Advancing Chronic Disease Management Through Remote Patient Monitoring

Posted on by Joseph Gerard

Doctor treating an elderly patient

Written by Harry Wolf,

According to the CDCP, three in four American adults have at least one chronic health condition. And over half of adults have two or more.

It should not be surprising, therefore, that chronic disease drives the majority of health care spending and hospital utilization nationwide. For clinicians and health systems, the pressure to improve outcomes while reducing avoidable admissions has never been greater.

The good news? Remote patient monitoring, or RPM, has become a core strategy in chronic care delivery… 

A Brief Overview of RPM

RPM refers to the use of connected medical devices and digital platforms to collect patient health data outside traditional clinical settings. Data flows directly to clinical teams, thus enabling proactive interventions – rather than reactive treatment.

For example, RPM programs can track blood pressure, pulse oximetry, weight, and symptom scores for high-risk cardiovascular and pulmonary patients. 

According to the National Library of Medicine, structured remote monitoring enables earlier identification of clinical deterioration and more timely medication adjustments. Earlier detection means fewer last-minute medication changes and more predictable care trajectories.

What do core RPM programs typically include the following components:

  • FDA-cleared devices that transmit real-time physiologic data
  • A secure digital platform for data aggregation and automated alerts
  • Defined clinical protocols for escalation and outreach
  • Dedicated clinical staff

RPM Can Improve Chronic Disease Outcomes

Well-structured RPM programs improve both clinical and utilization metrics. Benefits are especially pronounced in high-risk populations with heart failure, COPD, diabetes, and uncontrolled hypertension.

A 2024 systematic review, published by Springer, found that digital monitoring interventions for COPD were associated with reduced hospitalizations and improved self-management behaviors. 

Patients using structured monitoring tools demonstrated better medication adherence and earlier reporting of symptom exacerbations. Of course, improved adherence at scale directly affects readmission metrics and quality-performance benchmarks.

A 2025 multicenter study in the Journal of Medical Internet Research showed that older adults with multiple chronic conditions reported reductions in hospital readmissions and improved care coordination in RPM-supported cohorts. 

The findings showed measurable gains in transitional-care stability. For hospitals operating under value-based reimbursement models, even modest reductions in 30-day readmissions produce significant financial – and operational – impact.

Key Clinical Impact Areas

When RPM programs are designed with structured protocols, various improvements are commonly observed. Such as? Well:

  • Earlier detection of physiologic instability
  • Improved medication titration accuracy
  • Higher patient-engagement rates
  • Reduced emergency department visits

Clinical teams gain better visibility between visits rather than relying on episodic check-ins. And continuous data streams shift care from reactive to preventive.

Enhancing Adherence Through Structured Engagement

Medication adherence and lifestyle compliance remain persistent challenges in chronic disease management, as you may well be aware. RPM platforms create accountability loops that reinforce treatment plans outside the clinic.

A 2025 randomized controlled trial published in JAMIA demonstrated significantly higher monitoring adherence among heart-failure patients enrolled in structured RPM programs with defined engagement strategies. 

Patients receiving routine feedback and clinical follow-ups were more likely to consistently submit biometric readings. 

Consistent data submission… It allows clinicians to make evidence-based adjustments – rather than relying on retrospective recall. Structured engagement models typically include:

  • Scheduled patient check-ins from clinical staff
  • Automated reminders tied to device use
  • Personalized education aligned with diagnosis
  • Escalation pathways triggered by threshold breaches

High-performing programs treat engagement as a clinical function – rather than a technical add-on. Human oversight, of course, remains central to sustained participation.

Operationalizing RPM at Scale

Technology adoption alone does not guarantee clinical transformation. Sustainable RPM implementation requires:

  • Workflow redesign
  • Reimbursement alignment
  • Dedicated staffing models

Centers for Medicare & Medicaid Services has expanded reimbursement pathways for remote physiologic monitoring and remote therapeutic monitoring – over recent years, that is. 

Policy updates published by Medtronic highlight ongoing refinements in outpatient and physician-fee-schedule structures. Reimbursement clarity directly influences administrative buy-in and long-term program viability.

Health systems evaluating RPM deployment should assess several operational domains:

  • Device logistics and inventory management
  • Clinical documentation and billing compliance
  • Data integration with existing EHR systems
  • Staff training and escalation workflows

Fragmented implementation… It can create clinician fatigue and documentation burden. Thankfully, fully-managed models often reduce internal strain by centralizing:

  • Outreach
  • Monitoring
  • Reporting

For instance, solutions such as Nsight Health’s remote patient monitoring provide fully-managed services that include patient outreach, enrollment, 24/7 clinical monitoring, FDA-cleared cellular devices, and billing support. 

Nsight Health operates with its own clinical team and infrastructure, allowing provider organizations to integrate RPM without building parallel internal departments. 

Addressing Barriers and Equity Considerations

Despite strong outcome data, RPM adoption still encounters barriers related to digital literacy, connectivity, and clinician workload. Rural and underserved populations may face additional infrastructure constraints.

User-friendly device design and cellular-enabled connectivity are essential for reducing disparities. Findings summarized by arXiv in 2024 highlight that simplified onboarding and automated data transmission improve participation among older adults. 

Device simplicity matters – when patients manage multiple comorbidities and complex medication regimens, that is. Programs seeking equitable implementation should prioritize:

  • Cellular-enabled devices that eliminate broadband dependency
  • Multilingual patient-education resources
  • Clear escalation protocols to prevent alert fatigue
  • Continuous quality-review processes

Equity-focused design increases the likelihood that RPM benefits extend beyond digitally-savvy populations. Broader adoption strengthens community-level chronic-disease management.

Data Integration and Clinical Decision Support in RPM

Continuous data collection… It only delivers value when it informs actionable clinical decisions. Remote patient monitoring programs that integrate directly into electronic health records create a unified view of longitudinal patient data, reducing fragmentation across care settings.

RPM-supported care models improve care-coordination efficiency when biometric data is embedded within shared clinical dashboards. Integrated-data workflows allow clinicians to identify high-risk patients earlier – as well as prioritize outreach based on stratified risk scores. 

For busy care teams, risk-based prioritization prevents alert overload. And it supports focused intervention – where it matters most.

Clinical decision-support systems within RPM platforms typically apply threshold-based alerts, trend-analysis algorithms, and protocol-driven escalation pathways. Structured review processes help transform raw data into meaningful treatment adjustments.

Effective integration strategies often include:

  • Automated EHR documentation of transmitted biometric data
  • Risk-stratification tools embedded within clinician dashboards
  • Tiered alert systems aligned with diagnosis-specific thresholds
  • Multidisciplinary review workflows for complex patients

Clinical leaders should also evaluate interoperability standards when selecting RPM vendors. Such as? HL7 and FHIR.

Seamless data exchange… It reduces manual entry, lowers documentation burden, and improves coding accuracy for reimbursement.

Data governance plays an equally critical role in maintaining trust and compliance. Secure transmission protocols, HIPAA-aligned storage, and role-based access controls protect sensitive health information – while enabling cross-disciplinary collaboration, that is.

When RPM data is operationalized within structured clinical pathways, decision-making becomes proactive rather than episodic. Providers move beyond snapshot-based assessments toward dynamic, data-informed management plans.

Financial Performance and Value-Based Care Alignment

Chronic disease management increasingly operates within value-based reimbursement models where outcomes, not volume, determine financial sustainability. Remote patient monitoring supports this transition by aligning real-time clinical oversight with measurable quality metrics.

For example? Well, a 2025 analysis reported by Medical Economics highlighted a Michigan Medicine RPM initiative that reduced hospitalizations among high-risk patients by nearly 60 percent. 

Patients enrolled in structured at-home monitoring experience significantly fewer acute-care episodes, compared to matched controls, that is. 

For health systems participating in shared-savings programs, reduced admissions directly influence both penalty avoidance and incentive eligibility.

Beyond utilization metrics, RPM programs contribute to improved performance of:

  • HEDIS measures
  • Blood-pressure control benchmarks
  • Transitional-care management indicators

Continuous biometric tracking supports more accurate documentation of disease severity and clinical interventions.

Financial impact areas typically include:

  • Reduced 30-day readmission penalties
  • Increased capture of reimbursable RPM service codes
  • Improved quality-measure performance scores
  • Lower total cost of care for high-risk cohorts

CMS reimbursement pathways for remote physiologic monitoring and remote therapeutic monitoring continue to evolve. 

With ongoing refinements to outpatient and physician-fee-schedule policies, regulatory clarity strengthens the business case for sustained RPM investment.

Operational discipline… It remains essential to financial success! Programs must ensure accurate time tracking, compliant documentation, and consistent patient engagement to meet billing thresholds.

When clinical outcomes improve alongside reimbursement optimization, RPM becomes more than a digital add-on. Yes indeed, it functions as a strategic infrastructure component supporting long-term value-based performance.

Redesigning Workforce Optimization and Care Teams 

Workforce shortages continue to strain areas like primary care, cardiology, pulmonology, and endocrinology practices. Remote patient monitoring offers a structured way to redistribute clinical workload – while maintaining high-touch chronic-disease oversight, that is.

Centralized monitoring models reduce the burden on in-clinic providers. How? By shifting routine data review to trained remote teams.

Programs that incorporate dedicated monitoring staff improve response times and reduce clinician burnout associated with unmanaged alert volumes. For organizations already facing staffing constraints, centralized monitoring protects provider bandwidth.

Care-team redesign in RPM-supported environments typically clarifies roles across physicians, advanced-practice providers, nurses, and care coordinators. Defined escalation pathways prevent ambiguity when biometric thresholds are exceeded.

High-functioning RPM workforce models often include:

  • Dedicated RPM nurses responsible for daily data triage
  • Clearly defined physician-escalation criteria
  • Standardized outreach scripts for symptom follow-up
  • Documented protocols aligned with payer requirements

Redistribution of responsibilities also supports advanced-practice providers working at the top of their license. Physicians retain oversight for complex decision-making – while routine monitoring and patient engagement occur through structured workflows.

Fully-managed RPM programs can further streamline operations. How? By externalizing:

  • Patient enrollment
  • Device logistics
  • Documentation support

Workforce optimization through remote patient monitoring ultimately strengthens both patient access and clinician sustainability. Structured team-based models transform chronic-care delivery into a coordinated, data-driven system – that is: rather than a sequence of disconnected visits.

Advancing Chronic Disease Management Through RPM 

Remote patient monitoring has transformed healthcare. In particular, it has matured into a clinically validated and financially aligned strategy for advancing chronic disease management. 

Evidence across cardiovascular, pulmonary, and multi-morbidity populations demonstrates measurable reductions in hospitalizations, stronger adherence, and more stable care transitions – when programs are structured around proactive oversight.

Sustainable success depends on more than device distribution, though. Integrated data workflows, risk-stratified dashboards, reimbursement compliance, and clearly defined team roles determine whether remote patient monitoring delivers lasting value. 

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Author bio: Harry Wolf is a freelance writer. For almost a decade, he has written on topics ranging from healthcare to business leadership for multiple high-profile websites and online magazines.

