Clinical Case: Coaching And Teaching

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List the goal for this teaching/coaching plan
Describe three teaching resources
Identify the teaching strategies that can be used
List the specific instructions that may be needed regarding her medication and what adverse reactions to be aware of/and what to do
Identify two factors that may negatively influence adherence to the medication and how they can be overcome
Describe how to include the family
Provide information on how and when she should seek support and help

Sample Solution

The goal of this teaching/coaching plan is to provide effective and efficient instruction on how to manage chronic pain, while supporting the individual’s autonomy, self-efficacy, and overall quality of life. This can be accomplished by providing resources and strategies that promote behavior change in order to reduce suffering from chronic pain.

There are many different teaching resources that can be used for this purpose. Three such examples are online programs, books or pamphlets about chronic pain management, and physical exercise DVDs specifically designed for people with chronic pain. Online programs offer individuals access to educational materials regarding managing their condition as well as interactive exercises and quizzes which allow them to track their progress over time (Gifford et al., 2019). Printed materials such as books or pamphlets provide a source of information about understanding their diagnosis and tips on how they can modify lifestyle factors which may contribute negatively towards their condition (Smith & Sluka, 2013). Physical exercise videos specifically designed for individuals with chronic pain also offers an easy way for them to learn new exercises which may help reduce discomfort (Martel et al., 2018).

When incorporating these resources into coaching sessions there may be several different strategies used depending on the needs of the individual being coached. These techniques could include motivational interviewing techniques such as open-ended questions, reflective listening, summarizing key points made during sessions (McClanahan et al., 2020). Other methods might consist of problem solving approaches where possible solutions are brainstormed together with consideration given towards any obstacles encountered when trying out those strategies (Rice et al., 2016). Cognitive behavioral therapy principles could also be incorporated into coaching sessions by exploring maladaptive thoughts and behaviors associated with the management of one’s condition in order to eliminate them or replace them with more adaptive ones (Yoo & Lee 2017). Additionally, education around topics like pacing activities throughout the day or time management skills could be beneficial when helping clients better understand how their behavior influences the severity of symptoms experienced (Kemppainen et al., 2018).

As humans, we continuously seek out things that can produce pleasurable feelings. One of the few ways to attain this feeling of euphoria or pleasure is by consumption of chemical substances. However, continuous consumption of these substances can lead to development of dependence towards them and this is more commonly known as addiction. Currently, the cost of social and economic impacts due to drugs of abuse addiction sums up to more than $740 billion annually (National Institute on Drug Abuse, 2017). Despite this, the clear neurophysiological mechanisms underlying development and progression of addiction is still unknown.

Addiction can be defined as repeated self-administration of alcohol or other drugs (AOD’s) despite knowledge of adverse medical and social consequences and attempts to abstain from AOD use (Robert & Koob, 1997). Initial intake of drug may be due influenced by genetic, psychosocial or environmental factors however, subsequent doses is most probably caused by action on drug on the brain to induce the drug-seeking behaviour. Addiction is comprised of three stages which are ‘binge/intoxication’, ‘withdrawal/negative affect’, and ‘preoccupation/anticipation’ as seen in Figure 1 (Koob &Volkow, 2010).

Figure 1. The Three stages of addiction and brain areas each stage associates with (Herman & Roberto, 2015)

‘Binge/intoxication’ refers to the consistent intake of drug after initial dose which may cause decrease in dopamine release after each intake due to sensitization. This will then lead to ‘withdrawal/negative affect’ stage where absence of drug will cause a decrease in dopamine causing anxious and restless feelings resulting in the craving or ‘preoccupation/anticipation’ stage. Two major factors known to modulate these behavioural changes are reinforcement where a stimulus increases the chance of response and neuroadaptation, the process by which neuronal structures change in response to drug exposure. Modulation of these factors motivates initial response to a drug and formation of long-term craving however, relapse is thought to be caused by permanent neuroadaptations that will cause discomfort during withdrawal (Robert & Koob, 1997)

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