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The process
Patient motivation is key and must include an appreciation that success is dependent on equal
effort by the counsellor and the patient. The counsellor must be consistent and not deny the
patient’s reality.
Patients are given an initial interview of one hour and may be offered regular follow-up
sessions. A detailed history of the problems presented is taken and various options may be
considered, depending on the counsellor’s perception of the patient’s ability to benefit from
them. The patient is also screened for depressive symptoms and social behaviour patterns are
observed.
In the early stages it is common for a patient to hold negative beliefs which may block
progress. These commonly include:
I will never make it
There is no point in trying
Others will reject/dislike me
I have no control over my life.
Time is important when addressing such issues as fear, anger, denial and confusion. Many
fears arise out of public misconceptions about epilepsy which may be allayed with proper
information, together with support and reassurance.
The counsellor’s actions are to:
Identify problems
Offer coping strategies
Overcome blocks to change
Set and review agreed tasks.
Coping strategies are important in epilepsy counselling. They enable the patient to deal with
his or her problems in a particular way. Once it is understood that choices are available, the
patient may explore these options with the counsellor. In time, a more balanced view of the
potential intrusion of epilepsy into everyday life may be achieved and general anxiety levels
lowered as the patient feels more in control.
Further reading
ARNTSON, P., DROGE, D., NORTON, R. et al (1986) The Perceived Psychosocial Consequences of Having Epilepsy:
Social Dimensions (Eds S. Whitman and B. Hermann). Oxford University Press, Oxford.
USISKIN, S.C. (1995) Counselling in epilepsy. In: Epilepsy, (Eds A. Hopkins et al), Second Edition, pp. 565-571.
Chapman & Hall Medical.
