Hope Modules: Brief Psychotherapeutic Interventions to Counter Demoralization from Daily Stressors of Chronic Illness
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Demoralization refers to the helplessness, hopelessness, confusion, and subjective incompetence that people feel when sensing that they are failing their own or other’s expectations for coping ( p. 14). Psychiatric patients often become demoralized when distress from daily stressors is added to that from symptoms of mood, anxiety, or psychotic disorders. Psychiatric patients commonly face pile-ups of stressors that can include unemployment, loss of social status, conflicted relationships, stigmatization, and stress from an uncertain future [2, 3]. Ensuing demoralization can foster avoidant coping, rather than the assertive coping necessary for meeting challenges . As unsolved problems accumulate, a vicious cycle of worsening demoralization can begin. Self-neglect, reflected in unhealthy diet, sleep, exercise, or substance use, is a frequent consequence. Personal relationships often deteriorate, and adherence to treatment regimens decline. Suicide among patients with severe...
Kaethe Weingarten, Ph.D. and her Witnessing Project (www.witnessingproject.org) provided ongoing consultation and inspiration for this work. Lisa Catapano, M.D., Ph.D. collaborated with the author in an initial workshop presentation of the hope modules, “Teaching the “common factors” of psychotherapy with psychotherapeutic modules of evidence-based practices,” at the 2013 Annual Meeting of the Association for Academic Psychiatry in Charleston, SC, Oct 16–19, 2013.
Compliance with Ethical Standards
IRB Review is not applicable for this study. There is no protected health information, and this study is HIPPA compliant.
The author states that there is no conflict of interest.
- 1.Frank JD, Frank JB. Persuasion and healing: a comparative study of psychotherapy. 3rd ed. Baltimore, MD: Johns Hopkins Univ Press. 1991;14.Google Scholar
- 4.Shea SC. The practical art of suicide assessment. Hoboken, NJ: John Wiley. 2004;78–79.Google Scholar
- 7.Griffith JL, Dsouza A. Demoralization and hope in clinical psychiatry and psychotherapy. In: Alarcon RD, Frank JB, editors. The psychotherapy of hope: the legacy of persuasion and healing. Baltimore, MD: Johns Hopkins Univ Press; 2012. p. 158–77.Google Scholar
- 8.Thurman H. Jesus and the disinherited. Boston: Beacon Press; 1976. p. 11.Google Scholar
- 9.Hillesum E. An interrupted life. New York: Henry Holt; 1983. p. 130.Google Scholar
- 11.Weingarten K. Hope in a time of global despair. In: Flaskas C, McCarthy I, Sheehan J, editors. Hope and despair in narrative and family therapy. New York: Routledge; 2007. p. 1–23.Google Scholar
- 13.Southwick SW, Pietrzak RH, White G. Interventions to enhance resilience and resilience-related constructs in adults. In: Southwick SW, Litz BT, Charney D, Friedman MJ, editors. Resilience and mental health: challenges across the lifespan. New York: Cambridge University Press; 2011. p. 289–306.CrossRefGoogle Scholar
- 14.Wade A. Despair, resistance, hope: response-based therapy for victims of violence. In: Flaskas C, McCarthy I, Sheehan J, editors. Hope and despair in narrative and family therapy. New York: Routledge; 2007. p. 63–74.Google Scholar
- 16.Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.Google Scholar
- 30.Gonzales L. Deep survival—who lives, who dies, and why. New York: W.W. Norton; 2004.Google Scholar
- 32.Cacioppo JT, Patrick W. Loneliness: human nature and the need for social connection. New York: W.W. Norton. 2008.Google Scholar
- 34.Noorani F. Hope modules. In: Building resilience in humanitarian workers. Google Sites; 2016. https://sites.google.com/site/gwresilienceworkshop/. Accessed 22 Oct 2016.
- 35.Nguyen NP, Dendeluri S, Kocher E, Dyer A, May C. The refugee crisis in Greece: a psychiatric needs assessment. Research poster presentation at the 169th Annual Meeting of the American Psychiatric Association; Atlanta, GA. May 13-18, 2016.Google Scholar
- 38.Argyris C, Putnam R, Smith DM. Action science. San Francisco: Jossey-Boss; 1985.Google Scholar
- 39.White M. Maps of narrative practice. New York: W.W. Norton; 2007.Google Scholar
- 40.Griffith JL, Griffith ME. Engaging the sacred in psychotherapy: how to talk with people about their spiritual lives. New York: Guilford Press; 2002.Google Scholar
- 41.Levinas E. Totality and infinity (A. Lingis, trans.). Pittsburgh, PA: Duquesne University Press; 1961.Google Scholar
- 42.Wampold BE. The research evidence for the common factors models: a historically situated perspective. In: Duncan BL, Miller SD, Wampold BE, Hubble MA, editors. The heart and soul of change. 2nd ed. Washington, DC: American Psychological Association; 2002. p. 49–82.Google Scholar
- 43.Sprenkle DH, Davis SD, Lebow JL. Common factors in couple and family therapy. New York: Guilford Press; 2009.Google Scholar
- 44.Norcross JC, editor. Psychotherapy relationships that work: therapist contributions and responsiveness to patients. London: Oxford University Press; 2002.Google Scholar