medical communication/counseling training for the “ trainers ”...
TRANSCRIPT
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Medical Communication/counselingTraining for the “Trainers”
คณะแพทยศาสตร์ มหาวิ�ทยาลั�ยสงขลัานคร์�นทร์
17-18 ธั�นวิาคม 2558
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What is counseling?
• The means by which one person helps another to clarify their life situation and to decide upon further lines of action.
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• Two way communication• Make the counselee realized his/her
own situation• Help him/her to find the suitable
solution to cope/correct the problems
What is counseling?
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So as Medicine, counseling is both art
and sciences
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• Directive counseling• Advocacy counseling• Informative counseling• Supportive counseling
Riccardi VM, Kurtz SM. Communication and counseling in health care. Springfield. Illinois 1983.
Types of counseling
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• AdviceCounselor : tells the best option
Counselee : expected to be compliance
Use : traditionally and currently in routine medical practice when a single option is clearly the best (or the least hazardous); emergency surgery
Directive counseling
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• Facilitate an action based upon choicesCounselor : tells all available options
Counselee : exercises his/her own informed decision making process
Use : increasingly with more choices available and none may be better than the rest; cancer treatment options, amniocentesis, selective abortion
Advocacy counseling
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• Relate factual data or explanation on how to do something without asking for decision
Counselor : explain only
Counselee : expected to comprehend
Use : telling the diagnosis, explaining about medications
Informative counseling
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• Giving aid or feedback to assist in coping and realistic adaptation to a given situation
Counselor : listen and provide emotional support and compassion
Counselee : allowed to vent and adjust at his/her own pace
Use : at all time usually with bad news
Supportive counseling
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Effective Counseling
Patients’problem
Knowledge Techniques
AttitudeAwareness
Characteristics
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CounselorCounselor CounseleeCounseleeContent
Technique
Environment
Component of Counseling
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Environment
Privacy
Avoid interruption
Adequate lighting and temperature
Consider the arrangement of seat
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ควิร์จะจ�ดท��น��งอย�างไร์?
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• I. Attitude• II. Skills• III. Manner / charisma
Being a good counselor
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AttitudeFaith
EmpathyOptimism
Realistic understandingUnbiased view
SkillsVerbal
Non-verbalCounseling technique
CharismaMaturity
PolitenessCourtesy
SensitivityRespect
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CounselorCounselor CounseleeCounseleeContent
Technique
Environment
Component of Counseling
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• Medicalinformationdiagnosis, burdenprognosisoptions• Psychological
normal coping mechanism help / service
Content
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• Contents vary depending upon the types of counseling for each session / moment
• Consider how much to give and how many times “give small bites if you can”
• Frequently what you plan to do is not what is eventually done !
Content
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• Keep in mind of the followings:- Always tell the truth- Use language patient understands- Prioritize what you will say
- Use wording that minimizes reaction but convey similar meaning- Give time period in range
Content
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Effectiveness of counseling depends on- Basic/current knowledge about the
situation- Education- Beliefs/culture- Concern- Readiness to listen
Counselee
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• Communication SkillsListeningObservingEncouragingQuestioningProbingSilencing
ReflectingParaphrasingRefraining
ReframingInterpretingClarifyingSummarizing
Techniques/Skills
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• Questioning• Probing• Repeating (Reiterating)• Paraphrasing• Reflection (Interpreting)• Reframing• Summarizing• Encouraging
Verbal Non-Verbal
• Vocal quality• Speed of voice• Volume of voice• Listening• Silencing• Touching• Refraining• Interrupting• Observing• Facial expression