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Index
Half Title
Title
Copyright
Dedication
Contents
Foreword
Preface
List of Contributors
Introduction: A New Approach to the Clinical Encounter
I Building Rapport
1 Elicit One Goal: Be More Efficient by Learning the Patient’s Agenda
2 Validate Three Different Ways: Be Authentic in Your Validation by Expanding the Ways in Which You Can Agree With the Patient
3 Mirror the Patient’s Language to Build Rapport: Use the Patient’s Phrasing to Avoid Misinterpretation
4 Use the Power of “And”: Introduce “And” Rather Than “Or/But” Statements to Your Interview to Establish Rapport, Validate the Patient’s Experience, and Facilitate Chang
5 Redirect Demanding Patients: Reinforce That the Patient, Like Everyone, Is Entitled to Good Medical Care
6 Be Silent: Use Active Silence to Support the Patient’s Emotional Expression
7 Be Playful: Introduce Playful Irreverence to Challenge Rigidity, Signal Affection, and Build Social Connection
8 Handle the Hollering With a Calming Question: Through Tone of Voice, Active Listening, and Setting Limits, Invite a Conversation to De-Escalate a Shouting Patien
9 Recognize Your Own Emotions: Identify and Process Your Countertransference During the Interview to Improve the Patient’s Well-Being (and Your Own
10 Reflect the Patient’s Statements: Use a Well-Timed Reflection to Disrupt a Negative Thought Spiral
11 Introduce Progressive Muscle Relaxation: Give the Patient an Active Task to Change Their Emotional Experience
12 Use Emotional Validation to Manage Negative Countertransference: Disarm Your Negative Emotions and Humanize Your Patients
13 Consider Fear When the Patient Is Angry: Assess What the Patient Might Be Afraid of When They Become Upset
14 Validate the Patient’s Perspective of Where They Are Now and Where They Need to Go: Understand and Support the Patient’s Reality and Goals to Enhance Motivation for Treatmen
15 Share How You Feel: Put Your Own Feelings Into Words to Reset a Difficult Conversation
16 Agree to Disagree: De-Escalate an Argument by Repeating This Short Phrase
17 Be Honest About Your Limitations: Relieve Yourself of Unobtainable Expectations and Reset the Conflictual Encounter
II Taking a History
18 Be Curious: When Curious About What a Patient Has Said, Ask More Questions to Obtain Useful Information and Show the Patient That You Are Intereste
19 Prioritize Information You Need Right Now: Shift Your Line of Questioning Without Shifting the Topic
20 Use Open-Ended Questions for Sensitive Topics: Invite Greater Honesty and Avoid a Sense of Judgment Through Open-Ended Question
21 Attend to Affect: Emphasize the Patient’s Emotional Words for a Richer History
22 Validate and Move: Use Validation as a Transitional Tool in the Unwieldy Interview
23 Write a Timeline: Organize Chaotic Histories and Validate the Patient’s Experience
24 Ask “How Come?” Instead of “Why?”: Vary Your Phrasing Slightly to Improve the Tone of the Intervie
25 Observe Caregivers’ Nonverbal Cues: Gather Information From Caregivers to Increase Accuracy and Efficiency in the Diagnosis of Cognitive Disorder
26 Roll With Impaired Reality Testing: Provide a Validating and Grounded Interview for Patients With Psychotic Symptoms
27 Ask for Help Understanding: Frame an Open-Ended Question as a Plea for the Patient’s Assistance
28 Collect the Social History First: Re-Order the Traditional Interview to Better Engage Reluctant Patients
29 Ask About Family History: Use the Family History as a Lead-in to Sensitive Questions
30 Wonder Aloud With the Patient: Use and Re-Use a Brief, Non-Committal Phrase to Explore the Patient’s History and Treatment Option
III Making an Assessment
31 Track Symptoms and Behaviors: Keep a Log to Aid Diagnosis and Begin Treatment
32 Find the Key Worry: Consider the Anxious Patient’s Most Important Worry in Making the Diagnosis
33 Consider Past Healthcare Encounters: Ask How Patients’ Past Healthcare Experiences May Inform Their Current Experienc
34 Identify What Is Solvable: Focus on Concrete Objectives That You and the Patient Can Realistically Solve Together
35 Talk About Traits, Not Diagnosis: Think of Maladaptive Thoughts and Behaviors on a Spectrum of Normal
36 Label the Patient’s Affect: Help Manage the Patient’s Emotional Experience by Putting It Into Words
37 Talk About the Mind-Body Connection: Connect Psychiatric and Medical Symptoms to Encourage Openness to Mental Health Intervention
38 Emphasize Function Over Feeling in Chronic Illness: Shift the Visit’s Focus to Capability to Reinforce the Patient’s Self-Efficacy and Agree on Achievable Outcome
39 Consider the Social History in Your Assessment: Apply the Social History as a Tool for Understanding the Patient’s Diagnosis and Treatmen
40 Remind the Patient What Is Not Working: Ask How the Patient Feels About Their Current Behaviors in Order to Motivate Change
41 Ask About Medication Side Effects: Assess Experiences of Side Effects When Medications Are Seemingly Ineffective
42 Ask the “Why” About Online Information: Focus on the Patient’s Motivations for Sharing Information Brought to the Encounte
43 Recall the Patient’s Strengths: Consider How the Patient’s Abilities Can Be Used in the Service of Their Healt
44 Accept or Change: Simplify the Possible Outcomes to Help the Patient Stop Venting and Decide on Action
IV Planning Treatment
45 Set the Stage: Spend One Visit Preparing to Make Significant Treatment Changes
46 Fish for Change Talk: Guide the Patient Into Talking About Behavior Change More Quickly
47 Imagine the Future: Envision the Patient’s Healthy Life in Order to Prioritize Treatment Goals
48 Prescribe Change: Use a Prescription Pad to Emphasize Non-Pharmacologic Interventions
49 Ask the Patient’s Beliefs Regarding Medications: Understand What Patients Think Medications Will Do for Them to Clarify Treatment and Improve Adherenc
50 Anticipate Challenges: Be Specific in Planning Ahead and Removing Obstacles to Treatment Success
51 Experiment With Change: Introduce Change as Something the Patient Can Simply Try Out—No Commitment Necessary!
52 Operationalize Improvement: Be Specific With the Patient About What “Better” Means
53 Frame Limit-Setting From the Patient’s Perspective: Consider How Setting Effective Limits Will Improve the Patient’s Car
54 Share Difficult Decisions: Give the Patient Options When Collaborating on a Treatment Plan With Which the Patient Is Reluctant to Engag
55 Define Efficacy for Medication Changes: Understand the Patient’s Goals and How They Will Know If a Medication Change Is Workin
56 Help Patients Resist Urges: Review How Patients Can Refrain From Acting on Unhelpful Impulses
57 Accept Ambivalence: “It’s Okay Not to Change”: Allow Patients to Acknowledge and Accept When They Are Not Ready to Chang
58 Plan for a Crisis: Write a Three-Step Crisis Plan to Anticipate Patients’ Triggers and Coping Skills
59 Normalize Challenges: Validate That Treatment Is Difficult for Many Patients
60 Reinforce the Positive: Encourage Healthy Decision-Making and Adherence With Plentiful Encouragement
Index
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