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Re-attribution video resource: 2nd Edition Managing Somatic Presentation of Emotional Distress Presented by Dr Linda Gask Using a four-stage model: feeling understood, changing the agenda, making the link, and negotiating treatment. In-depth techniques are discussed in the first part of the tape and opportunities to practice the skills are provided in the second part. The […]

Home GP training Communication skills Mentoring Establishing phase Non verbal Listening without interruption 2 levels without distortion On-going phase Agendas Assessment Resolution Open questioning Non-judgmental Mentee’s agenda defined Boundary keeping No redirected thinking End phase Reflecting Analysing Setting objectives Summarising   Brad Cheek: this page was archived February 2016 Home Training CPD IT Search

Home GP training Communication skills Mentoring Introduction Negotiating skills Learning styles Needs analysis Planning learning Educational resourcing Evaluating learning Introduction Mentors are… “…influential people who significantly help you reach major life goals” Phillips-Jones Learning is a life long process that has several phases. Most notably a childhood phase. where the teacher’s agenda dominates and the

Guidelines for giving constructive feedback Focus on the positive – what you talk about you are reinforcing – where possible give positive feedback first and last. Be descriptive, not evaluative. Talk about the specific behaviour and give an example where possible. Use an “I” statements. Where feedback is negative suggest alternatives where appropriate. Ask yourself

Adapted by the iiCR team from the Guide (in: Silverman, Kurtz, Draper. Skills for Communicating with Patients. Radcliffe Medical Press. 1998 (p8)) and validated by Suzanne Kurtz. Calgary Cambridge – further information The expanded framework Building the relationship Developing rapport 25 Use of notes: if reads, writes notes or uses computer, does in a manner

Identifying manipulative patients Applying guilt / transference Being anxious / chaotic Urgent important Threat of harm to patient A story that doesn’t fit together Analgesic use Variable behaviour Dysinformation / non-information Behavioural strategies that manipulative patients use Strategies for tackling the issue Being proactive – preparation Listening Sticking to the agreed agenda Assertiveness Negotiation Creating

This sort of patient has a thick record file, often detailing numerous negative investigations, but may have many past physical health problems which are time-served. They have been to many other doctors in the past, but no-one has been able to “help” them. They spend 30 minutes or more pouring out their story to you

  …or is it doctor dependency? How and why do patients become dependent? Consider The patient’s role Why are patients reliant on their doctor? Consider positive and negative aspects to this. Emotional attachment to the doctor The doctor’s role Why do doctors “need” patients? Where does this need come from?# Emotional attachment to the patient

Rules for discussing video consultations The content of general practice The anthropological approach Balint The biomedical approach Stott & Davies model Byrne and Long – the primary care consultation The Calgary-Cambridge approach Cycle of care The disease-illness model Equipoise Six category intervention analysis Health belief model Helman’s folk model of illness Maslow’s Hierarchy of Needs

A model to assist patients who are emotionally distressed. Background Affect Trouble Handling Empathy Some examples of questions Background What’s going on in your life right now? Affect How is this affecting you? How do you feel about that? Trouble What is troubling you most? Handling How are you handling this? Empathy I can understand