Psychosocial Adaptation to Traumatic Limb Loss

SYBIL J. KOHL, ACSW*Houston, Texas

Psychosocial adaptation to traumatic limb loss is complex and multifaceted. Analysis of the process aids understanding. The model is an outgrowth of psychosocial counseling sessions, observations and interactions with patients and their families.

Major issues are: Survival Struggle, Ideations of Death, Thought Disturbances, Phantom Sensations, Mourning, Quest for Meaning of Injury, Role Relationships, Body Image, Intimacy and Vocational Options. The physical restoration program consists of 1) Acute, 2) Prosthetic Fitting and Training, and 3) Post-Training phases. Every issue is not experienced with equal intensity by each patient nor can one assume that the foci of each issue in each phase have been resolved prior to the person's entering the next phase. Since amputees are bombarded by the, issues, they and their families require assistance from all members of the rehabilitation team to identify and prioritize issues for successful coping and resolution.

The model can: 1) train multidisciplinary staff members regarding patients' emotional response patterns, 2) coordinate interventions of staff to facilitate optimal patient adjustment, 3) initiate direct counseling with the injured person and family to identify unresolved issues and prioritize treatment goals, 4) orient family members with the patient's and their own adjustment process and 5) orient new staff members to particular issues related to amputation.

*The Institute for Rehabilitation and Research, 1333 Moursund, Houston, TX 77030