References:

Unathored, 2025, About Chronic Diseases, Centers for Disease Control and Prevention.

https://www.cdc.gov/chronic-disease/about/index.html

Po, Hui-Wen, Chu, Ying-Chien, Tsai, Hui-Chen, Lin, Chen-Liang, Chen, Chung-Yu, Ma, Matthew Huei-Ming, 2024, Efficacy of Remote Health Monitoring in Reducing Hospital Readmissions Among High-Risk Postdischarge Patients: Prospective Cohort Study, National Library of Medicine.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11437225/

Mishra, Vineet, Stuckler, David, McNamara, Courtney L., 2024, Digital Interventions to reduce hospitalization and hospital readmission for chronic obstructive pulmonary disease (COPD) patient: systematic review, Springer Nature.

https://link.springer.com/article/10.1186/s44247-024-00103-x

Testa, Damien, Iborra, Vincent, Dutech, Mireille, Sanchez, Manuel, Raynaud-Simon, Agathe, Cabanes, Elise, Chansiaux-Bucalo, Christine, 2025, Impact of a Home-Based Remote Patient Monitoring System on Hospitalizations and Emergency Department Visits of Older Adults With Polypathology: Multicenter Retrospective Observational Study, Journal of Medical Internet Research.

https://www.jmir.org/2025/1/e64989/

Mohapatra, Sukanya, Issa, Mirna, Ivezic, Vedrana, Doherty, Rose, Marks, Stephanie, Lan, Esther, Chen, Shawn, Rozett, Keith, Cullen, Lauren, Reynolds, Wren, Rocchio, Rose, Fonarow, Gregg C., Ong, Michael K., Speier, William F., Arnold, Corey W., 2025, Increasing adherence and collecting symptom-specific biometric signals in remote monitoring of heart failure patients: a randomized controlled trial, Journal of the American Medical Informatics Association.

https://academic.oup.com/jamia/article/32/1/181/7738853?guestAccessKey=

Unauthored, 2026, 2026 updates and changes to Medicare hospital inpatient (IPPS), outpatient (OPPS), ambulatory surgical center (ASC), and physician (MPFS) fee schedules, Medtronic.

https://www.medtronic.com/content/dam/medtronic-wide/public/united-states/customer-support-services/reimbursement/crhf-medicare-outpatient-hospital-updates.pdf

Littrell, Austin, 2025, At-home monitoring cuts hospital admissions by nearly 60%, study finds, Medical Economics.

https://www.medicaleconomics.com/view/at-home-monitoring-cuts-hospital-admissions-by-nearly-60-study-finds

Jat, Avnish Singh, Grønli, Tor-Morten, 2024,Harnessing the Digital Revolution: A Comprehensive Review of mHealth Applications for Remote Monitoring in Transforming Healthcare Delivery, arXiv.

https://arxiv.org/abs/2408.14190

 

Please also review AIHCP’s Case Management Certification program and Case Management Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Behavioral Psychology and Therapies

Posted on by Mark Moran

Behavioral Psychology is a branch of counseling and techniques that emphasize the direct role social experiences and learning play a role in behavior.  Cognitive Behavioral Therapy is an offshoot from it.   Behavior Therapy focuses on how current behaviors are affected through previous learning experiences and how they shaped the current behavior.  Behavior Therapy is concerned less with the subconscious and how it played a role in one’s current behavior but more so how past experiences, learning, and how classical and operant conditioning formed one’s individual behavior.  Like many schools of thought, it adheres to a strict conceptual model for its approach but for many therapists, it is integrated with other schools of thought to meet the needs of the client.   Among the many psychological schools, Behavior Therapy is the most empirically based approaches despite its limitations if used as the only lens to examine human behavior.  It perspective is a critical piece of understanding individuals and helping them find productive change and healing.  For that reason, it and many of its techniques are widely applied with other Psychoanalytic and Rogerian therapies.

Behavioral Therapy sees mental issues as issues associated with past learned behavior

Please also review AIHCP’s Behavioral Health Certifications, including Grief Counseling, Crisis Counseling, Trauma Informed Care, Anger Management, Stress Management, as well as Spiritual Counseling and Christian Counseling.

Behavioral Therapy

Behavioral Therapy emerged in the Mid 20th Century and continues to adapt and add key components from the original thought.  Key pioneers and founders of Behavioral Therapy include Joseph Wolpe, Hans Eysenck, B.F. Skinner, Arnold Lazarus, Albert Bandura and David Meichenbaum (Tan, 2022).  Traditional Behavior Therapy is based on behavior being conditioned by one’s learning and social environment.  Classical conditioning as well as operant conditioning play large roles in how behavior evolves within a person.

Classical conditioning is based off IvanPavlov and his studies on canine responses to stimuli.  In classical conditioning, the dog salivates in response to the treat or food.  The salivation is referred to the unconditioned response or natural response to the food or unconditioned stimuli.  The UCR to the UCS is a natural response to something that occurs subconsciously within any living creature.  Pavlov however incorporated a conditioned stimuli next to the unconditioned stimuli to help provoke a conditioned response.  He added the ringing of a bell during dinner time for the dogs.  The dogs continued to salivate and eat due to the food, but later when the food was removed, the ringing of the bell still conditioned a response of salivating.  A CR emerged due to the CS.   This illustrated that living things can be conditioned and behavior changed at neural level over time.

Operant conditioning also played a role for Wolpe, Skinner and other early behavioral therapists.    Operant conditioning looks to alter behavior through consequences.  Behaviors that are reinforced with pleasant stimuli or reward, or even the absence of negative stimuli constitute positive/negative reinforcement of it.   These consequences look to maintain or increase a certain behavior.  Behaviors that are met with punishment and negative stimuli look to eliminate or reduce a certain behavior (Tan, 2022).

Unconditioned and Conditioned Responses to Unconditioned and Conditioned Stimuli

Behavior modification became a key component in changing a person way of thinking and acting.  Skinner even took this a step farther than most and indicated that all behavioral events and modifications determine what a person will or shall do, even to the extent of denying free will (Tan, 2022).    Obviously, this was an extreme outlook and narrows human behavior only to present stimuli and events without considering the numerous other things at play.  Nonetheless, one cannot deny the profound effect environment and stimuli plays within the role of behavior and decision making.

As the school of thought developed, cognitive and other elements would become important tenets in Behavior Therapy.

Techniques and Therapies

Behavioral Therapy employs a broad range of techniques and therapies.   First and foremost, the therapist is more so in control than in Rogerian therapies and other Person-Centered Therapies.  The therapist takes a central role.  The client proposes the “what” while the therapist presents the “how”.   Hence, there is far less concern with the therapist-client relationship.  Although not disregarded, especially when integrated, the emphasis of healing and change is more so in the techniques and the now instead of focusing on a relationship or probing into the past.

To help understand the client, behavioral assessment is the first and key stage in helping  the client.  This involves targeting the “what” of the problem and identifying symptoms and problems of the client (Tan, 2022).   Counselors propose operant conditioning as a key element of change.  They utilize positive and negative forms of reinforcement to help the client change.  Some cases involve complete extinction of any positive or negative.  If dealing with a child’s temper tantrum, extinction would be utilized as a way to completely to ignore the outburst and when the child is again calm to implement positive reinforcement.    Punishment or aversive control can also be utilized to produce change.  Positive punishment adds an adverse stimulus, while negative punishment removes something positive.  A child may be forced to do a choir or with positive punishment associated with undesired behavior, while negative may involve grounding a child or taking away a privilege.  In some cases though, punishment and extinction can also cause unwanted desires in anger and aggression.  Because of this, positive reinforcement is seen as the best psychological tool in promoting healthy change (Tan, 2022).

Another technique utilized in Behavior Therapy is Token Economies.  This technique is a positive reinforcing strategy based on reward of token which has a symbolic value for something that can earned through good behavior.  This is a common technique used in schools which keep track of desired performance and behavior with recognition and reward.

Modeling represents another utilized strategy to help foster change.  In modeling, the client observes another person’s behavior and the consequences surrounding it.  Bandura listed certain ways modeling can be utilized in changing behavior.  He first emphasized teaching which includes simple observation and application of the model.  Second, in therapy, prompting involves the client performing a certain behavior that was observed. Motivating a client through modeling involves focus on the reward of the other person and hence motivating the client to replicate the behavior.   Reducing anxiety involves watching the model perform an anxious deed to be replicated by the client.  Maybe this involves the model dealing with something that is a phobia for the client.  Finally, live modeling involves replicating the behavior or acting it out in therapy under the guidance of the counselor (Tan, 2022).

In addition, Behavior therapies also look to incorporate certain social skill and assertiveness training.   In this, the therapist helps the client understand their current behavior and why he or she responds in certain situations and how to respond differently, utilizing a variety of modeling and rehearsal techniques.  In this way, Behavior Therapy works closely with a variety of management techniques to work on behaviors that need changed, included areas of anger, assertiveness, as well as stress management.  In addition, the counselor looks to help the client meet goals and self directed change.  Bandura believed strongly in the self efficacy of a client to successfully implement change in one’s life (Tan, 2022).  In meeting goals, self talk and other cognitive ways to help someone through a situation is encouraged.  Meichenbaum employed stress inoculation training, as a type of exposure therapy to stress itself and how one responds to stress.  This CBM (Cognitive Behavior Modification) was also utilized by the military to help soldiers in stressful situations (Tan, 2022).

Learned behaviors can be undone and replaced with new and healthy behaviors through a variety of behavioral techniques. Please also review AIHCP’s Healthcare Certifications

Behavior Therapy also focuses heavily on relation strategies which serve to relax the central nervous system and the reactions to stress and distress.  They employ a wide variety of exercises involving breathing, guided meditation and progressive muscle relation to face and deal with stress, emotions and trauma (Tan, 2022).   Mindfulness is also employed in a variety of stress management strategies.

Another key tool used in Behavior Therapy involves systematic desensitization.    Wolpe believed that exposures to phobias or traumas can help an individual modify current behavioral reactions and recircuit reactions to them. Utilizing the SUD scale (Subjective Units of Discomfort), the therapist gradually exposes the client to a phobia or issue.  For example, a person who fears a spider will be begin to be introduced to issues surrounding the spider with the therapist documenting the SUD scale input between 1 to 100 with 100 being the most anxious.  Minimal dosing with the word, moves forward to a picture, then it progresses to dead specimens to alive specimens to eventual complete exposure and touching (Tan, 2022).   Wolpe referred to this as counterconditioning a certain behavioral response with a new and healthy response.  Other forms are more intense.  Flooding involves exposure without the feared stimuli or its consequences but at a higher maximum level.  One modern utilization of this is EMDR (Eye Movement Desensitization Reprocessing).  This technique has gained popularity in therapies facing trauma and has proved to be effective way for many clients to face trauma and phobias itself (Tan, 2022).

Moving Forward

Behavior Therapy has evolved to include many multi-dimensional aspects, included mindfulness as well as cognitive therapies.  It is a very successful type of therapy but like all therapies when utilized singularly, it can miss important aspects of healing regarding the past, or unresolved memories.  Yet despite this, it still possesses a comprehensive approach to multiple issues. It helps the person gain autonomy  and confidence through goals and freedom to reset one’s mindset to produce new desired behaviors.

