Therapy & HIV positive clients: exploring aspects that promote psychosocial adjustment using constructivist grounded theory

Snow, Sean (2022) Therapy & HIV positive clients: exploring aspects that promote psychosocial adjustment using constructivist grounded theory. Doctoral thesis, London Metropolitan University.


Background/Aim: With the advent of antiretroviral medication Human immunodeficiency virus (HIV) has moved to a chronic disease with life expectancy comparable to a noninfected individual. With antiretroviral medication (ART) individuals with HIV can expect to live longer yet are likely to encounter an increasing diverse array of medical, psychological, social and cultural challenges. Current research links a HIV diagnosis to a theme of adjustment as a positive diagnosis may be accompanied by stigma and has the power to influence and transform individual identities. A HIV positive diagnosis is often accompanied with vulnerability, helplessness and uncertainty with higher incidences of psychological distress such depression, generalised stress and anxiety. Existing literature has primarily focussed on the efficacy of CBT interventions in relation to HIV. Yet from a pluralistic perspective there is unlikely to be one appropriate ‘model’ as different people are helped by different processes at different times of their diagnosis trajectory.
Design/Method: This grounded theory study explored the experiences via semi structured interviews from a heterogenous group of eight participants aged between 23-47 who have completed a course of therapy in relation to a HIV diagnosis within the previous 2 years.
Results: The data analysis identified that a HIV diagnosis can invariably be accompanied by complex life adjustments as an individual adapts to new experiences of a physical, social, intimate or spiritual nature. Research findings identified two core-categories. The first core category ‘Process of growth in therapy’ embodied a process of interpersonal and intrapersonal growth, facilitated within the process of therapy emerging from subcategories ‘Processing the diagnosis overwhelm’ and ‘Understanding the relationship with the self & HIV’.A second core-category identified the process of ‘Therapy as a process of challenging exploration & psychosocial adjustment’ emerging from sub-categories in ‘Confronting Stigma’ and ‘Exploring, challenging beliefs about the self, world & others’.
Conclusion: This research is situated within existing literature and how it may provide suggestions for practitioners working with this diverse socio-economic client group. These results may facilitate the efficacy in delivering psychological interventions and help promote an individual’s capacity for psychosocial adjustment in overcoming the challenges in their social and domestic roles living with the stigma associated with HIV.

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