106 Helping Individuals, Families, and Groups with Stressful Life Transitions Life-Transitional Stressor Illustration 1: Mr. S. was dying and having trouble dealing with his impending death. This manifested itself through displays of enormous anger. He was furi- ous and out of control. He threw his food tray off the stand and threw food at the staff. He would not cooperate with any of the hospital rules and regulations. Mr. S. had alienated almost everyone around him. The nursing home where he had been living refused to take him back, as had the long-term clinic serv- ing people suffering from alcohol disorders, where he had been prior to the nursing home. If his name was mentioned to almost anyone in the hospital, the immediate reaction was, “Oh, HIM! We know him. He’s a real winner.” One nurse I spoke to said, “Oh, he’s just an alcoholic. No one wants him on their floor and I sure don’t.” She even said that he could eat if he wanted to, that plenty of people ate with esophageal cancer (he had lost tremendous weight, going from 185 to 113 pounds). Illustration 2: The diagnosis of leukemia for John, 2 years old, represented a life transition for him and his family. The transition for John included the “life entrance” into the new role of being a cancer patient and being hospi- talized. His 32-year-old mother, Sharon, was undergoing a life transition that involved adapting to a new role—that of the mother of a child with can- cer. Life transitions are usually a source of stress, but the stress can be more intense when the transition is unexpected and abrupt. Sharon had no way of anticipating or expecting John’s cancer within a period of less than 48 hours, she made the transition from being a concerned mother of a toddler with a slight stomachache to the mother of a child with a potentially terminal ill- ness. This life transition was even more stressful because before the onset of John’s illness, Sharon and her husband had decided to separate. Thus, Sharon’s life-transitional stressor also included the adaptation to the status of being a single parent of a severely ill child. Once students have identified the life-transitional stressors in each of these cases, break students into small groups to help each other formulate a life-transitional stressor using one or more of their own cases. Once they have completed this task, have them share their explanations with the rest of the class. Subsequently, distribute a list of skills used to help people deal with life transitions. Have the students use the format described in this guide for chapter 5 for either a Record of Service or Critical Incident Report to conceptu- alize and evaluate their interventions and, if necessary, propose alternative ones.