Please also review AIHCP’s Healthcare Certification Programs and see if they meet your academic and professional goals.

Other AIHCP Blogs

Patient Centered Therapy:  Access here

Existential Therapy:  Access here

Reference

Tan, S-Y. (2022). Counseling and psychology: A Christian perspective (2nd Edition). Baker Academic.

Additional Resources

Cherry, K. (2025).  “How Behavioral Therapy Works”. Very Well Mind.  Access here

Gillette, H. (2025). “Your Guide to Understanding Behavioral Therapy”.  PsychCentral.  Access here

“Joseph Wolpe’s Contributions to Psychology: Pioneering Behavioral Therapy” (2024). Neurolaunch.  Access here

 

The Impact of Indoor Environmental Conditions on Mental Health Outcomes in Clinical and Home Settings

Posted on by Joseph Gerard

Clip art style image of a two people cleaning up a cluttered mind in a sunny outdoor environment.

Written by Harry Wolf,

Depression, anxiety, and cognitive fatigue… Such conditions are not shaped by psychosocial stressors alone. Indoor environmental conditions measurably influence neurobiology, emotional regulation, and treatment response in both clinical and residential settings. 

For professionals working in health care delivery and education, environmental quality has become a clinical variable – rather than a background detail.

Indoor Air Quality and the Risk of Depression 

Indoor air quality can affect cognitive clarity, mood stability, and overall psychiatric vulnerability. Indeed, fine particulate matter and elevated carbon dioxide concentrations are increasingly associated with measurable declines in executive function and increased depressive symptoms.

According to findings by Spain’s Instituto de Postgrado, cognitive performance is improved when indoor particle concentrations are reduced under double-blind conditions. 

For clinicians and administrators, those results suggest that untreated air-quality deficiencies may quietly undermine therapeutic engagement and cognitive resilience.

Diminished cognitive flexibility can translate into impaired engagement in psychotherapy, reduced medication adherence, and increased frustration tolerance issues. In home settings, especially among older adults, subtle declines in air quality may erode cognitive reserve.

Common contributors to compromised indoor air quality? They include:

  • Insufficient ventilation in tightly sealed buildings
  • Accumulated indoor particulates from cooking or outdoor infiltration
  • Off-gassing from building materials – and from furnishings

In larger homes and clinical settings, uneven airflow is more than just a comfort issue. When certain rooms receive less ventilation, air can become stale, temperatures fluctuate, and particles start to build up over time. Over time, these imbalances can start to affect how people feel, think, and respond especially in spaces meant for recovery, focus, or therapy

This becomes harder to manage when each room serves a different purpose. A therapy room, for example, may need a steady, quiet environment, while offices or living areas have different requirements. Relying on a single system often leads to some areas being overcooled while others are left inconsistent.

In situations like this, solutions such as Five-Zone Ductless Systems make a noticeable difference. They allow each room to be controlled independently while still running on one outdoor unit, making it easier to maintain stable air quality and temperature across the entire space without overcorrecting in certain areas.

Artificial Lighting and Depressive Symptoms 

Light exposure… As you probably know, it regulates circadian rhythms, melatonin secretion, and mood stability. Inadequate daylight or excessive artificial light at night alters neuroendocrine function in ways strongly associated with depressive symptoms.

A 2024 systematic review published by PubMed found that exposure to artificial light at night was associated with increased odds of depression, with risk rising incrementally per lux increase. 

Controlled indoor light modifications could improve depressive symptoms.

For shift-working nurses, inpatients under constant illumination, or residents in poorly daylit homes, light exposure patterns can directly influence sleep architecture. It can affect emotional regulation, as well. 

Circadian disruption may therefore complicate pharmacologic management and behavioral interventions.

Key lighting-related risk factors include:

  • Continuous overnight corridor or bedside illumination
  • Limited daylight penetration in deep-plan buildings
  • Blue light exposure late in the evening

Design responses extend beyond aesthetics. Tunable white lighting, access to natural daylight, and scheduled dimming protocols… They all help synchronize circadian rhythms. 

Environmental services teams and clinical leadership benefit from viewing lighting plans as behavioral health interventions. Illumination levels, spectral composition, and timing form part of the therapeutic milieu.

Environmental Noise and Anxiety Disorders 

Environmental noise acts as a chronic stressor – with measurable neurobiological consequences. Activation of the hypothalamic-pituitary-adrenal axis under persistent noise exposure contributes to anxiety, irritability, and sleep fragmentation.

Studies show there are reported associations between long-term environmental noise exposure and increased risk of depression, anxiety, and suicidal behavior. 

A 2025 study in Frontiers in Public Health found that higher ward noise exposure was associated with increased perioperative anxiety among hospitalized surgical patients. 

For individuals already experiencing medical uncertainty, acoustic overload compounds psychological burden. And it prolongs stress activation.

Health care workers are similarly affected. Noise exposure can potentially cause elevated stress, insomnia, and anxiety symptoms among staff. Burnout risk, clinical error potential, and reduced empathic capacity may follow sustained exposure.

Common indoor noise sources include:

  • Alarms, paging systems, and medical equipment
  • HVAC cycling and duct vibration
  • Urban traffic infiltration

Acoustic mitigation strategies require interdisciplinary coordination. Sound-absorbing ceiling tiles, alarm management protocols, and zoning of mechanical systems reduce unnecessary exposure. 

Residential environments supporting recovery from psychiatric hospitalization similarly benefit from quiet zones and sound-dampening materials.

Mental health treatment does not occur in isolation. Auditory load shapes emotional tone, concentration, and sleep continuity – in both institutional and domestic contexts.

Thermal Comfort and Mood Instability

Thermal stress… It has increasingly been linked to mental and behavioral health outcomes. Elevated indoor temperatures and high humidity levels can exacerbate irritability, aggression, and depressive symptoms.

Findings by Nature show that humid-heat exposure may substantially increase the global burden of mental and behavioral disorders – under high-emission scenarios, that is. 

Additional 2025 findings using WHO-SAGE data demonstrated stronger associations between depression risk and wet-bulb temperature. For clinicians practicing in regions with rising heat indices, environmental monitoring may therefore become part of psychiatric risk mitigation.

Thermal discomfort disrupts sleep, impairs cognitive flexibility, and increases physiologic stress load. Patients with severe mental illness may be particularly vulnerable – due to medication-related thermoregulatory effects.

Thermal risk factors often include:

  • Inconsistent cooling across multi-room facilities
  • High indoor humidity during the summer months
  • Inadequate heating in winter affecting vulnerable populations

Precision temperature control reduces physiologic strain. Zoned HVAC solutions, humidity regulation, and building envelope improvements allow clinicians and facility operators to maintain stable indoor conditions. 

Residential settings caring for older adults or individuals on psychotropic medications benefit from proactive climate management – rather than reactive adjustment.

Environmental Clutter and Sensory Overload 

Visual clutter and excessive environmental stimuli can heighten cognitive load and anxiety. Overstimulating indoor environments challenge attentional filtering mechanisms – particularly among individuals with autism spectrum conditions or acute psychiatric symptoms.

In clinical environments, chaotic visual fields can similarly increase perceived lack of control and attentional strain.

Common contributors to sensory overload? They include:

  • High-density signage and visual alerts
  • Poor storage systems leading to exposed equipment
  • Inconsistent spatial organization across rooms

Environmental simplification enhances perceived safety and predictability. Streamlined visual design, concealed storage solutions, and consistent spatial layouts reduce cognitive burden and may improve therapeutic engagement. 

Behavioral health units in particular benefit from calm visual fields that support emotional regulation.

Attention to visual order does not require sterile minimalism. Intentional organization and reduced sensory noise collectively support psychological stability in both institutional and residential settings.

Wayfinding Complexity and Cognitive Load 

Navigation within health care environments is rarely neutral. Complex layouts, inconsistent signage, and visually ambiguous corridors… They all increase cognitive load and can heighten stress responses – in both patients and staff. 

Disorientation may rapidly escalate into agitation – for individuals already experiencing anxiety, cognitive impairment, or acute psychiatric symptoms, that is. Poorly organized spatial layouts increase mental effort, elevate physiologic stress markers, and reduce perceived control. 

In places like large hospital campuses and multi-wing outpatient centers, wayfinding demands often compete with clinical stressors. Therefore, it compounds emotional strain – during already vulnerable moments.

Cognitively vulnerable populations are particularly sensitive to navigational complexity. Individuals with mild cognitive impairment, dementia, traumatic brain injury, or severe mood disorders may struggle to construct reliable mental maps of confusing environments. 

Heightened uncertainty activates vigilance systems – which can worsen anxiety. And it can reduce cooperation with care processes among patients.

Here are some common wayfinding-related stressors:

  • Inconsistent signage
  • Long, visually uniform corridors without distinguishing landmarks
  • Poor differentiation between public and restricted areas
  • Frequent spatial reconfiguration without updated orientation cues

Disorientation does not merely inconvenience patients. Staff members navigating inefficient layouts can also potentially experience cumulative cognitive fatigue – particularly in high-acuity settings where rapid response is critical. 

Design strategies that improve environmental legibility can mitigate these risks. Clear sightlines, color-coded zones, intuitive floor numbering systems, and distinct architectural landmarks reduce cognitive burden. 

Memory care units often employ simplified circulation loops and recognizable visual anchors to support orientation – demonstrating how design can function as a cognitive support tool.

Predictability and clarity within built environments reinforce psychological safety. When individuals can reliably anticipate spatial outcomes, autonomic stress activation decreases. 

For health care systems focused on trauma-informed design, wayfinding coherence represents a measurable and modifiable determinant of mental health stability.

Integrating Environmental Design Into Mental Health Strategy

Indoor environmental conditions intersect with neurobiology, behavior, and treatment response – in measurable ways. Things like air quality, lighting, acoustics, and thermal stability… They all influence mood regulation, cognitive performance, and anxiety expression across care settings.

Environmental optimization should be viewed as a systems-level intervention. Meaning? Multidisciplinary collaboration among personnel like clinicians, facility managers, architects, and mechanical engineers.

Priority actions include:

  • Continuous monitoring of air quality metrics
  • Circadian-informed lighting design 
  • Structured noise-reduction protocols 
  • Zoned climate-control systems 

Environmental assessment tools can be incorporated into quality improvement frameworks alongside infection control and patient safety benchmarks. 

Graduate programs in health care administration and clinical education increasingly address built-environment impacts as part of systems-based practice.

Mental health outcomes reflect both psychosocial and physical context. Proactive environmental design reduces preventable stressors – while reinforcing therapeutic interventions already in place.

Designing Indoor Environments That Support Mental Health Outcomes

As we have seen, indoor environmental conditions measurably influence depression risk, anxiety levels, sleep quality, and cognitive performance. So, designing environments that support optimal mental health outcomes is of the utmost importance!

Health care leaders who are evaluating facility upgrades or residential care transitions should incorporate environmental audits. Attention to ventilation, lighting schedules, acoustic control, and thermal zoning will strengthen overall mental health outcomes.

