Engaging the Patient

• Therapeutic Alliance:

  • concept of the relationship between the patient and the clinician
  • a strong alliance between the patients and the therapist is an active component within treatment and has been shown to have a significant impact on patients outcomes

  
• Therapeutic Alliance:

  • communication is the main focus of a therapeutic alliance - encompasses hearing the patients narrative, establishing connection and bringing empathy as a central component

  
• Therapeutic Alliance:

  • 4 other components of therapeutic alliance
  • seeing the person - their values, beliefs, uniqueness and developing a reciprocity within relationship and sense of teamwork
  • fostering autonomy - supporting person to learn about themselves and to act towards a independent future - supported self management
  • sharing the journey - legitimising the pts condition
  • therapeutic space - aspects of privacy, could be environment, could be sense of comfort within relationship which allow the patient to share and recognitions and management of unconscious bias

  
• Fear Avoidance Model pt1:

  • some pts think that pain means damage so they shouldn't do things that hurt or it'll get worse
  • this can lead to fear and avoidance or to high levels of attention being diverted to pain
  • this can leads to secondary issues of disease, disuse, disability and associated low mood because the person is doing less of the things they care about and even secondary pain can occur due to disease and disability

  
• Fear Avoidance Model pt2:

  • by understanding what the patient truly cares about and what they've lost, we cant start to identify shared treatment goals which help motivate the patient

  
• • Activity cycling refers to patterns of activity where the person does a lot of activity and then they need to rest, leading to an overall decrease in activity
  • this leads to more pain

  
• Impact of Pain:

  • reduced physical functioning
  • narrow patterns of behaviour
  • family life
  • social life
  • education/work
  • finances
  • intimate relationships
  • impact on:
  • sleep
  • appetite
  • routine
  • communication
  • distress
  • mood
  • sense of self
  • loss of vitality
• DO THIS LECTURES CASE STUDY WHEN REVISING!!!