Academic literature on the topic 'Change (Psychology) Psychotherapist and patient'

This chapter demonstrates how a psychotherapist treated a patient with extreme Non-Epileptic Seizures (NES). During the patient’s seizure episodes, her face and neck would change color, from red to white or the reverse. She would hold her chest and grimace in pain. Her skin would break out in a cold sweat and she would describe experiencing nausea and double vision. Sometimes she would lose consciousness. So distressing was the seizure episode, both for the patient and the psychotherapist, that a first course of psychotherapy was purely dedicated to stabilization and anxiety prevention techniques. After the end of this initial course of psychotherapy, the patient was understandably dismayed that she continued to suffer from regular NES. The psychotherapist then tried Lifespan Integration, a directive, somatic trauma-based therapy. Since the patient’s last session, she has been seizure free. Moreover, she has returned to work and has been able to enjoy the time spent with her family.

Health psychology is concerned with understanding human behaviour in the context of health, illness, and health care. It is the study of the psychological factors, which determine how people stay healthy, why they become ill, and how they respond to illness and health care. Health psychology has emerged as a separate discipline in the past 30 years and there are many reasons for its rapid development. An important background factor is the major change in the nature of health problems in industrialized societies during the twentieth century. Chronic illnesses such as heart disease and cancer have become the leading causes of death, and behavioural factors such as smoking, diet, and stress are now recognized as playing a major role in the aetiology and progression of these diseases. The provision of health care has grown enormously and there is an increased awareness of good communication as a central ingredient of medical care and of the importance of such factors as patient satisfaction and quality of life as key outcomes in evaluating the efficacy of medical interventions. Although health psychology has developed over a similar time period to general hospital/liaison psychiatry and shares some common areas of interest, there are some clear differences between these two fields. Liaison psychiatry has a primary focus on hospital patients, particularly those experiencing psychological difficulties in the face of a physical health problem. In contrast, health psychology has a much broader focus on both healthy and ill populations and on the psychological processes that influence their level of health or their degree of adaptation to disease. Whereas health psychology has been mainly concerned with developing explanations based on theory, for health-related and illness-related behaviour, liaison psychiatry has concentrated on the diagnosis and treatment of either unexplained symptoms or psychiatric disorders occurring in people with medical conditions (see the other chapters in Part 5 of this volume). In this chapter we provide an overview of the main themes and areas in health psychology. Four broad areas of behaviour will be reviewed, namely behavioural factors influencing health, symptom and illness behaviour, health care behaviour, and treatment behaviour. Inevitably such an overview is selective and the interested reader should seek out a more comprehensive introductory text or more in-depth accounts of specific areas.

Chapter 5 provides an overview of cognitive behavioural case formulation as a ‘hypothesis’ about the causes, precipitants, and maintaining influences of a person’s psychological problems (cognition & emotion), interpersonal problems, and behavioural problems, and illustrates how this approach to assessment allows the cognitive and behavioural specialist to organize complex and contradictory information about an individual, identify therapy-interfering events, accept what each patient may bring to treatment, develop a blueprint for guiding treatment, and identify markers for change.

The clinical training of healthcare professionals and the delivery of safe healthcare is reliant on a vigorous organizational safety culture, one where the workplace and medical training environment is free of hostility and harassment. Sexual harassment and sexual misconduct are significant problems for women in healthcare. For all staff members, it is imperative that the hospital has clear, solid policies and, even more importantly, procedures and communication of those procedures for reporting problems concerning harassment. This research inquiry uses case study action research in the context of an OD intervention in school of health science and medical center that provides clinical and medical training and community patient care. The organization has significant organizational cultural issues around harassment. Results indicate the need for more proactive strategies around leadership and organizational cultural change that can apply to medical schools, schools of health science, and medical centers.

Chapter 8 focuses on the recent enhancements to clinical processes that improve the patient–provider experience and increase successful long-term outcomes. Professionalism has at times been criticized as not being genuine, but clinical care is like an Olympic sport, it takes a lot of training to become effortless and natural. By actively incorporating essential components of the biopsychosocial model, patient-centered care, interprofessional collaboration, motivational interviewing, the stages of change model, healthcare ethics, and model strategies from clinical psychology, it is possible to engage in more successful and satisfying outcomes with patients. Because most chronic problems are not truly best served by a series of injections or surgeries, we need to increase knowledge of, motivation toward, and competence in the range of chronic condition management approaches that are evidence-based, safe, and effective in clinical practice.