Educating Students With Chronic Illness

Statistics show that chronic illness is rising among all age groups, including students. Last month I mentioned in my blog some new research that supports this, and the problem that poor health is associated with students dropping out of school.

My colleagues Ann Fantauzzi and Paula Leitz and I have become increasingly concerned about this situation as we personally see the impact that chronic illness has on the education of young people we know through our professions. Ann is a former teacher and now a teacher mentor, Paula is a professor focusing on teacher training, and I treat a number of youth with chronic conditions, including cancer and fibromyalgia, in my clinical practice.

One of the biggest problems we see is that the school system is well accustomed to accommodating children with acute and/or short-term disabilities, like broken arms or legs, and traditional disabilities, like visual or auditory impairments. But they don’t do as well accommodating students with chronic relapsing-remitting conditions like cancer, multiple sclerosis or chronic fatigue syndrome, for example.

Although federal disability laws require schools to accommodate students with disabilities, we have found that school personnel, including administrators, teachers, principals and others, often need to be educated about the unique nature of chronic relapsing-remitting conditions. It can be confusing to see a student alter between periods of relatively good health and extreme weakness and disability, and the flexibility required to accommodate these students can be difficult to achieve in the stressed American school system.

What seems to work best in these cases is a combination of established pedagogical techniques, notably differentiated instruction, and chronic illness models, such as the Fennell Four-Phase Model.

Chronic illness models, including the Fennell Four-Phase Model (FFPM), address the universe of issues and concerns facing students and families with chronic conditions. FFPM outlines Four Phases that people commonly pass through as they learn to incorporate their altered physical abilities or psychological outlook into their personality and lifestyle.

Differentiated instruction is designed to accommodate the varying learning needs of students, whether they are gifted, learning disabled, chronically ill or typical. Differentiation allows teachers to provide high-quality learning opportunities while engaging each class member at his or her own level. Differentiation is also validating for students. It presents curriculum in a way that is relevant to their lives and helps them make connections between concepts, which in turn helps them to retain new ideas.

Overall, differentiated instruction gives the student more control over their own work because it is set up cooperatively with the teacher, and provides educators a greater sense of management and choice of outcomes for individual assignments.

By blending the FFPM approach with differentiated instruction, educators can develop individualized approaches to teaching students with chronic conditions that meet the students “where they are.” By using FFPM to take into consideration the medical, social, familial and psychological situation the student is facing, educators can use differentiated instruction to develop curriculum and assignments that are relevant to the student’s life, interests and abilities.

We’ve found that combining these approaches offers students a greater opportunity to maintain their education while coping with the relapsing/remitting nature of chronic illness.

More on Crime, Trauma and the Four-Phase Model

In a recent blog post, I mentioned that David Kaczynski, Gary Wright and I were on Northeast Public Radio discussing crime and long-term trauma. This is a topic I’ve been working on a lot recently, and one I wanted to explore a bit further in my blog.

In February, David and I spoke to the good people at the Mental Health Alternatives to Solitary Confinement Coalition, meeting at the Urban Justice League in New York City. This group is working to gain appropriate psychiatric care for inmates with severe mental illnesses. We talked about how the Fennell Four-Phase Model (FFPM) can describe the universe of trauma that emerges from violence and crime.

When we talk about violence, we naturally think about the victim’s experience of trauma — how is that person coping with what has been done to him or her? However, for the good of our community, we need to recognize that violence and crime can cause trauma in all parties involved in a crime — the victim, of course, but also family and close friends, but also the perpetrator, his family and friends, and even the law enforcement community which is trying to bring justice to the situation. For example, families of perpetrators are frequently traumatized by the impact of what their loved one has done to harm another. In addition, many criminals have been victims of trauma before they turn to violence.

FFPM describes the phases that any of these parties experience due to long-term trauma. It doesn’t pass judgment on any of the parties – it is a values-neutral, systems-based approach that understands that trauma is painful for all parties in different ways. It acknowledges that trauma-related symptoms change over time and in response to different experiences and circumstances.

It recognizes that if trauma isn’t treated, it is likely to be repeated.

People who have long-term trauma go through four predictable phases. In Phase 1, Crisis, the person is trying to contain the urgency and focus on the things that are necessary to cope with day-to-day life. In Phase 2, Stabilization, the person is carving order out of chaos and developing new norms. In Phase 3, Resolution, the person establishes an authentic new self and develops a supportive, meaningful philosophy. And, in Phase 4, Integration, the person appreciates that the experience is part of his or her life, but not something that defines him or her.

Once we have assessed the person’s Phase we can implement targeted psychiatric, physical and behavioral treatments to help them progress to the next level on the pathway toward Integration. And, by continually assessing and taking into consideration the impact of life events on the experience of trauma, we can limit regression into earlier Phases during times of greater stress.

When we view crime in light of the long-term trauma and Phase model, we open the door to resolution and healing, and development of a safer, more just society.

Chronic Illness Workbook Blog

Welcome to The Chronic Illness Workbook Blog! I’m so glad you found us. Whether you’re already familiar with the Workbook and the Fennell Four-Phase Model of chronic illness and trauma, or are new to our work, I think you’ll find information of value here.

For more than two decades, I’ve been working individually with people who are trying to navigate the “new normal” of life with a chronic condition, and also training other medical and mental health professionals whose clients are traveling this difficult path. With this blog, I intend to bring much of the information that I share during my speaking engagements and my weekly counseling and professional development sessions to a wider audience through the Internet.

I’ll be talking a lot about the Fennell Four-Phase Model of chronic illness and trauma, which has been used worldwide since the early 1990s. If you’re not yet familiar with the Fennell Four-Phase Model, you can find a brief overview on my website at www.albanyhealthmanagement.com/ourfocus_ffpm.shtml. In this blog, we’ll get further in depth with the philosophy of the model and its utilization in the treatment of chronic illness with Fennell Four-Phase Treatment (FFPT).

I’ll also bring you insight about chronic illness and trauma, particularly as they relate to health conditions, criminal justice and education. I’ll be culling topics from my speaking engagements and news events as they relate to our work. And I’ll invite my colleagues to contribute to broaden the knowledge we collectively gain.

If you have any questions or comments, I’d like to hear from you. Since medical blogs can be a frequent target for spammers, I’ve implemented some extra security steps, including the requirement for all comments to be approved before they are posted. So if you don’t see your comment appear right away, please don’t worry – it’s probably waiting for me get a free moment to review it so I can post it on the blog.

If you have a question for me that you don’t wish to post on the blog, e-mail me using my contact form.

Thank you for reading this far – please let me know if there are topics you’d like to read about or information you are seeking. I look forward to our dialogue and hope you will, as well.