Social support

Heart transplantation represents the final option for refractory, end-stage HF patients who have exhausted medical and device therapies. Heart transplantation is not a cure, but should be considered a trade between a life-threatening syndrome and the risks associated with the operation and long-term immunosuppression. Assessment of appropriate candidates includes comorbid illnesses, psychosocial behavior, available financial and social support, and patient willingness to adhere to lifelong therapy and close medical follow-up.1 Overall, the transplant recipient s quality of life may be improved, but not all patients receive this benefit. Posttransplant survival continues to improve due to advances in immunosuppression, treatment and prevention of infection, and optimal management of patient comorbidities. 

Refer patients to a local PD support group where they can obtain educational materials as well as empathy and social support from fellow PD patients. Support groups that include patients with advanced disease may upset patients with early disease therefore, the advantages and disadvantages of attending should be explained to the patient. 

Family members of AD patients are also profoundly affected by the increased dependence of their loved one as the disease progresses. Early education and social support of both the patient and family is also important treatment. The Alzheimer s... 

Improving interpersonal functioning and enhancing social supports can be accomplished through 12-step facilitation (TSF), or any other mechanism for developing a sober social network. 

Axis IV Quality of life (patients own perceptions about the level of their physical and emotional well-being, their functioning, the social support they receive and the fulfillment of their personal and spiritual aspirations)... 

Wight, R. G., Botticello, A. L. Aneshensel, C. S. (2006). Socioeconomic context, social support, and adolescent mental health a multilevel investigation. /. Youth and Adolescence, 35(1), 115-26. 

Lack of social supports (family, friends, or professionals)... 

Every patient who uses tobacco should be offered at least brief treatment. All patients attempting tobacco cessation should be offered practical counseling (problem-solving/skills training), social support, stress management, and relapse prevention. 

Interventions are more effective when they last greater than 10 minutes, involve contact with a professional, provide at least four to seven sessions, and provide nicotine-replacement therapy (NRT). Group and individual counseling is effective, and interventions are more successful when they include social support and training in problem-solving, stress management, and relapse prevention. 

As you may remember from Chapter 1, social support predicts successful treatment outcome. Because of this factor, collaterals who are important allies to the client in her or his efforts to overcome a drug problem should be strongly encouraged and welcomed throughout the treatment process. Therapists and counselors should maintain regular contact with supporters of the client when appropriate. Obviously, client confidentiality should be protected under these circumstances, but being friendly, helpful, and respectful to collaterals and keeping them in the treatment loop, so to speak, will ultimately help the client. 

They also have added new social support networks in their lives to serve as guides and cheerleaders as they ve made significant life changes. The people who surround them now advocate for them. The stress in their social relationships is likely diminishing over time as they have developed confidence in their recovery and as they have worked to improve their interaction styles with others. People like to be around them now, because their real selves have appeared since they stopped using drugs. There are many who care about them in ways that they may not have experienced in many years — maybe even in their lifetimes — because they have protected themselves with new social skills and networks. 

Multiple Chemical Sensitivity A Survival Guide. Pamela Reed Gibson. Oakland, CA New Harbinger Publications, 1999. Features survival tools for coping with many aspects of MCS coping with the life impact of a chronic illness and with the unique aspects of MCS the need for social support, medical intervention and environmental controls self-help options identity and psychological issues applying for disability benefits and much more. 

BEHAVIORAL SOCIAL SUPPORT PREDICTS DEPRESSION OUTCOME... 

The interactions of depressed persons with others play an important role in the etiology of depression. According to Coyne (1976) depressed persons elicit support behaviors intermixed with rejection from others. Brown (1994) found that depression chronicity is related to a lack of social support. We investigated whether observable behaviors (which may reflect support-seeking and giving) in an interaction of depressed patients and others (i.e., partner and stranger) (1) predict depression outcome and (2) discriminate between patient and others interactional patterns. 

During the early 1960s, Timothy Leary conducted the Concord Prison Experiment to study the psychotherapeutic use of hallucinogenic drugs in prison inmates. Treatment involved administration of psilocybin and group psychotherapy in 32 prisoners. A follow-up study of recidivism in these prisonsers concluded that there was no long-term treatment effect and emphasized the value of postrelease social support (Doblin 1998). 

Female gender Prior history of depression Family history of depression Active substance abuse Recent stressful life event Poor social supports Previous suicide attempt Postpartum period Chronic medical illness... 

Individual characteristics can determine how a person reacts to a trauma and thereby contribute to the risk for developing PTSD. These include neurosis, limited social support, a family history of an anxiety disorder, and a personal history of previous significant stressors, particularly childhood sexual or physical abuse. 

Antipsychotics. Paranoia has long been a recognized symptom of BPD. In addition, these patients are at risk for psychotic decompensation in the face of acute stress. This typically takes the form of an Axis I brief psychotic disorder and often quickly resolves with increased social support and the alleviation of the stressors. 

Once eligibility has been objectively determined as above then the decision to initiate ART is further informed by the patients individual circumstances which include readiness for and understanding of the implications of ART, and access to nutritional as well as social support. 

Within this Held, most of the research and results have been focused on the effects of drug therapy on the disorders induced by alcohol, and by the abuse of opiates. For a broader discussion of substance abuse see Chapter 18. In all instances of alcohol or drug abuse the first objective is to wean the patients from the addictive substance, treating or preventing the effects of withdrawal for those substances which cause physical dependence (alcohol, nicotine, opiates, caffeine, certain psychotropic agents such as benzodiazepines, possibly antidepressants). The second phase is the prevention of recurrence or relapse, which relies on a combination of social support, psychotherapy, and pharmacotherapy where available. In this respect, alcoholism is exemplary. 

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