Engaging environmental upgrades as part of comprehensive care planning positions organizations to support both physiological and psychological resilience – among both patients and staff. So look at which solutions you could incorporate in relevant environments.

Was this article helpful? If so, take a look at our other informative content.

 

Author bio: Harry Wolf is a freelance writer. For almost a decade, he has written on topics ranging from healthcare to business leadership for multiple high-profile websites and online magazines.

References:

  • Pérez, Ainhoa, Bordallo, Alfonso, 2024, Indoor air quality improves cognitive performance, Instituto de Postgrado.

https://www.icns.es/en/news/air_quality_improves_cognitive_performance

  • Unauthored, 2025, Humid heat increases mental health risks in a warming world, Nature.

https://www.nature.com/articles/s44220-025-00548-7

  • Chen, Manman, Zhao, Yuankai, Lu, Qu, Ye, Zichen, Bai, Anying, Xie, Zhilan, Zhang, Daqian, Jiang, Yu, 2024, Artificial light at night and risk of depression: a systematic review and meta-analysis, PubMed.

https://pubmed.ncbi.nlm.nih.gov/39721676/

  • Wang, Chunliang, Su, Kai, Hu, Linming, Wu, Siqing, Zhan, Yiqiang, Yang, Chongguang, Xiang, Jianbang, 2024, Exploring the key parameters for indoor light intervention measures in promoting mental health: A systematic review, Science Direct.

https://www.sciencedirect.com/science/article/pii/S2950362024000122

  • Shen, Jie, Ma, Hui, Yang, Xiaohui, Hu, Mingcan, Tian, Jieyin, Zhang, Liting, 2025, Environmental noise and self-rated health in older surgical patients undergoing general anesthesia: a cross-sectional study of anxiety as a behavioral pathway for healthy aging, Frontiers in Public Health.

https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1652514/full

  • Hu, Xinling, 2025, Systematic Review and Meta-Analysis of the Association between Environmental Noise Exposure and Depression and Anxiety Symptoms in Community-Dwelling Adults, National Library of Medicine.

https://pmc.ncbi.nlm.nih.gov/articles/PMC12459723/?utm_source=openai

  • Fritz, Manuela, 2025, Beyond the heat: The mental health toll of temperature and humidity in India, arXiv.

https://arxiv.org/abs/2503.08761

  • Hopcroft, Rosemary L., 2026, A Cluttered Home Causes More Stress for Women Than Men , Institute for Family Studies.

https://ifstudies.org/blog/a-cluttered-home-causes-more-stress-for-women-than-men

  • Strachan-Regan, K., Baumann, O., 2024, The impact of room shape on affective states, heartrate, and creative output, National Library of Medicine.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10965811/

 

Please also review AIHCP’s Certification program and CE Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

 

Divorce and Heartbreak Grief Video Blog

Posted on by Mark Moran

The pain of a breakup and divorce has many levels of loss and secondary losses.  While each can be horrible for a person, different individuals have different experiences for a variety of reasons.  This video takes a closer look at the multiple factors in relationship loss and grief.

Please also review AIHCP’s Grief Counseling Certification

 

Three Barriers in Rehabilitation That Require Timely Intervention 

Posted on by Joseph Gerard

Planning is key in healthcare management

Written by Deepika,

In times past, the term rehabilitation had a rather simplistic meaning. You hurt, you rest, and you feel better. That sounds easy, right? Well, the same cannot be said today, as the idea of rehabilitation has evolved from basic recovery to a dynamic process. 

It is still about healing the body, but also includes care tailored to patients’ unique goals and challenges. Metropolitan areas like Denver, with a 713,000+ population, comprise a mix of patients recovering from joint replacement or healing from work-related injuries. 

Physical rehab in Denver must go beyond cookie-cutter methods to ensure meaningful patient progress. Now, growth often brings with it certain barriers. Likewise, healthcare is still striving to identify the different hurdles to patient progress for timely intervention. 

Are you aware of such barriers, particularly the most common ones? This article will focus on three main roadblocks to rehabilitation. Care teams can use the insights shared to keep the patient at the center of every step. 

 

One-Size-Fits-All Treatment Plans 

Across industrial verticals, what has helped bring about the revolution of adding value to customers? The simpler answer is personalization. Healthcare, being a largely people-oriented industry, cannot afford to neglect personalization either. 

This is crucial in light of how the definition of rehabilitation covers a holistic approach. In other words, healthcare providers must move from a disease-centered approach to a wellness-focused one. Care that is not tailored to a patient’s needs can thwart recovery and frustrate patients. 

A 2025 review of patients in exercise rehabilitation found that 27 items of evidence were identified in the form of expert recommendations and randomized controlled trials. Shockingly, none of the evidence was implemented in clinical practice. This was especially true of areas like prescription and personalized assessment tools. 

The authors of the study concluded that this lack of tailored assessment led to suboptimal patient outcomes. It only shows that the definition of rehabilitation has evolved, but only in paper, not in practice. Individualized care is a must, which may include adjusting the intensity of therapy or setting realistic recovery goals. 

In many urban areas, the needs of patients coming for rehabilitation are wide and varied. Rehabs in such settings would have to go beyond standard protocols and offer reconditioning therapy. It is an approach aimed at restoring the strength and mobility required after deconditioning. 

Total Physical Therapy shares that deconditioning happens when your body loses function in certain areas due to inactivity. What does diversity of needs have to do with this? Patients who arrive after periods of illness, hospitalization, or inactivity will not respond to generic therapy. 

So, how do healthcare professionals make treatment plans fit the individual in question? It may be done in the following ways:

  • Conducting in-depth patient assessments, including their health and lifestyle 
  • Adjusting the timing or frequency of an exercise based on patient feedback 
  • Reviewing and updating treatment plans periodically to match the patient’s progress 

 

A Lack of Patient Cooperation 

It doesn’t take long for someone in the healthcare field to understand how real the conflict between a patient and their specialist can be. Traditionally, the medical profession has worn a badge of honor that almost deifies those involved in it. 

However, discords are not uncommon, and they may range from minor disagreements to downright cases of violence. From the perspective of rehabilitation, a lack of patient cooperation acts as a major hurdle. It can not only delay the recovery process but also increase the risk of complications. 

Now, how does non-cooperation arise in the first place? It could take various forms, depending on factors mentioned below:

  • Fear of pain if a patient’s therapy involves inadequate pain management 
  • Cracks in knowledge, which can go as far as patients skipping exercise sessions because they feel no immediate relief 
  • Worry regarding the recurrence of injuries, which contributes to patient hesitancy.
  • Busy schedules, comprising work or caregiving, that lead to missing sessions or inconsistencies in treatment 
  • Psychological distress, including anxiety or depression, that lowers a patient’s motivation to participate in their recovery

We have some real-world examples to support this. As per a 2025 qualitative study, physiotherapists testified to a major lack of patient adherence. From the healthcare provider’s viewpoint, the main reasons were a lack of motivation and communication gaps. As for patients, many reported psychological factors, physical limitations, and second thoughts about rehabilitation. 

This makes for a dual approach wherein we understand how cooperation issues may emerge from both patient experience and provider interaction. So, what can be done about this? Healthcare professionals should conduct frequent reviews to detect this barrier. 

Moreover, simple and thorough instructions should be provided to patients. Just ensure the dialogue is supportive, leaning more toward patient concerns. 

 

Breakdowns in Team Communication 

Communication, be it with patients or fellow team members, is the cornerstone of high-quality care. This is not something new, but an important part of care that has been known since the time of Florence Nightingale. 

You may wonder how communication just breaks down, especially since healthcare teams are so closely knit these days. Well, the process is more of a slide than a leap. In other words, it happens so subtly and gradually that discrepancies may see the light of day only when things go haywire. 

Let’s say a patient needs to be handed over by a hospital to an outpatient rehab team. During the transition, important patient information, such as recent progress or new complications, is not conveyed. Since the new team will be clueless as to the latest health stats, their treatment may not work, or worse, negate the progress already made. 

A similar scenario occurs when different healthcare providers give instructions that contradict each other. An example would be a physical therapist who wants the patient on advanced exercises, whereas the nurse instructs them to rest due to swelling. One can only imagine how disastrous the consequences of such miscommunication can be. 

Since we are at it, let’s walk through some other communication gaps that usually take place:

  • Delays in reporting complications can prevent timely interventions. 
  • Unclear discharge plans often lead to incomplete therapy or missed appointments. 
  • A lack of distinct roles may cause each healthcare professional to (falsely) assume that someone else is handling a particular task, which raises the risk of incompletion. 

Research suggests that over 70% of adverse events in healthcare originate from communication failures. When do most of these failures happen? Not so surprisingly, at the time of handovers or transfer from one unit to another. This means nobody can say that they didn’t see an adverse event coming, at least in the majority of cases. 

Now, nurses usually act as the central link in the care team. This means they are in a solid position to remove this particular barrier. For instance, nurses can ensure that the transitioning team receives complete and accurate patient information. 

They can also clarify unclear or conflicting instructions before they affect patient care. Only when gaps are addressed at the earliest can patients experience faster recovery. 

 

Based on what was just discussed, how immune would you consider your facility to be? Indeed, immunity against poor rehabilitation care is a matter of constant vigilance. If you observe that communication between care teams is falling apart or audit a care plan only to find that patient progress is stalled, take action. 

The future of rehab is dependent on turning every possible obstacle into an opportunity for growth. Your patients are looking for meaningful recovery, something which takes time and intention. 

The journey counts, which means every small victory is important. So, which barriers could be hiding in plain sight, and how can your team pull them down for better outcomes?

Author’s Bio:

Deepika is a budding content creator who enjoys exploring various niches, be it lifestyle or healthcare. With a knack for breaking down complex topics, she strives to make information relatable and accessible to everyone. During her leisure, Deepika enjoys reading novels and practicing fine arts to keep her creativity alive. 

Please also review AIHCP’s Nursing Management Certification program and Nurse Manager Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Grief Counseling: Different Grieving for Different Deaths

Posted on by Mark Moran

They say the only two certain things in life are death and taxes.  Death is indeed definite.  Ironically though is part of life.  Every breath and heart beat is determined from then on and into the future the very moment a the infant takes its first breath outside the womb and its first heartbeat within it.  Every day brings one closer to death but when living, the inevitability of death is rarely focused on or discussed.  Death anxiety is a cultural norm.  The myth and fear that one should not speak about such fearful things as to summon it remains fixed in society.  The moment of death is shunned while birth is celebrated.  Even those of faith, still fear its grasps despite the hope of a better world to come.  Due to the unknown and fear, death subjects become taboo or too morbid to discuss in some families as if the grim reaper is outside the door itself.

The types of deaths we experience in life differ objectively but also subjectively based upon multiple accidental qualities

Obviously such fears of death, or to even discuss the critical part of our entire existence is not healthy.  Death and loss occurs everyday and eventually death finds one’s family and friends.  Those who flee death are less prepared, while those who study it and discuss it understand its implications.  This does not guarantee one escapes the pain of loss associated with death of a friend or loved one, but it does recognize the reality which is crucial in understanding and coping with loss.

