Goal of Health Psych
to gain deeper understanding of psychological processes so as to improve health outcoems of individuals
psychoneuroimmunology
- studies systemic communication and functional influence
- includes psychology, neuroscience, endocrinology, immunology, cardiology
- it is an interdisciplinary science that believes our psychological, behavioural, and physical processes are closely related
Relationship between naturopathic medicine and health psychology
- treat the whole person
- address the root cause
- prevent health problems by helping people cope with stress and change health-related behaviours
- encourage healthy lifestyles
- minimize the effect of physical illness
- understand the effects of chronic illness
- support positive regard for self
- support healthy relationships
- emphasize a biopsychosocial model of health and well being
Multidimensional correlations of health
- the meaning a person gives to his/her symptoms or condition
- what the individual consciously or unconsciously wants and believes
- the individuals personality, response style and psychological state
- social context: social expectations, rules/patterns learned from the family and culture
4 premises of medical care
- doctors treat patients, not diseases
- the body has the final word
- all medical care flows through the relationship between physician and patient
- the spoken language is the most important tool in medicine
6 Essentials of counselling
- learn to be present
2 .intentional interview skills - be aware of your biases, issues, judgements
- communication skills
- building the therapeutic relationship
6/ Theoretical foundations and specific counselling techniques
DSM-IV
- the diagnostic, and statistics manual
- clinical guide, not a definitive source
- useful depending on orientation
- useful to understanding DSM axis
- usedul to understand DSM terminology and assessment
DSM-IV “MENTAL DISORDER”
- a clinically significant behavioural or phsychological syndrom or pattern that occurs in an individual and that is associated with present distress or disability, or with a significantly increase risk of suffering death, pain, disability or important loss of freedom
The engagement process includes
- blending
- conveying empathy
- creating a safe space
- clinician genuineness
- clinician expertise
Blending
the behavioural and emotional clues from the interview that suggest the the engagement process is proceeding effectively
- allows you to monitor the degree of engagement during the interview
Building rapport
- attention to both verbal and non verbal langrage
- eye contact, tone, body language, posture, movement, breathing
- empathy
- active listening
Establish Safety
- non judgemental curiosity
- respect
- compassion
- pace of interview
- emotional stability
Convey Genuineness
- mindfullness, presence
- emotional integrity
- congruence with self
- honest communication
Demonstrate Expertise
- awareness, insight
- clinical interview, exam, assessment
- ‘docere
How to maintain appropriate boundaries
- keep your focus on the patient
- be aware of your personal needs
- avoid dual relationships
Why people dont listen
- they cant suspend their own needs
- they feel like they have to defend themselves
- they are preoccupied
- your style of communication is not effective
- what we say makes them anxious
When someone might not hear what you think you said
- transference and counter-transference
- the listeners own agenda
- preconceived notions
- emotional reactivity
Benefits of Active listening
- speaker feels heard
- speaker feels worthwile
- listener checks accuracy
- listener witholds own feelings
- speaker offers own solutions- taking responsibility
- promotes warmth and understanding
4 keys to attentive listening
- ask for clarification
- reflect content
- reflect feeling
- reflect meaning
How to let go of your own needs and listen
- pay attention
- suspend your agenda
- ask specific Q’s
- affirm understanding
- be willing to relinquish control
- let go of your needs
Be aware of own nonverbal habits:
- touch
- eye contact
- facial expression
- tone
- breathing
- body language
5 Different Gates
Spontaneous Gate Natural Gate Referred Gate Phantom Gate Implied Gate
Spontaneous gate
patient changes content region
natural gate
transitional question- bridge
referred gate
Dr refers back to an earlier statement
Phantom Gate
out of context (TRY TO AVOID)
Implied Gate
natural process but no specific point of reference
The termination
actual closing/gestures
goal- to stabilize the relationshop and convey a quiet warmth
Why we need humor
enhances self-esteem
enhances immune system
helps increase pain tolerance
Why we dont use humor
too busy
too serious
too much ego
Chronic/High levels of anxiety associated with what
- palpitation/ chest pain
- cold and sweaty extremities
- band- like pressure around head
- constriction of the throat
- fatigue
- lack of appetite
Genaralized anxiety disorder
unrealistic or excessive anxiety and worry about multiple life circumstances and is associated with the presence of cognitive, behavioral, and physical disturbances.
Motor Tension
Trembling, twitching, feeling shaky
Muscle tension, aches, soreness
Restlessness
Easily fatigued
Autonomic Hyperactivity
Shortness of breath or sensations of being smothered
Palpitations, tachycardia
Sweating, cold/clammy hands, flushed/chilled
Dry mouth
Dizziness, lightheadedness
Nausea, diarrhea, or other abdominal distress
Frequent urination
Trouble swallowing; lump in throat
Vigilance and Scanning
Feeling “Keyed up” or on edge Exaggerated startle response Difficulty concentrating or mind going blank due to anxiety Trouble falling asleep or staying asleep Irritability
Sx of Depression
Reduced energy level Change in sleep habit Change in eating habits Withdrawal from interactions with others Gloomy, dark or sad seelings Self-criticism Sense of helplessness
Working with depression
- Dr-Patient relationship
- Journalling
- cognitive therapy
- lifestyle factors
If there is bad communication
- inaccurate symptom reporting
- misdiagnosis
- Pt may not understand Tx
- poor outcomes
Prevention Behaviors
Primary- before a person is at risk
Secondary- when risk factor develops
Tertiary-manage or reverse course of Dz
Factors that influence health behaviors
Having reliable information Believing health goals are valuble Willingness and ability to comply with treatment Personality characteristics Social reinforcement
Methods of promoting compliance
Internal motivation
Problem-solving
Social influence
Multiple sources of information