THYMESummaryReferencesSeeing the whole personSeeing the whole person: a biopsychosocial perspective in HIV careIntroductionWhy do we have models in healthcare?The biomedical modelCriticisms and a move away from the biomedical modelThe biopsychosocial modelWhy should medicine consider psychological and social factors?BiopsychosocialBiopsychosocialEffectivenessEconomicsEthicsLiving with HIV: attending to the whole personMultifaceted impact on wellbeingAn integrated approachBiopsychosocial care planningThe impact of HIV on sense of selfNarrative explorations and systemic practice in HIVThe importance of considering the impact of personal valuesSummaryResource boxReferencesHIV diagnosis: the impact on mental health and wellbeingTelling someone they’ve got HIV: the sooner the betterThe 5S modelSetting the sceneSubject broachingStaff and service user reflectionSignpostingSensitive, supportive and informal approachStages of accepting an HIV diagnosisIdentityContaining concerns and worriesMental health problemsIllness-related post-traumatic stress disorderHow intertwined are HIV and mental health?RiskAdherenceLife outcomesPrognosisStigmaPositive relationshipsConclusionReferencesNavigating stormy waters: difficult conversations in HIV carePerson-centred communication - Rogers’ core conditionsThe importance of empathyCreating an effective clinical encounterBarriers to effective communicationBehaviours that block communicationIdentifying and responding to cuesResponding to patients in distressTherapeutic use of selfSo how can healthcare practitioners develop thisSupervision and reflective practiceReflection, self-awareness and teamworkSummaryReferencesTraumatic beginnings, complicated lives: attachment styles, relationships and HIV careAttachment theory and mental healthSecure attachmentInsecure attachmentAnxious/ambivalent attachmentAvoidant attachmentDisorganised attachmentThe impact of traumatic stressResilience: why are some people less affected by trauma?Adverse experiences: the influence on physical healthDirect impact on healthIndirect impact on healthLack 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 choicesAttachment and marginalised groupsThe context of careHIV teams as a ‘pseudo family’Styling services to specific attachment needsEasing high distress: proactive and consistent approachesSometimes less is moreRecognising the complexity: interdisciplinary responsesThe attachment style of healthcare professionals: why this mattersComplicated healthcare interactions and shifting rolesAddressing complex dynamicsDelivering services: the provision of a secure baseRecommendationsFrom dark places, some good things can grow...ConclusionReferencesChemsex among men who have sex with men: a social psychological approachIntroductionThe prevalence of chemsexContextualising chemsex in people’s livesCase study 1: JaniesCase study 2: JuanIdentity process theoryChemsex and sexual riskWhy engage in chemsex? Social and psychological driversIt can be about the sex, the confidence and the connectionPsychological issues: what comes first - the adversity or the chemsex?The predisposing factorsWhen the party is over: the unwanted impactChemsex and identity threat: a complicated, bidirectional relationshipSo how can we help promote wellbeing?A vulnerable starting pointThe complex relationship between harm and copingUnderstanding distress responsesThe impact of coping strategicsHow can we help reduce the risk of harm?Important aspects of a healthcare clinician’s approachCare delivery for chemsex usersConclusionsNotesUseful resourcesReferencesThe seemingly intractable problem of HIV-related stigma: developing a framework to guide stigma interventions with young people living with HIVIntroductionWhat is HIV-related stigma?Why is HIV stigmatised?Stigma may be a layered experienceWhat are the mechanisms through which HIV-related stigma operate?Young people living with HIV and stigmaHIV-related stigma: the impact of sociocultural contextInterventions to address HIV-related stigmaInterventions for young peopleCurrent situationPhysical sensationsExploring the evidence base for addressing HIV-related stigmaGroup-based interventionsWorking with an individual young personBringing the evidence together: points for cliniciansClinicians assuming responsibilityConsider family-based and systemic workingWhat is advantageous versus what is achievable?Be mindful of complex needsSummaryReferencesMultidisciplinary management of neuropathic pain in HIV careUnderstanding neuropathic painWhat causes neuropathic pain?How do people present with neuropathic pain?How to assess someone with neuropathic painScreening toolsMedical management of HIV-associated painGoals of medical management of neuropathic painThe use of physiotherapy in managing neuropathic painTreatmentPhysical exerciseGoal-setting and pacingThe use of psychological therapies in managing neuropathic painCognitive-behavioural therapyAcceptance and commitment therapyCompassion-focused therapyPain management programmesSummaryReferencesThe psychological impact of ageing with HIVIntroduction: defining ageing and old agePsychological impact of ageing with HIVThe history of ageing with HIVAccelerated versus accentuated ageingBiographic age versus chronologicalVoyage into the unknownEmotional wellbeingCognitionPersonalityIsolationStigmaSuccessful ageing with HIVIndividualised careConclusionReferencesNeurocognitive issues for adults in HIV careHIV and HIV-associatcd ncurocognitive disorder (HAND)ChronicAcuteDefining HANDAntiretroviral medicationPrevalence of HANDRisk factorsHAND and neurological changeHAND and neurocognitive changeHAND and functional changeNeuropsychological assessmentPresentation/screeningScreening questionsClinical historyNeurocognitive assessmentScreening testsFull neurocognitive assessmentComputerised testingRepeat assessmentsFunctional assessmentDifferential diagnosisAgeingDiscussing the resultsNeurorehabilitationGeneral principalsRehabilitation interventionsMetacognitive strategy instructionDistraction minimisationVerbal self-instructionGroup-based neurocognitive rehabilitationReducing other risk factorsUtilising the learningSummaryReferences
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