With every death, there is pain and loss experienced within a family, community, or culture.  It is unavoidable because with death comes change.  The change of no longer sharing a life with someone or being able to speak with someone or experience that person’s friendship.  Death of a loved one brings emptiness and sadness, but these are not adverse or pathological reactions to be dismissed, rejected, or hidden.  They are instead natural responses to losing someone that is loved.  The reactions of death and loss are a result of love.  Without love or attachment to someone, then there is no grief.  There may be the simple statement of regret for that family, or person, or at a communal level or national level, a sense of anger and injustice, but true loss and pain is directly correlated with a more intense connection.  Connection and attachment correlate with the degree of adjustment and pain in loss.

Every loss is unique and one cannot judge a mere relationship or assume connection with every type of death one experiences within a family or community.  Different deaths have different meanings for people and how they react.  One could lose a parent and be devastated over the loss, while someone estranged to a parent one never knew may feel no connection or intense pain.  One may lose a pet that was the center of one’s world, while another may just see a pet as a pet.  In other cases, one may be deeply struck by losing a grandparent, while others may not even know their grandparent.

In this blog, I preface that while we will discuss types of deaths, this is a general guide to reactions and common feelings.  It in no way attempts to say this is the way one will feel if this person or that person dies.  This should be seen as a general map of the more common grief reactions based on healthy connections without extraordinary circumstances.   So, very well, the reader may connect to one point, but completely disagree with his or her own experience in the next.   So, consider these different types of grief to different types of deaths as a general review.

Please also review AIHCP’s Grief Counseling Certification and see if it matches your academic and professional goals.

Accidental Qualities to Consider in Death and the Reaction to It

Accidental qualities are the unique elements that make deaths different for different people experiencing them.  One could classify a particular relational death but the accidental and subjective aspects the story can increase emotional intensity or decrease.  Some can complicate normal trajectory of grieving into complicated and prolonged grief disorders itself.  Here are some things to consider as accidental qualities

Sudden Death or Expected Death

This is a huge factor in complications in grieving for some.  While complicated grief is less common than normal grieving, complications are tied to sudden deaths at a higher level.  Sudden death also brings more shock and awe and denial than other types of death.  It is the sudden call on the phone at night with the horrible news.  It is the call that one wishes was a nightmare and forever changes one’s life.  One can be at work, or dinner, or at an event and the sudden news forever shatters the person.  Sudden death can also create and imprint upon the person a fearful death anxiety.  Unexpected death makes one question one’s own mortality.

Likewise, expected death while not as abrupt can bring about different reactions.  If someone is very elderly, or if someone is terminal, the death is expected.  One in fact is experiencing anticipatory grief and may be grieving already before the death occurs.  The death can be seen as a relief for caregivers, or for family members who see the deceased as free from suffering.  Some may experience guilt for this reprieve but they should not allow it to overtake them.  Others may feel the intense pain of choosing to take a person off life support or a particular drug.  The choices of palliative care can be a painful one for a family. Family should openly discuss their feelings when someone terminal or elderly finally passes.  Again, this loss could be far more intense for a child who dies of cancer, as opposed to an elderly person in palliative care.  Does this mean the loss is painless or not deserving to be experienced based on these things?  Obviously, one is more tragic, but one should not be felt to pretend to be happy merely because one is finally relieved of suffering.  There is an ambiguous as well as bitter sweet feeling when one loses an elderly family member over a stretch period of time.

Tragic Loss

Sudden loss carries with it a litany of accidental qualities added to the relationship of the death. Please also review AIHCP’s Grief Counseling Program

A tragic loss usually coincides with a sudden loss but also includes a horrible death scene, or way the person died.  This could involve war, a murder, or a tragic violent act.  This can lead the survivor into a deep sense of mourning and anger.  In addition, successful suicides can deeply hurt with with additional emotions of anger, guilt, or increased suicidal thoughts oneself.  Tragic loss does not necessarily mean complications for the survivors, but it can lead to it.

Ambiguous Loss

Some family losses remain ambiguous and one never experiences closure.  These deaths involve unrecovered bodies in war, or acts of nature.  In addition, mourning a person who is kidnapped or loss leaves a person with a perpetual what if scenario.  One cannot grieve death for fear of accepting it or even worst a horrible situation existing for a loved one.

Estranged Family Relationship

Estranged family relationships can intensify or lessen the impact of a loss.  In some cases, when a family member who passes is estranged, there can be a feeling of anger, guilt, or a mixture of sadness and anger.  Whether the justification for estrangement was legitimate or not, it can lead to an array of issues at the funeral with other family members who may feel estranged members are not welcome.

Abuse and Trauma

Abuse leaves trauma and when an abusive family member dies there may exist sadness, but also joy and justification.  Some may feel a mixture of these feelings.  Abuse can also make the abused feel guilty for the death of the abuser.

Emotional Connection

How attached to someone is essential to the equated pain, suffering and adjustment.   Some individuals are closer to siblings or cousins than others.  Some have a deeper connection to a friend than a different friend.  So the mere title of the relationship does not always entail the emotional response.  The more attached and connected to a person emotionally, physically, spiritually and financially, the more intense the change.  Loss always equals change which equals grief.

Age of the Griever 

Children grieve differently than adults.  Those with mental issues also express grief differently.   It is important to be aware of the age of the griever and their relationship with the deceased to fully understand their ability to understand death, much less express it in a healthy way.

Family Support

Support or no support plays a large role in reaction to loss.  One who loses a spouse and has no other family or friends can experience deeper loneliness and pain.  Those with support can share their grief and also receive additional care in funeral planning and post funeral life.

One can consider numerous other accidental qualities to even add to this list which make every death for someone unique and different in their grieving journey

Types of Losses to Death

Loss of a Child

From a purely objective status, the loss of the child is the greatest grief loss

This is considered objectively to be the most painful loss despite subjective accidental qualities.   Losing a child has its own accidental qualities that have a strong universal impact on any healthy parental relationship with the child.   Again, the way it occurred suddenly in an accident, or in a cancer ward, shapes different experiences, but the emptiness, pain, and life long mark upon the heart never leaves.   Losing a child in the womb, at birth, in infancy, adolescence, or young adult are all horrible in their own unique ways for the parent.  It is singularly the most destructive change agent in a person’s life.   The universal component captures the essence of unnatural.  Children bury their parents, not the other way around.  So while, some situations may give different perspectives on the loss, the grim reality remains a parent has buried his or her child.  This type of loss that individuals like to avoid to even think about.  The intense anxiety that the  thought itself produces in the mind is painful enough.  The intrusive image, or even conversation usually is immediately dismissed abruptly.  One can then only imagine the nightmare and pain a parent carries in his or her heart when this loss occurs within any accidental possibilities.  The nature of itself is horrible enough to keep one awake at night.

Loss of a Parent

Losing a parent is considered objectively to be the second most painful loss.  Again, without a variety of accidental qualities, this loss ties oneself to one’s very existence.  The caregiving and connection over life itself bonds the child to the parent.  This attachment matures and changes throughout life to different needs.  Obviously a child who loses a parent experiences a far greater blank in life.  The pain of growing up without the parent and experiencing the parent in one’s life into adulthood.  For adults who lose their parents, there is still a pain but it does follow a logical and natural course of burying an elderly parent.  This too can have complications in whether the parent suddenly passed away or was terminal.   Grievers may feel they are no orphans to the world when the final piece of source of physical existence no longer remains.  For many, this emptiness comes sooner while others are blessed to experience this pain far later, but whether sooner or later, the loss of a parent leaves a deep emptiness and existential question of self.  It also shifts one responsibility.  One becomes, in adulthood, the new patriarch or matriarch of the family and with that new responsibilities and worries.

Loss of a Grandparent

For many, the loss of a grandparent is something that occurs in younger adulthood.  Again, it can strike at any age which also creates different responses.  For some, a grandparent may have raised them while others may have rarely seen the grandparent.  Grandparents usually represent the first experience of death at a intimate and closer level of relationship for individuals.  It introduces the person to the reality of death and that everyone will eventually die.  For others, a grandparent represents unconditional love.  In many cases, one represents reprieve from harder discipline that comes from parents.  They are sources of wisdom, family history, and wit them dies a certain era and part of one’s life. Some may even feel guilt for not seeing them enough, which is a natural reaction and not one that should be allowed to fester.

Loss of a Sibling

Losing a sibling, especially, at a younger age, or in a sudden and horrible accident can have great impacts on an individual.  For many, siblings, as well as cousins, are a a loss a long term relationships that are meant to span across one’s entire life. Siblings should be a person’s first friend.  A shared story and identity in culture and family values and traditions binds brothers and sisters, and cousins, together.  The assumed outcome is a long life, but when lives are shortened, this can bring one to horrible life changes and death anxieties.    The closer the bond, even twins, the more intense the pain of loss.

Loss of a Spouse

Losing a spouse should be an intense loss equal to that a parent in some cases.  With divorce and so many bad decisions, the modern world has come to see spouses as replaceable, but for those truly in love, losing a partner can leave one truly alone in life.  A younger couple who experiences this may subjectively suffer differently from a couple with children as opposed to a couple who has spent 50 years of marriage together.  With these losses, unique challenges emerge.  Younger spouses look to rebuild, spouses with children look to raise children alone, and older spouses may very well die of a broken heart.   With these losses, roles of duties, income disparity, and other secondary losses with groups of people can all emerge and create further pain and discomfort in the new adjustment of life.

Loss of a Pet

This is the most disenfranchised of losses because according to some, pets are not people.  The connection and love that human beings share do not need to be confined to merely other humans.  In fact, many pets carry higher family values than some actual family members.  Many pets are considered children to the person and play a deep connective and important emotional role to the person.  While, pathology can exist in some extreme cases, for most pets, they are family and deserve the same love and grief when they are gone and people will grieve their pets as grieving any other family member.  In fact, this is normal in itself and should be respected.

Conclusion

Please also review AIHCP’s Grief Counseling Certification Program

While the death of a person creates loss for other people, the type of death and the accidental qualities surrounding it make one singular event a very different experience for other people.  Grief Counselors need to be aware of the whole story surrounding the grief of someone who has lost a friend or family member.  Grief Counselors can just not assume the loss will be felt in a certain way due to relationship status, but must instead understand the subjective relationship the person had with the deceased.  There will be some common threads with particular losses but there will also be numerous accidental qualities to a particular loss that can play a key role how the person reacts and how the person adjusts to the loss.

Please also review AIHCP’s Grief Counseling Certification, as well as its Child and Adolescent Grief Counseling Program, Pet Loss Grief Counseling Program, Christian Grief Counseling Program, Grief Diversity Counseling Program, Grief Perinatal Program, Grief Practitioner Program and finally its Grief Support Group Leader Program.

All programs are open to qualified clinical and non clinical professionals.

