Medical Communication/counselingTraining for the “Trainers”
คณะแพทยศาสตร์ มหาวิ�ทยาลั�ยสงขลัานคร์�นทร์
17-18 ธั�นวิาคม 2558
What is counseling?
• The means by which one person helps another to clarify their life situation and to decide upon further lines of action.
• 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?
So as Medicine, counseling is both art
and sciences
• Directive counseling• Advocacy counseling• Informative counseling• Supportive counseling
Riccardi VM, Kurtz SM. Communication and counseling in health care. Springfield. Illinois 1983.
Types of counseling
• 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
• 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
• 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
• 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
Effective Counseling
Patients’problem
Knowledge Techniques
AttitudeAwareness
Characteristics
CounselorCounselor CounseleeCounseleeContent
Technique
Environment
Component of Counseling
Environment
Privacy
Avoid interruption
Adequate lighting and temperature
Consider the arrangement of seat
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• I. Attitude• II. Skills• III. Manner / charisma
Being a good counselor
AttitudeFaith
EmpathyOptimism
Realistic understandingUnbiased view
SkillsVerbal
Non-verbalCounseling technique
CharismaMaturity
PolitenessCourtesy
SensitivityRespect
CounselorCounselor CounseleeCounseleeContent
Technique
Environment
Component of Counseling
• Medicalinformationdiagnosis, burdenprognosisoptions• Psychological
normal coping mechanism help / service
Content
• 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
• 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
Effectiveness of counseling depends on- Basic/current knowledge about the
situation- Education- Beliefs/culture- Concern- Readiness to listen
Counselee
• Communication SkillsListeningObservingEncouragingQuestioningProbingSilencing
ReflectingParaphrasingRefraining
ReframingInterpretingClarifyingSummarizing
Techniques/Skills
• 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
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