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How To Cope With Life Changes

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Interviewed by Melissa Moniz
Wednesday - March 25, 2009
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Dr. Nancy Hughes

Clinical/Rehabilitation Psychologist

Interviewed by Melissa Moniz

How long have you been practicing at REHAB?

I began my employment here at REHAB in 1991. Our psychology department includes a rehabilitation psychologist and two neuropsychologists, Dr. Tanya D’Avanzo and Dr. Lauren Dawson. We are committed to building a strong acute rehabilitation inpatient program, with a specialty in traumatic brain injury, spinal cord injury and stroke.

Can you explain what your job entails?

I work with people who are struggling with fairly significant life changes and adaptation to those unpredicted events. I often tell patients that I am interested in their thinking (cognition), feeling (emotions) and behavior (what they do or don’t do to help them heal and resume independent and functional lives.)

Do you usually see patients one-on-one or in groups?

We see patients individually, with family members and in treatment groups. Some issues are best addressed alone, while other problems need to be addressed within a family system, and still other issues are most efficiently managed within a group setting.

Do you notice a difference in gender and how men and women cope with life changes?

So many variables enter into how people cope and adjust to change. For example, age, gender, educational level, medical history, social support system, cultural background, personality style and even their belief system. Everyone has their own way of coping. I suppose you could generalize. For example, women may be more open and verbal about their life experience, whereas men may internalize and focus more on mechanical and tangible goals. But in the end, successful coping is a human experience that combines personality traits, learned skills and environmental tools.

What are the most common issues you see people struggle with?

With certain kinds of neurological disorders, you might see some changes in cognitive function, such as the ability to remember, abstract and/or problem-solve.

Humans have a tendency to fear the unknown and reluctantly relinquish what is comfortable and habitual, so they may become anxious, angry or depressed. Change is scary, loss of control is unsettling and living in today’s world can be very stressful.

For people who are dealing with depression and anger, how do you help them get past that?

I always encourage patients to stay in the present tense, participate in the process of therapy, and make the best of each day possible because days have a tendency to build on one another. Goal-setting helps to stay focused and productive. Schedule “worry time.” Reinforce and support desired behavior. Education is power. When you are tired, rest. Forgive. Try to be helpful to others. Be open to what is possible.

How important is it for a patient to have a support system?

It is incredibly important! We have had patients who are very similar in functional ability, but those who have a family advocate or just someone to assist them back into the community makes all the difference in the world. I even have patients who find a great deal of emotional support from their pets. All of these things help people to cope successfully.

Could you explain what a visit with an outpatient is like?

The journey begins with a clinical interview and evaluation. We attempt to discern patient’s strengths and problematic areas. What is the presenting problem or symptom, treatment history and goals of therapy? What do they have control over versus what do they not have control over? We problem-solve and develop a cognitive-behavioral plan of treatment, identify potential number of session and establish objective outcome measures. Then we begin the process, which may change and adapt over time.

Does the success a patient has with psychological treatment depend upon how open they are?

Very much so. You can’t really make someone participate in therapy or even convince someone to change. As their psychologist, you are an advocate, an active listener, an assistant problem-solver, and you offer ideas and a new or different perspective. However, your patient or partner in the process needs to have some sense of commitment and be willing to take on the hard work of change, coping and adjustment.