Additional Blogs

Death of a Friend: Click here

Child Grief and Death. Click here

Additional Resources

Fisher, J. (2023). 5 stages of grief: Coping with the loss of a loved one. Harvard Health Publishing. Access here

Solomon, D. (2025). Do’s and Don’ts When a Loved One Is Dying. Psychology Today.  Access here

Ten Reasons Why Losing a Grandparent Still Hurts Deeply as an Adult — Understanding Adult Grief and Ways to Cope. Grief Support Center. Access here

Bahou, C. (2025).  “Coping with the loss of a parent: Handling grief and more”. MedicalNewsToday.  Access here

How to Support Patients Undergoing Ultrasonic Rhinoplasty

Posted on by Joseph Gerard

Doctor holding a patient's hand before an operationWritten by Marchelle Abrahams,

Cosmetic medicine is tapping into advanced technology. Less invasive procedures. Faster recovery times. More natural-looking results.

When plastic nasal specialist Dr. Olivier Gerbault invented ultrasonic rhinoplasty in 2016, the medical fraternity hailed it as “modernizing rhinoplasty techniques.” Also known as piezo rhinoplasty, the method enables accurate reshaping of the nose.

Today, the surgery is openly discussed on social media. Influencers share their experiences, from consultations to their post-op. The before-and-after results are striking. 

Previously, a “nose job” entailed breaking nasal bones followed by a long, sometimes traumatizing recovery. But like any other surgery, patients must be given all the information so they can make a more informed decision. 

Many are under the impression that rhinoplasty surgery is purely for cosmetic purposes. Functional reasons exist, says Shah Aesthetic Surgery, such as correcting a deviated septum, a crooked nose, or improving breathing. 

As a care provider, your role is patient preparation and recovery monitoring.

 

Preparing the Patient for Surgery

The doctor would have consulted the patient on the essential steps they must take before undergoing the procedure. This follows the detailed evaluation.

If the patient has any doubts or would like further information, relay their fears to the physician. Sometimes, they are more comfortable confiding in a nurse than with a doctor.

Things to Avoid

It goes without saying that smoking is not allowed before undergoing ultrasonic nose surgery. Not everyone is aware of this, so remind the patient to stop smoking at least 15 days before, experts recommend.

If they need a reason to quit altogether, tell them that smoking disrupts the flow of oxygen and blood, which the body requires to heal. Tobacco creates hypoxia in the nasal tissues. If tissues are deprived of adequate oxygen, healing can be seriously compromised.

Certain medications are also not advised before surgery. Aspirin, ibuprofen, and some herbal supplements may increase the risk of bleeding.

Nutrition

Encourage the patient to stay hydrated in the weeks before surgery. They should also follow a nutritious, balanced diet. Like tobacco, alcohol can also slow down the healing process.

Home Prep

Most patients don’t realize that the recovery space must be properly prepared before leaving their home. Suggest that they prepare their home for the postoperative period. 

  • Set up a comfortable sleeping area. 
  • Store foods and snacks within easy reach.
  • Ensure all post-operative medications are easily accessible. 

Manage Expectations

Some patients expect miracles a few hours after the procedure is complete. Unfortunately, you have to play the Bad Guy and explain that even though the swelling is visibly reduced, they’ll only see the full results within six to 12 months.

 

Immediate Post-Op Care

Wound Care

For the first three days, monitor and change the “mustache” dressing (a small gauze pad placed under the nose to absorb drainage). Ensure the nasal splint remains dry and in place for about eight days.

Managing Inflammation

Stress the importance of consistently applying cold compresses and sleeping with the head elevated (using two to three pillows) to help reduce swelling.

Hygiene

Advise the patient to use a saline nasal spray to keep the nasal passages moist and help clear away mucus and crusting.

Pain Management

Administer prescribed pain medication as directed. Although an ultrasonic nose job is associated with less pain, swelling may still cause discomfort.

Again, Manage Expectations…

Ultrasonic rhinoplasty surgery doesn’t cause swelling, black eyes, or general pain related to traditional rhinoplasty. However, patients should expect some tenderness near the affected area. No cause to panic; it should disappear within six to ten days.

Most patients report cold symptoms or nasal congestion after surgery, but these usually disappear after a week.

 

Educate Your Patient

Follow-Up

Explain to the patient what to expect when they return to the doctor’s rooms for their post-op examination. If the doctor is satisfied with the healing process, they’ll remove the splints within a week and any external stitches.

Nose Taping

Nose-tapping is essential in aftercare. It helps to decrease the swelling. Knowing how to do it helps maintain the new shape of the nose.

Doctors usually recommend doing it for up to six weeks after the operation, starting when the nasal cast is removed. Talk the patient through the process. Teach them to apply the tape to the bridge of the nose. You can also share a few online tutorials with them.

Once they are discharged, they have to apply their own nose taping. Some may choose to tape their noses daily or a few times per day, depending on how they feel.

Restricted Activities

Advise the patient to avoid strenuous exercise for at least three to four weeks to prevent swelling or injury. They can resume light activity after surgery.

Also, caution them against wearing glasses for several weeks to avoid putting pressure on the nasal bones.

Emotional Support

We don’t talk enough about the psychological effects. No matter how small the procedure, some patients need to be reassured that everything is going as planned. Never mind the swelling, bruising, or healing time.

Be patient and validate their experience. 

 

Demand for Plastic Surgery Nurses

You may have become an RN, thinking of specializing. Many nurses consider specializing in pre- and post-operative care in the cosmetic surgery sector.

According to the American Society of Plastic Surgeons, more than 2.62 million reconstructive surgeries are performed in the U.S. annually. It shows the growing demand for certified plastic surgical nurses (CPSN).

As a CPSN, you’ll conduct preoperative assessments, assist the surgical team during procedures, monitor patient recovery, and educate patients on wound care. Basically, everything you’re doing now, but in a more active way.

You’ll be part of a dynamic team, including surgeons, nurse anesthetists, surgical technologists, and other medical staff. The express goal is working together to ensure safe procedures, smooth recoveries, and positive patient outcomes.

 

Advocate for Improved Patient Care

RNs have varied roles. Yet, it is easy to forget sometimes that we’re working with real people with real emotions. 

They cry. They hurt. They complain. The list goes on and on. There may be days when your emotions can override how you care for them. However, don’t forget that your patients remain the center of your universe during your workday.

Always advocate for their best interests, even if they don’t see it as such.

 

Author Bio

Marchelle Abrahams is an award-winning journalist (Responsible Drinking Media Awards, 2019) who found her voice after carving a niche as a features writer for Independent Online Media. Currently, she freelances for various print and online publications, while ghost-writing blogs for several clients.

Please also review AIHCP’s Nurse Patient Education Certification program and CE Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Cybersecurity in Healthcare: The Complex and Troubling Intricacies of Social Engineering Threats

Posted on by Joseph Gerard

Cybersecurity on a laptop.

By Lucy Peters

The healthcare industry has long been a favored target for cybercriminals. In 2024, the industry faced more cyberthreats “than any other critical infrastructure industry,” an American Hospital Association News article highlights the findings of the Federal Bureau of Investigation’s Internet Crime Report for that year. Ransomware is just one major threat, though these aren’t the only cyber-risks that the healthcare industry faces. While many may recognize common cybersecurity terms like ransomware and malware, social engineering threats can feel less familiar despite their potential for massive security disruption. Typically cloaked in a clever disguise, these cyberattacks largely depend on a victim’s human nature to attack and obtain access to valuable data, underlining an extra sinister side of cybersecurity that all professionals must be aware of.

 

The unsettling nature of social engineering

Many may conjure up an image of a lone hacker behind a cyberattack, furiously typing away as they unlock sacred information. Armed with elite skill and high-level know-how, bad actors are often depicted as “evil geniuses.” While this may be how some breaches occur, attacks that stem from social engineering utilize a much more unsettling approach. Rather than fall back on computer science know-how and hardcore skill, bad actors often use tactics that play on a victim’s human nature in order to achieve their goal.

There are a number of different ways that social engineering can drive a cyberattack through to success. Phishing is a majorly popular way that social engineering is put to work to extract valuable information from victims, often making use of specific wording that helps play into human psychology by appealing to a person’s emotions. An email from an illegitimate source that states an account is in danger and that action “must be taken now” is just one example in which a phishing scam may involve malicious social engineering. Business email compromise, or BEC, is another common type of social engineering strategy, in which hackers often trick victims by pretending to be a valuable figure within the company itself, from vendor to manager or even the CEO. BEC threats often use stolen yet legit credentials in order to pass through security measures, ultimately making these types of scams sophisticated and financially damaging in nature.

An IBM Think article titled “What is social engineering?” further explores the many faces in which such threats may take form, and why it often works out for cybercriminals. Aside from phishing, social engineering may take the form of ‘scareware,’ the article describing it as a sort of malware that induces fear into the victim, ultimately persuading them to share sensitive information or take an equally dangerous action. Another form highlighted by the article is ‘pretexting,’ in which a cybercriminal may tailor a scenario that caters to the victim and points to a sort of resolution via something that may look like “click here to resolve.” The IBM article goes on to point out that nearly every social engineering attack utilizes some sort of pretexting, making it necessary for professionals to understand how to identify in real-world application. Cybercriminals tend to find success in social engineering methods due to their simple yet manipulative nature. IBM explains this concisely: “They manipulate victims’ emotions and instincts in ways proven to drive people to take actions that are not in their best interests,” the article states.

 

The ramifications — a closer look

The healthcare industry is exceptionally connected, from sensitive patient records to financial information. While this makes it a “perfect” target for cybercriminals, it also illustrates the striking amount of damage that any attack can have. One 2025 TechTarget article by Jill Hughes highlights a number of some of the largest healthcare data breaches that were reported that year, all of which listed involved “hacking or IT incidents.” First listed is the Yale New Haven Health System, or YNHHS breach, which happened to impact 5,556,702 individuals and involved a “multimillion-record” breach. According to the article, an investigation by YNHHS brought to light that an “unauthorized third party had gained access to its network.” It’s important to note that while the breach did not involve any electronic medical records, vast amounts of personally identifying information were involved, underlining a significant concern for patients across the board.

Outside of the most commonly known risks associated with sensitive data and financial consequences, healthcare organizations and their patients can be affected in ways that may be less obvious upon first thought. Operational disruption or a strained infrastructure within a facility, for example, can heavily impact the patient experience. In addition to schedule disruption and long wait times, patients may fail to receive the care they may need at the moment, causing them to go elsewhere. Reputational damage is another major point of concern, as patients are likely to lose trust in a facility that falls victim to an attack — especially if it was preventable from the get-go.

While operational disruption wreaks havoc on the facility, professionals themselves may discover a variety of shortfalls in the meantime. Short-staffed and often made to rely on manual practices throughout an attack, healthcare workers can become overly stressed and overwhelmed, which can make one more prone to human error while on the job. A lack of preparedness on the facility’s part can lead to even more chaos, especially should employees feel unprepared or downright lost during a cyberattack. On the flip side, those that fall victim to a social engineering attack may face additional fallout. Based on the situation, an employee may require retraining, face investigation, and even disciplinary action. In some cases, an accidental incident may cause a facility to rethink their training altogether, instead opting to retrain the staff in an improved way.

 

Preparation will always set the tone 

Social engineering threats are intimidating, however, every healthcare professional plays a critical part in their prevention. Training is a major part of this, as education is crucial for employees to understand the risks and how to identify them straight on. However, in conjunction with the importance of upholding such knowledge and best practices, the healthcare industry plays a critical and powerful component in cybersecurity as a whole.

