Counselling - by Ron Metcalfe

It is highly unlikely that you will find alot of counsellors with experience of working with clients with Hepatitis C!! It’s an area I am thinking of specialising in myself, once I have completed treatment - and put enough distance between me and the experience to be professional! My guess is that counsellors who work for drug projects (like Mainliners or the Blenheim Project) will have worked with HepC clients; that would mean approaching them as a ‘punter’ to access the service.

Although you might access some counselling services through your workplace (or their Employee Assistance Programme) I realise you have not made any disclosures there and wish to keep confidential in that forum. I should point out, however, as a Case Manager for an EAP myself I often have to reassure employees that any information or call to an EAP is completely confidential from the employers (they get only statistical info so they can see how the service is being used by their employees). But the services through an EAP will likely be for ‘short term’ counselling – up to 6 or so sessions, whereas my guess would be that you would want or need more sessions than that. It may be worth checking what is available through them however!

To locate counsellors in private practice, there is a good “Find A Therapist” section on the British Association for Counselling & Psychotherapy website. You can see details of counsellors in an area by entering your postcode or town name. All these counsellors will operate within the BACP Code of Ethics (also viewable on the website) and the website info will include their qualifications and fee rates.

There may also be low-cost/no-cost counselling services available through local voluntary organisations – depending on how well served your local community is! I am thinking of Women’s Centres, etc.

Looking at all this, you can see why I think is essential that hepatology centres (like the one we attend) in the NHS should have counselling services available for patients. You can see how it would not only help people prepare for treatment but also support them through to a more successful outcome (particularly where people feel overwhelmed with it all and this becomes a factor in stopping the treatment or undermines a good outcome through depression, etc).

A comment separate to the issue of finding counselling services; hospitals could boost their statistics for successful outcomes and likely save money on the cost of drugs and services (eg for patients who ‘stop’ treatment as they cannot cope with the emotional roller-coaster) by providing counselling for patients on treatment.

We all know and hear, it isn’t just coping with the medical side of this treatment that is important, it’s also important how we cope emotionally with it. It is commonly and traditionally acknowledged that the liver is the ‘seat’ of anger – and that people with HepC often are ‘angry’ or ‘liverish’ (as my Carol so adroitly puts it). How ironic that the drugs for HepC treatment are particularly known for producing side-effects of ‘irritability’ (riba-rage)! There is a lot of ‘emotion’ to cope with on treatment but not a lot to help or support patients in coping with their very personal and individual responses to it. (A clinic nurse with 50 patients or more can only humanly provide so much support to each one!)

Reproduced by kind permission of Ron Metcalfe from a reply given to a hepatitis C patient on the web. - April 2005

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