Arthritis Self-Management

Home > Articles > Health Care and Self-Management >

Counseling: An Integral Part of Arthritis Care

by David Wayne Smith, DEd, DABPS, DACFE, Jeffrey Lisse, MD, Cydney Lamb, MA, CRC, Gina Corteza, and John Polle, BA

In recent months, your arthritis has been seriously affecting your quality of life. Pain is affecting your ability to do your job, and your lack of energy and loss of ability to do things around the house is putting strain on your relationship with your spouse. Upon hearing how things have been going, your rheumatologist has recommended counseling — but you’re not sure about it. Isn’t counseling for people with a mental illness?

The short answer is no — counseling is simply a tool that can help you deal with the challenges arthritis brings. In this article, we describe counseling for people with arthritis, using our experience at the University of Arizona Disability Assessment Research Clinic (DARC) to illustrate how it can help.

What is counseling?

Counseling is a broad term that encompasses many different types of advisement, including mental health counseling, family or couples counseling, career or educational counseling, and substance abuse counseling. What they all have in common is that a trained professional meets with you, either one-on-one or in a group setting, to discuss the issues you are facing and help you come up with solutions. Many types of counseling can help people with arthritis, depending on the specific problems they face. This article focuses on rehabilitation counseling, which helps people with physical limitations cope with pain and loss of function.

Although part of the purpose of counseling may be to help you deal with emotional struggles, counseling is different from psychotherapy. Psychotherapy tends to focus on chronic emotional, behavioral, or mental health issues, whereas counseling is typically focused on dealing with specific situations. That said, there can be overlaps between the two types of help — some psychotherapists may provide counseling, and some counselors may use psychotherapeutic approaches. However, only psychotherapists are qualified to address mental health issues such as clinical depression or an anxiety disorder.

Why counseling?

If you have arthritis, there are a number of reasons you might like to seek counseling. You may feel as though your life isn’t working any more, and you may need someone to talk to you, listen to you, or both. You may need assistance dealing with specific challenges you are facing, whether they are related to work, family or other relationships, or any other aspect of your life. Whatever your situation, a professional counselor can help you analyze your problem, define reachable goals, and decide on a course of action. People aren’t always aware that they may benefit from counseling, and often it’s the rheumatologist or other treating physician who sees the need and makes a referral. It’s important to make the members of your health-care team aware of any emotional issues you’re facing so that they can help you get the care you need.

Counselors are trained to be good listeners. People with a chronic illness often have high levels of pain, sleep disturbances, short-term memory loss, fatigue, and depression or anxiety. The counselor can help you understand that these are common effects of having arthritis and come up with ways to cope with these effects. If you see a rehabilitation counselor, part of the counselor’s role is to confer with your physician or physicians about your arthritis treatment, obtaining medical records as well as other pertinent documents essential to a better understanding of your health status. The counselor will endeavor to help you sort out the issues and the options available for dealing with these problems. The more informed you are, the easier it will be to cope with your arthritis.

A counselor will also work with you to identify any barriers to solving the problems you face. When those barriers are psychological or behavioral, the counselor may need to refer you to a psychotherapist. When making such a referral, the counselor should recommend a psychotherapist who has experience working with people with chronic medical conditions. One example of an issue that may require the help of a psychotherapist is learned helplessness, in which people come to believe they have no control over pain or loss of function and therefore do not make efforts to actively manage their condition.

Another example is depression, a condition of long-lasting low mood and other symptoms that is common in people with arthritis. A client of Dr. Smith’s named Kathy recently had to deal with depression. Having received a diagnosis of systemic lupus erythematosus in her teens, Kathy married her high school sweetheart. As time passed, however, her husband became absorbed in his work as an engineer, while Kathy gained considerable weight and developed a strong feeling of neglect. By the time she contacted the DARC, she no longer felt life was “worth living.” Dr. Smith saw Kathy and her husband together and helped them understand that Kathy was deeply depressed and would need psychotherapy. Kathy was referred to a clinical psychologist and has been in psychotherapy for several months. Dr. Smith often confers with the treating psychologist and also sees Kathy on a regular basis in order to review her progress.

Last Reviewed on November 29, 2012

David Wayne Smith is Director of the University of Arizona Disability Assessment Research Clinic (DARC), part of the Arizona Arthritis Center of Excellence (AAC) at the University of Arizona in Tucson. Jeffrey Lisse is Ethel P. McChesney Bilby Professor of Medicine and Chief of Rheumatology at the University of Arizona College of Medicine. Cydney Lamb, MA, is a rehabilitation counselor and Gina Corteza is a patient advocate, both at the DARC. John Polle is an information specialist at the AAC.

Get the latest arthritis news and the most useful self-management tips delivered to your inbox twice a month! Sign up for our free e-mail newsletter today.

Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.