Preparation in the form of foundational security measures is an essential for any healthcare entity — while employees can be properly trained, threats can be complex and can continue to evolve. As such, developing an industry-wide mindset that accepts that human error or a high-tech threat may one day become a reality can be a great way to approach security framework measures. With this mindset, the industry can be more proactive with a vigorous security system that thinks ahead, rather than lags behind. A 2025 MSSP Alert article by Faisal Misle highlights several beneficial recommendations for healthcare organizations. Among the suggestions include the implementation of multi-factor authorization, the strengthening of email systems, and even the enlistment of an AI-driven threat detection system. Other suggestions include a comprehensive response plan, as well as routine training to maintain consistency. When coupled with other measures like routine security audits, healthcare organizations can take charge and adapt as necessary.

The unsettling nature of social engineering threats can make for a challenging security environment in healthcare. Through impactful training and foundational security measures, the healthcare industry can buckle down and proactively prevent threats.

 

Author bio

 

Lucy is a freelance writer who enjoys contributing to a range of publications, both in print and online. She spent almost a decade working in the care sector with vulnerable people before taking a step back to start a family and now focuses on her first love of writing.

 

 

Please also review AIHCP’s Health Care Management Certification program and CE Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Spiritual Direction and Guidance in Prayer Life

Posted on by Mark Moran

As St Teresa of Avila states, a soul that does not pray is likened to a body that is limbless. The importance of prayer is central to life itself.  One can use any physical analogy, as oxygen, or the heart, and none still compare to illustrate the importance of prayer to the soul and life itself.   Through grace, gained through the death of Christ on the cross, communication with God was restored.  The price of sin was paid in full.   Through the great price of each soul, souls could again via application of Christ’s Blood which earned for humanity the gift of grace, again possess a parental relationship with God.  Fueled through sanctifying grace and the removal of Original Sin, a soul bought by Christ, could again commune with God in an effective and purposeful way.

Prayer is essential for spiritual life. Please review AIHCP’s Christian Counseling as well as Spiritual Direction Program

Hence, prayer is communication and participation in the Divine while on Earth.  As creatures, justice demands prayer to God.  One is to know and serve God through adoration, contrition and thanksgiving, and petition, but through the virtue of charity, one not only serves and worships out of justice, but also prays out of love.  God has elevated humanity from mere creatures but to also images of His own likeness in which one can share in His Divine Life.  Prayer opens this door and should beyond its mechanical functions of proper worship be also a conduit of love.  This love is that of a child for his parent!

When the soul becomes deeper in love with God, prayer then becomes more profound and connected to God.  Spiritual Directors should help and teach their spiritual children how not only to pray and its purposes, but also how to develop and foster a deeper and real relationship with Jesus Christ.

Please also review AIHCP’s Christian Counseling Program but also its Spiritual Direction program.

Jesus Taught Us How to Pray

Jesus told His followers that the Father and He are one and no one can go to the Father but through Him.  He also taught His followers the “Our Father” which encompasses the core values of adoration, contrition, thanksgiving and petition.   This is purely the most basic and mechanical structure of prayer but it lays the ground work and reasons of it.  Through the simple words of the “Our Father” our Lord leads one to deeper mysteries of prayer that are essential for spiritual development.

Types of Prayer

Prayer entails adoration, contrition, thanksgiving and petition.  Most likely, one of these four elements will play a role in one’s prayer at a particular point in life.  All are essential.  Christ teaches that one must love God with one’s whole heart, mind and soul.  He also teaches one must seek forgiveness as well as be thankful for what the Father has granted.  In addition, He reminds one to ask the Father for what is good and what one needs.  In one way or the other, one’s prayers have centered around these themes.

 

Christ taught us how to pray throughout His ministry

Vocal prayer can be singular or communal.  Worship must be balanced.  Spiritual and religious are complimentary concepts not competing ideals.  One who is religious partakes in communal and ritualistic prayers, such as Sunday worship, or Mass, or communal prayer gatherings.   One who is spiritual endears oneself to Scripture, daily and morning offerings, rosary, or other meditations.  One who is only religious lacks spiritual growth but only visual status.  Like the Pharisees, they are dead inside.  One who is only spiritual embarks on their OWN journey and OWN dogma and disengages from the Mystical Body of Christ.  Humility and obedience demand more.  So, like two lungs, prayer life must be religious and spiritual, communal and singular.  One must have a personal and communal life with God to function fully as a member of the Mystical Body of Christ.  It is important then to balance these two elements of spiritual life.

Within personal prayer, there are many ways to speak to God.  One can use pre-ordained prayers of trusted tradition, but they must not just be words recited but words felt.  One can also use one’s own words to express worship, thanksgiving, petition and contrition to God.  In fact, speaking to God, as if speaking to someone in a room, but of course with the respect God deserves, is a powerful way to form a strong relationship with God.  God should be so close to oneself, that one should speak to Him throughout the day about occurrences and issues.

Mental prayer is an essential aspect of spiritual life.  Mental prayer is conscious choice to engage God in the quiet of the mind.  Some religious propose postures of kneeling, or upright posture to avoid drowsiness, others support ideas of comfort, especially if one is seeking to fall asleep in the arms of God.  Depending on the situation, body posture can determine alertness and ability to focus on the conversation with God.  St Teresa of Avila refers to this as Prayer of Recollection because the soul is putting itself together as it enters deep within itself to speak with God.  This prayer is deeply personal and open.  It involves visualizing being with Jesus and speaking with Him in an intimate and real way.  This is an active prayer though which involves the activation of the will to seek out God.  The feelings of joy or peace that result are graces and consolations bestowed upon the soul by God, but it is the soul, especially in its early stages of spiritual development, seeking out the union with God.  This is not to say God was not always available, but in many ways, one’s spiritual anchors tied to the world, muddy or dampen one’s soul and its ability to hear and receive grace.  By seeking out God, this type of mental prayer grounds oneself and opens oneself to many graces.

Tied to the mental faculties but different in direction is meditative prayer.  Also known as contemplative prayer, meditation or visual imagination of an event of the life of Christ excites the soul to dwell on upon the mysteries and extract from it deeper meaning.  Many meditative prayers find their source in reading Scripture, or focusing on a sacred image or symbol.  The mind then reflects on the event and focuses on finding meaning of the event to oneself.  The mind completely opens itself to the Holy Spirit to guide it through the meditation to find the truth of the mystery.  This is very different from Eastern Meditation which looks to become divine or find unity in the divine, but this seeks to participate with the divine.

It is common for meditation, like its Eastern counterpart, to also find a place of quiet and relaxation.  Thomas Merton explored many of these Eastern strategies in an attempt to utilize some of the practices to meet Christian ends.  This resulted in a mixed reactions from different circles of Christianity which saw some of the Eastern practices in themselves detrimental to Christian beliefs, while others saw the exercises as universal human ways to prepare the mind and body for spiritual realities.  Such exercises as breathing seem to be neutral and safe when applied with Christian ends and they are supported by medical science as ways of initiating the parasympathetic nervous system.  The key in Christian meditation is not to escape the body or become divine but instead to commune with God.  Quiet places, relaxed mindsets, and guided prayer can lead someone within the Christian tradition to these realities.  It is important that meditation is based on Christ and guided through Christ and opened to the Holy Spirit.

While there is a lot of physical and physiological benefits of Eastern techniques to prepare the body for meditation, the Christian tradition has numerous techniques to excite the soul and prepare the mind for communication with God.  St Ignatius Loyola in his Spiritual Exercises encourages individuals to focus on the life of Christ and to choose events within it found in Scripture.  He invites one to activate the senses of sight, taste, smell, touch and hearing in all meditations.  He opens with preludes of thoughts to imagine about Christ.  He then presents one’s imagination to create within in the mind the entire set of the story itself.  From the weather, to the buildings, to the sounds of the time, to the actual touch of the ground itself.  He asks one to imagine in various preludes Our Lord teaching, or preaching, or healing and imagine oneself as a bystander watching and even maybe interacting.  Afterwards, one can even engage Christ in this meditation and it can develop more into a mental prayer of discourse.  Since Jesus is also divine, He senses our prayers and questions throughout history to that very moment.  So one can speak to Him there, or in one’s own present monologue.  This echo of prayer through time is possible because Christ is divine and not subject to temporal time itself.

So, far we have only spoken of prayers that are actualized through oneself.  These prayers are invoked by oneself and initiated by oneself to God.  God’s response can at times be overwhelming via consolations or one may simply feel peace.  Other times, one may fall asleep to the peace of God.  These are all from the sensory standpoint, natural in sensation.  They do not encompass supernatural overtones beyond the norms of supernatural and natural connection.   St Teresa of Avila compares this type of active recollection with the analogy of water.  Water representing the source of grace and God Himself is felt in prayer but through active recollection it is sought and migrated.  St Teresa compares it to a aqueduct that transports water from the source.  The water is artificially transported through manual intent but it arrives nonetheless, but there is a difference between experiencing the source as is without effort.  In this type of prayer, Avila refers to passive recollection and also the Prayer of the Quiet.  In this, God for His own purposes or designs, chooses freely to give this grace and gift to a soul through no effort on its own.  A stunning grace or consolation may appear to the soul where the soul finds the peace of God in its genuine form without effort.  In this, Avila states the soul should merely be receptive and thankful for such an act of love.  It illustrates that the soul is removing many of its blinders and has opened itself to such divine favors.

This, however, remains a natural within physical ramifications.  Avila points out that there are beyond more intense and higher forms of prayer and religious experience that are far more mystical and wonderous for the soul.  She points out the Prayer of Union is a type of prayer that again is passive and mystical where God elevates the soul to such a state of happiness with His presence that the body loses consciousness and the soul is free of the bodily senses.  Only the presence of God endures.  This can last for few minutes to even longer periods of time.  This gift from the Creator to the soul is an extreme gift of insight and love for a soul that has opened its will to God.  As one becomes closer to God, the mystical experiences become more intense but so does the crosses and sufferings of life.  Avila points out that with such gifts comes a greater longing to be with God and a more willingness to suffer for Him.

 

Issues in Prayer Life

Early Phases

Prayer at is basic level captures the act of worship but so many times it is seen as a choir or requirement.  It becomes a checklist of things that need done in a given day.  Many beautiful prayers become repetitious mantras instead of meaningful conversation with God.   Prayer also becomes a time of need.  When something bad occurs, individuals run to God with sometimes necessary concerns but also trifle things.   Of course, one should not dismiss the return to God in dire times.  This shows acknowledgement of God and His power, but it also portrays a selfish spiritual life and one that neglects a living relationship with God.  Also, one can see prayer as a contract instead of a covenant.   Individuals believe prayers that if not answered mean God does not care, or they did not pray well enough, or that God is not a God of love.   Instead, prayer should be one of covenant where the soul walks with God through tribulations and joys alike, seeking resolution but also accepting the cross and the graces needed to endure it.  Prayer is then not a magic cheat code or mantra but a communication with God that is about relationship and covenant due to not only justice but also love itself.  It is not something performed ritualistic becomes one has to do it, or because one needs something, but it is the life source of the soul in daily communication with the Creator and Father.

