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Clin Skills block 2

Resist the Righting Reflex Understand your patient’s motivations Listen Empower RULE
Open-ended questions Affirmations Reflective statements Summaries OARS
Desire Ability Reason Need Preparatory change talk: DARN
Precontemplation Unaware or under-aware, not thinking about change
Contemplation Aware, thinking about it, not yet made commitment to action
Determination/Preparation Intending to take action in the next month
Action Modifies behavior, experience or environment to overcome problem
Maintenance Working to prevent relapse, consolidate gains
Setting up the interview 1st S (SPIKES)
Perception of the patient - The patient's perception of medical situation P (SPIKES)
Invitation - How patient would like to receive diagnosis and info I (SPIKES)
Knowledge - Give patient the info K (SPIKES)
Emotions/Empathy E (SPIKES)
Strategy/Summary last S (SPIKES)
Collusion occurs when a physician somehow merges with their patient’s view of themselves and the world instead of helping their patient deal with it
There is a LACK OF CHALLENGE on more specific issues type of Collusion: “Your coping strategy of having several glasses of wine, might seem useful to you in the short-term, but they are not truly effective for you in the long-term management of your diabetes.”
There is a RELUCTANCE to give rational feedback Type of collusion: “I believe that we can work together to help you build up better coping strategies, at times when using wine is not the best option.”
“softening of accountability”. Type of collusion: “Oh, that’s okay if you don’t want to do anything about it. I know it’s hard to deal with of all of this and to stop drinking the wine.”
Stress A negative emotional experience accompanied by predictable biochemical, physiological, cognitive, and behavioral changes that are directed either toward altering the stressful event (i.e. the stressor) or accommodating to its effects.
Stressor A real or imagined aversive or threatening event or situation. Note that a ______ can be a negative event (e.g. loss of a job) or a positive event (e.g. birth of a new child).
Primary appraisal regarding the stressor – “Is this stressor something I need to worry about? Is it a threat? Does it matter?”
Secondary appraisal assess the individual’s coping resources – i.e. “Given this stressor, do I have enough energy/support/resources to cope with it adequately?”
Created by: SzechuanSauceEPL
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