Treatments counselling benefits

If chemotherapy is the treatment of choice, counsel the patient on risks and benefits of undergoing such therapy. Be sure that the patient understands the issues fully before moving forward. 

Both acute and chronic anxiety can be treated with benzodiazepines, although it is anticipated that for most anxiety disorders counseling will also play an important role. Benzodiazepines employed in the treatment of anxiety should be used in the lowest effective dose for the shortest duration so that they will provide maximum benefit to the patient while minimizing the potential for adverse reactions. For most types of anxiety, none of the benzodiazepines is therapeutically superior to any other. Choice of a particular agent is usually made on the basis of pharmacokinetic (Table 30.2) considerations. A benzodiazepine with a long half-life should be considered if the anxiety is intense and sustained. A drug with a short half-life may have advantages when the anxiety is provoked by clearly defined circumsfances and is likely to be of short duration. 

In addition to adequate pharmacotherapy, specific forms of psychotherapy may also be indicated. These may include cognitive or interpersonal psychotherapy or various behavior desensitization and biofeedback techniques. Some patients may benefit from insight-oriented psychotherapy group, family, or marital counseling or both. Finally, in more chronic disorders, patients often benefit from vocational rehabilitation. A knowledgeable clinician realizes that these disorders do not occur in a vacuum, and, regardless of diagnosis, each patient requires an individualized treatment plan to optimize outcome. 

The first option for treatment is one of information and advice only. For some clients who prefer to withdraw on their own, advice, written material, and support either through telephone counselling or one to two appointments may be all they require. Clients who may benefit from this level of treatment may (a) not have been taking tranquillisers for very long, (b) have received other help from elsewhere, or (c) have almost completed withdrawal. 

Although there is no specific treatment for Tangier disease, symptom relief and alleviation of complications can improve the quality of life for the patients. Families with Tangier patients may also benefit from genetic counseling. 

Orthopedic patients have benefitted from technological advances such as joint replacement and the arthro-scope, which allows the orthopedist to look inside a joint. The visit will start with a personal interview and physical examination. This may be followed by diagnostic tests such as blood tests, x rays, or other tests. The treatment may involve medical counseling, medications, casts, splints, and therapies such as exercise, diet changes or surgery. Eor most orthopedic diseases and injuries there is more than one form of treatment. The orthopedist will discuss the treatment options with the patient and help select the best treatment plan that will enable the patient to live an active and functional life. 

All insurance plans include as a reimbursed benefit the counseling and pharmacotherapeutic treatments that are identified as effective in this guideline. 

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