Many souls in their spiritual development face temptations and occasions of sin that call them back to the world.

Those on the peripheries of spiritual development have such illusions of prayer.  They are easily distracted by lies of the world.  They are hypnotized by occasions of sin, the needs of the flesh, and noises of secular concern.  Their prayer life is superficial at best.  For many, their faith is cultural identity.  One attends service or Mass on Sunday out of ritual and culture, not so much an act of love to God.  Some may not even attend regularly but only during holidays!  Prayers to them are in times of need or random acts of clarity that fade with new physical distractions.  Are these individuals evil?  By no means!  Many are good people but they are not directed to the higher priorities.  They may very well believe in God and the commandments but they have become stuck in the mud and progress in spiritual life has become stagnant.  Still, God has a way of shaking the soul and calling it to Him.  Spiritual Advisors and directors can help highlight this awakening and guide individuals from naive and spiritual immature assumptions about God and prayer and use these incidents as a way to cultivate a true relationship with God.

The soul that ventures into true prayer life still faces numerous issues.  The calls of the world are strong still.  Occasions of sin, old habits, and temporal desires still remain strong.  The devil does not release souls so easy.  The soul will be tempted and turned back to the noise but progress is key.  Encouragement, patience, and goals remain essential for this soul.  Much like a physical trainer, the spiritual director must expect setbacks.  Those who begin to train physically or diet have many set backs.  It is hard to retrain mindsets and replace old habits with positive coping.  Like addition, or bad diet, the brain has numerous neuro pathways that are set for default in times of stress, trauma, or triggers.  So, the soul that is experiencing new prayer and spiritual renewal faces the tugs of the world and bad habits.  These triggers should be expected.  Within training of the soul, goals should be realistic in prayer life, encouragement frequent, and progress modest but continual.  Setbacks should not be seen with despair but as opportunity to make better.  In this delicate early phase, the soul teeters back and forth between the cold lies of the world and warm truth of God.  Through grace, guidance and continual effort, new habits can be formed, virtues can replace vices, and a deeper understanding of prayer can ensure for the soul.

Later Phases and Complications

As anyone becomes more skilled in a process or shows progress, one naturally becomes proud of ones success.  In a diet, one becomes more confident and happy with how one looks as weight goals manifest in better clothing fits and reflections in the mirror.  As someone progresses in weight room training, one becomes more enamored with one’s growing physique and muscular definition.  In itself, this is not bad.  Self esteem and self concept is key in psychology and counseling for a healthy emotional self.  However, like so many times in psychology, subjective image and happiness can be the only goal for self satisfaction.  It is crucial to balance one’s own pride in improvement with humility and concern for others.  It needs to be evaluated not only in one’s own success but also in honoring the body that God has given as a temple of the Holy Spirit.  So both are important.  One should find sense of pride in improvement but not inherit the vice of pride in character.  This can be a tricky balancing act and is even more tricky in spiritual prayer life.

As the soul becomes more focused on God and more conscious of not offending Him, it can sometimes see itself as “better” than others, or even esteem itself.  This contradicts the gift of grace.  One works through faith, but one does not earn merit without the grace of the Holy Spirit gained by Christ at the cross.  Humility is key to maintain in this phase of spiritual development.  St Vincent De Paul emphasized the power of humility.  He pointed out that humility is something the devil cannot comprehend nor defend himself against.  This is why Mary was such a powerful adversary to him.  Her humility despite her grace stifled him and rebuked his very existence.  Christ teaches as well that the first shall be last and the last shall be first in heaven.  Humility is hence crucial when making gains.  As Mary declared to Gabriel, “my soul magnifies the Lord”.  One must then as one becomes more proficient in the habit of virtue, its cultivation and prayer life, reflect all glory and good to God.  These are the fruits of the Holy Spirit flowering within the soul allowing God’s inner presence of it to manifest, not the works of a broken nature.

Another later complication within prayer life includes the times of aridity or lack the emotional presences and joys experienced in prayer life.  Avila emphasized that not all prayer life is full of consolations, feelings of peace and joy, but many times, an aridity emerges, where the soul may not feel God’s presence.  Instead the soul feels as if the prayers are not heard, or as if the prayers are not good enough, or if the person is unworthy of God’s love.  This possible turn to despair or even return to physical distractions can attempts of the devil to test the soul.  It can also be a trial granted by God to teach the soul its needed humility and also purpose.  Yes, as children one should expect parental graces all the time, but one must also look at God as Creator and oneself as sinner.  To pray to receive consolations and good feelings, denies the very nature of justice and adoration to God for the sole purpose of His glory.  In love, one loves not for return, but for the very nature of the object itself.  Aridity teaches the soul to love without return, to humble itself before God, and to help it acknowledge how precious the presence of God is and how terrible sin separates the soul from God.

Many souls in later spiritual life face trials of desolation and aridity which God uses as ways to bring them closer and more dependent upon Him

Spiritual Directors can play a steadying force for souls who deal with aridity.  They can emphasize humility but also obedience to God’s will.  Many souls at this relationship level with God still are very connected to the world.  In fact, most of us are!  We have temporal needs and duties, but sometimes these temporal needs and duties can complicate a relationship with God when they become disordered or not properly prioritized.   Uniting one’s will with God realizes that prayer is a covenant and not only the consolations and blessings are part of the divine plan, but also one’s aridity, sufferings and crosses are also part of God’s will.  Christ told His followers, to take up their cross and to follow Him.  He accepted the Father’s will unto death in the garden.  Souls are expected no less to unite their wills with God and to carry their crosses.   In becoming closer to God, one must then find humility, obedience and acceptance of God’s will and understand that suffering and love of God is what matters most.

For Avila, life involved a convent, but for many individuals life involves a busy world where contemplation is not always an option.  Individuals can become distracted by deadlines, work schedules, family drama or emergencies, or basic temporal cares of the body.  Christ Himself lived such a life for 30 years.  He worked as a carpenter under St Joseph’s guidance.  He helped support His mother, Mary, and they dealt with daily struggles of debts, choirs and finding food on the table.  So how can a person advance spiritually in prayer, contemplation, and communion with God in a world that is so noisy at best, and at worst, tied to numerous occasions of sins, or as Avila describes “small reptile” scurrying along the floor?

First and foremost, everything ties in prayer to uniting one’s will to God.  As Christ said in the garden, “Let thy will be done”.  This was a difficult thing considering within the prayer, Christ asked for the cup of death to be passed on but He submitted.  Individuals too must submit their will despite their requests and by uniting one’s will, God’s plan unfolds.  Whatever state of being one is in, when one finally surrenders to God, things begin to fall into motion.  One may very well be surprised as well to see certain aspects of one’s life vocation fall into place into a greater plan as well with other pieces of the puzzle coming together.

Through submission of one’s will, the day becomes God’s day.  One then is open to offer up these daily tasks which can become distractions into living prayers.   Scripture teaches one to unite one’s sufferings and cross to Christ.  When one unites one’s temporal duties to God, they become spiritual prayers.  St Theresa the Little Flower, not to be confused with Avila, offered the most simple duties to God, such as sweeping the floor.  While many individuals feel the need to do great penances (which is good),  many forget the little things.  The little things are not in one’s control.  The little things are imposed and are not chosen.  When they are offered to God, they become a prayer.  Whether it is working a late shift, enduring a manager’s criticism, or doing the laundry when tired, the little things when given to Christ and shared in His passion, become not works of personal merit, but works of grace through Christ.  Daily offerings give each day, every joy, success, trial, tribulation or cross to Christ in advance and turn what would normally be a daily distraction into daily prayer.  It formulates humility, obedience, and keeps oneself focused on God.  Spiritual Directors should advocate within their spiritual children the necessity of the Daily Offering in all prayer life.

Prayer Cultivates Many Things

We discussed how critical prayer is to the life force of the soul.  It is in injection of God’s grace into the soul.  While it is only one of the many elements of communication with God and how grace is afforded to the soul, primarily actual graces, it serves as a function as critical as breathing in everyday life.  While other life giving graces are gained at Baptism and other spiritually nutritional graces granted for different sacramental needs such as in reconciliation, or Eucharist, daily prayer is the constant breathing and cycling of those graces throughout the self.  Through constant prayer, one’s primary end is always in sight.  It maintains that focus and spiritual exercise to keep the spiritual faculties sharp.  It helps cultivate virtues in daily life and directs the soul towards higher things.  It keeps the soul on the righteous road avoiding sideshows and distractions that can lead to spiritual ruin. When the soul is contact with God, it is able to see more clearly, act more purely, and perform its duties more perfectly.  Like making one’s bed in the morning, it sets the standard for the day.  Prayer organizes the soul and attunes it, so as to enable rest of the mind’s faculties to become more focused and aligned with the winds and storms of the day.  When one is spiritual set, one becomes mentally set.

With so many spiritual benefits that pour into one’s daily life, one cannot dismiss the necessity of prayer.  A new cultural phrase has emerges, as seen with Mark Wahlberg- He asks the question “Are you prayed up?”  Like food for the body, make sure the answer is always yes!

Conclusion

Please also review AIHCP’s Christian Counseling and also Spiritual Direction Program

We have reviewed what prayer is, its aim, types of prayers and issues involving spiritual progression at early and later phases.  We have sought direction through the teachings of Christ Himself, Scripture, and the value of mystical saints who elevated their prayer life with constant devotion to Christ and faith in the Holy Spirit.  Spiritual Directors can help souls find prayer, maintain it, and set realistic goals in prayer life.  However it is important to note that the battle for spiritual life is one tied to mental issues, as well as physical issues.  Bad habits, traumas, occasions of sins, and old ways of thinking can become roadblocks.  Even later in spiritual life, the devil can turn confidence to pride.  So one must forever remain humble and obedient to God’s will and remain dependent on God’s grace.  This is not about our prayers but how God transforms our imperfect communication into something beautiful through His grace.

Please also review AIHCP’s Christian Counseling Certification, as well as Spiritual Direction Program.

Additional Blogs

Spiritual Suffering.  Access here

Spiritual Vocation.  Access here

Early Issues in Spiritual Direction. Access here

References

St Teresa of Avila.  Interior Castle

St Ignatius of Loyola. Spiritual Exercises

Additional Resources

Mulcahy, T. “THE SOUL’S JOURNEY TO GOD: A CONCISE SUMMARY OF SAINT TERESA OF AVILA’S INTERIOR CASTLE”. Catholic Strength.  Access here

Ways to Build a Stronger Prayer Life. Bible Hub.  Access here

A Life Of Prayer (What It Is and How To Actually Do It). (2024). Daily Effective Prayer.  Access here

 

 

AIHCP VIDEO BLOG: PANIC ATTACKS

Posted on by Mark Moran

Most individuals suffer from depression or anxiety in the field of mental health.  Some of it is behavioral but other elements exist chemically and biologically, as well as triggered by past trauma.  All of these considerations need to be taken into account. This video looks at panic attacks, what they are, what triggers them and how to cope.

Please also review AIHCP’s Crisis Intervention Program, as well as Stress Management, and in addition AIHCP’s Trauma Informed Care Program