What to Expect from Treatment at Denver Diabetes Counseling

Jenna Eisenberg, a Licensed Marriage and Family Therapist will help provide a safe place for you to express your thoughts and feelings and for you to work toward resolving your problems, whether they are related to Diabetes or not.  You will have the opportunity to discuss your concerns and experiences, and Ms. Eisenberg will try to understand things from your point of view. Counseling will also help you explore alternative points of view and possible choices you have to make.  Clarifying the connections between your immediate concerns and the complexities of your personality and personal history are also typical components of treatment at Denver Diabetes Counseling.

Ms. Eisenberg often incorporates couples and family therapy into treatment when appropriate. And, if your are Diabetic, she prefers to work in unison with your Diabetes doctor or Endocrinologist.  
Once you and Ms. Eisenberg agree that significant progress has been
made regarding Diabetes related issues, psychotherapy may continue to address other important areas of your life.  

Your Rights as a Client
* You have the right to work with the therapist you feel most comfortable with. 
* You have the right to terminate therapy at any time; however, please let Ms. 
  Eisenberg know if you are not receiving the support or other services that you need 
  or expect anytime during treatment.
* You have the right to confidentiality, albeit specific legal exceptions, and must provide
  me written consent to contact other people relevant to you.
* You have the right to file a formal complaint against any mental health services you
  receive.  

Common Psychological Issues Addressed in Counseling with Type 1 and Type 2 Diabetics

Type 1 and Type 2 Diabetics, Diagnosed for at Feast One Year

Remember, family and friends of Diabetics can also experience most issues 
issues described below

* Focus on what the disease means to the you.
* Responsibility – yours, your therapist's and other members of your
  family/community.
* Stress management.
* Processing Anxiety.
* Difficulties adhering to diabetes treatment, this is usually done by
  keeping a week-long journal of glucose levels, insulin, food
  consumption, exercise, thoughts, feelings and moods, which will then
  be reviewed and processed in sessions.
* Interpersonal/relationship difficulties.
* Addressing shame/guilt.
* Increasing your support system.
* Lifestyle changes.
* Realization of one’s mortality and vulnerability.
* Dependence on health professionals.
* Knowledge/fear of possible long-term complications.
* Shame re: hypoglycemic episodes in public; Fear re: low blood
  sugar when alone.

Depression is also very common in diabetics, and is not generally listed as a complication of Diabetes. However, it can be one of the most common and dangerous complications. The rate of depression in diabetics is much higher than in the general population. Diabetics with major depression have a very high rate of recurrent depressive episodes within the following five years. (Lustman et al 1977). A depressed person may not have the energy or motivation to maintain good diabetic management.  There is some suggestion that the stress of depression itself may lead to high blood sugar in diabetics. Treatment of anxiety and depression may lead to a better medical prognosis and well as a better quality of life. 
 
For Newly Diagnosed Type 1 and/or Type 2 Diabetics:

Remember, our family and friends can also experience most issues described below

Learning you have Diabetes can feel overwhelming. There is so much to think about, and more than likely you will need to make major lifestyle changes.  When first diagnosed, you will likely be in denial. This is common for anyone who is told they have a life threatening disease, such as Diabetes. In the initial phases of treatment, attempting to explore and deal with these sudden feelings will assist you in avoiding certain unhealthy behaviors. Treatment for newly diagnosed diabetics will also address many of the above psychological issues; however, they are often faced with several of the issues below as well.
* Grief

* Denial

* Anxiety

* Depression

* Shame

* Guilt

Once you and Ms. Eisenberg mutually agree that you have made significant progress adjusting to living with Diabetes and you feel ready to proceed, the direction of treatment changes.

Treatment becomes more focused on issues, such as:
* Understanding how diabetes affects the whole person, usually by
  keeping a week long diary of glucose levels, insulin, food
  consumption, exercise, thoughts, feelings and moods, which will be
  reviewed and processed thoroughly.
* Becoming aware that living with diabetes is an ongoing process of
  emotional healing.

* Becoming aware of the different emotions that are experienced as part
  of the new diagnosis and the changes that will be made to your life.
* Highlighting the importance of psychosocial support and counselling,
  both individual and group, as part of the treatment for persons with
  Diabetes.