-
-
•Cognitive Behavioral Therapy
(CBT)
-
•Rational Emotive Behavioral Therapy
(REBT)
-
•Acceptance and Commitment Therapy (ACT)
-
Counter Transference
(doc’s feelings toward pt)
- •Guilt,
- reminder of someone/something else, stereotypes and bias
- •Lead
- to medical errors, negligence, carelessness in diagnosis
-
repeat (“You said that you don’t feel
like eating?”)
Reflection
-
= closed question, want details
(“Vomiting for a while, you say? How long?”)
Clarification
-
encourage pt to keep going (“uh-huh, I see, what
then?”)
Facilitation
-
allows time for pt to
think/set pace of questioning (**crickets chirping**)
Silence
-
only when inconsistencies, need strong
alliance (“You said that you are not under the influence of drugs but I can see
needle tracks on your arms”)
Confrontation/Challenge
-
saying something pt
might not be aware of, theory from observation (“You said that you don’t want
to undergo chemotherapy. Is it because you are afraid of losing your hair?”)
Interpretation
-
= (“I think I know why you’re here, let’s
now talk about your past med history”)
Transition
-
= ONLY WHEN IT HELPS THE PT OR ANSWERS
THEIR QUESTION!
Self-revelation/disclosure
-
Thank you, good job, that’s great to hear
Positive Reinforcement
-
normalizing experiences (“A lot of people
feel the same way when hearing they have an illness”)
Validation
-
express interest, concern, tell truth (“I
know it’s tough but I’ll do the best I can”)
Reassurance
-
ONLY AFTER LISTENING FULLY TO PT AND IF
PT IS READY TO HEAR
Advice
-
summary, written instructions better,
wait after shocking news before discussing treatment/options, call back to
check up
Ending Interview
-
pt’s tend to remember only 1st and last things doc says
REMEMBER
-
gives info, course of action, encourages
like a counselor, good when modifying self-injurious behavior
Deliberative (“doc=friend”)
-
decision up to pt,
good for first time consults
Informative (“info only”)
-
doc knows pt well, gives advice based on this,
flexible, takes input from pt
Interpretative (“shared decision”)
-
doc says and pt
obeys, good in emergencies and in cultural settings that expect it
Paternalistic (“doc knows best”)
-
what to do wit pt. with Histrionic (OVERLY DRAMATIC)
calm,say no to seduction, set boundaries
-
what to do wit pt. with
dependent
limits
-
what to do wit pt. with Borderline (Attention)
define appropriate behavior, giverespect, responsible for own actions
-
what to do wit pt. with
Narcissistic (Arrogant)
calm, non-defensive, build trust
-
what to do wit pt. with
Suspicious
- respectful, non-defensive, formal (warmth
- = more suspicion), explain in details/plan
-
what to do wit pt. with
Isolated
respect privacy, stay formal
-
what to do wit pt. with
Obsessive
- detail,
- include them in own care
-
what to do wit pt. with
Help-Rejecting Complainer
DO NOT ENCOURAGE SICK ROLE, limits
-
what to do wit pt. with
Manipulative
- respect, look out for malingering,
- confront inappropriate behavior
-
= biological human grouping
Race
-
common ancestry, beliefs, history
Ethnicity
-
shared values, behavior, traditions that
are learned and transmitted
Culture
-
•values,
beliefs, ideals
Subjective dimension
-
•“rules
and rituals”
Objective dimension
-
melting
pot”, host culture replaces original
Assimilation
-
“mosaic”,
keep original culture while adding parts of host culture
Acculturate
-
•Mental
illness defined by culture (sorcery, possession causing dz,
loss of soul)
Culture Bound Syndromes
-
•Respect
belief of patients, if no harm being done, find rx that can be taken along with natural
remedies
Role of Healers
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