Specialist Diabetes Counsellors
There are 33 counsellors in Ireland who are trained in diabetes care. This is one indication of how diabetes care has come a long way in recent years. While treatment of the condition is not immune to waiting lists, staff shortages and funding cutbacks, people diagnosed with diabetes today have more information available to them than ever before, not to mention constantly improving medication and equipment and access to a range of specialists, from dietitians to podiatrists.
In the past, psychosocial support was underdeveloped in Ireland. According to Anna Clarke, Federation Health Promotion Manager, psychosocial support is essential for some people with diabetes.
“Where some people may cope well with such a diagnosis, others may experience a range of problems – from being in denial about having it, to having difficulties managing it.
“People with all types of diabetes can attend a counsellor. It is open to anyone who needs support or is struggling with a particular issue related to their condition,” she explained.
Diagnosis can be scary
A diagnosis of diabetes can be scary, overwhelming and life-altering. A person must incorporate lifestyle changes that may be very different to their current lifestyle choices. They must also learn how to use their medication correctly and how to deal with serious events such as a hypo (low blood sugar).
“There are many issues related to a diagnosis of diabetes and these may not only affect the person, but also their family, friends and perhaps colleagues. If anyone is struggling with any aspect of their diabetes, I would urge them to consider seeing a counsellor. This really is an invaluable service,” Ms Clarke emphasised.
“People who have availed of this service have said that it is very helpful to have somebody that they can speak with openly about their concerns,” Ms Clarke added.
Reported highlighted need
The importance of psychosocial support following a diagnosis of diabetes was highlighted in the 2002 report Diabetes Care – Securing the Future, from the Diabetes Service Development Group. It clearly stated that the provision of dedicated psychological support to assess and address the psychological and emotional needs of people with diabetes should be an essential part of every diabetes healthcare team in the country.
However, by 2004, there were no psychologists working full-time in diabetes care in Ireland and just three offering a part-time public service to the estimated 200,000 Irish people with diabetes. In response to this, in that same year, the Diabetes Federation of Ireland introduced a groundbreaking course – the Counsellors Diabetes Educational Course.
The course was run over a six-week period and was aimed at already accredited counsellors, who wished to develop an in-depth understanding of diabetes and the many issues which those affected must regularly deal with.
Nineteen counsellors completed that first course and were subsequently able to offer counselling to people with diabetes. Today, 33 such counsellors are available nationwide.
Young adult idea
The original idea for the course came from the annual Diabetes Young Adult conferences, where the lack of psychosocial support was seen as a major problem. Due to the lack of psychologists available to people with diabetes, those affected had to look to other diabetes healthcare professionals for the support they needed. However, in most instances, these professionals simply did not have the time to provide the support so badly required. This was largely due to the increasing number of people presenting with diabetes.
Following this, a group of counsellors were approached by the Federation to gauge interest in providing a service for people with diabetes and to assess what would be required if such a service were to be developed.
The Federation concluded that an educational course would be well received and set about developing it. It was open to all accredited counsellors and 19 people applied for and completed the first course.
Counsellors lacked diabetes knowledge
Before starting the first course in 2004, the counsellors answered a questionnaire designed to assess their level of diabetes knowledge. The overall average score was six, which indicated a low level of basic diabetes knowledge. On the final night of the course, they answered another questionnaire and this time the average score was 18, indicating a good knowledge of diabetes.
The counsellors were taught about the actual condition, including the different types of diabetes, symptoms and diagnosis. They also learned about a number of other relevant topics, including:
• Dietary issues – food types and their effect on blood glucose and fats
• Treatment of diabetes – devices, tablets and insulin
• Responsibilities of the person with diabetes, eg. how to access care and their entitlements
• Complications of diabetes
• The effects of lifestyle factors such as alcohol, smoking, exercise
• How to manage stress
• The effect of a diabetes diagnosis on other people, for example, family
The list of accredited counsellors is available at all hospital-based diabetes clinics and many GP surgeries throughout the country.
NB As this is a private service, those availing of it must pay a fee and it is up to each counsellor to determine their own fee.