Reduction of Perceived Threats

• An example of perceived threat is client believing that are at risk of harm if they adhere to medical advice (eg severe side effects from taking a drug or withdrawal symptoms when giving up a substance).

  What matters is understanding that the client perceives harm is likely, even when the true risk is tiny, hence finding ways to remove the fear is important.

  Therefore, changing the client’s perception of threats is a useful target for improving adherence e.g: helping them think realistically about risk, whilst not minimising how they feel.
• Resistance-


  ·         Clients can resist medical advice if they perceive it as threatening.

  ·         Reducing this resistance can change their perception of the threat

  ·         E.g: If exercise is prescribed as a lifestyle change, the client may resist as they perceive it as unattainable or threatening

  ·         Helping them to understand easy ways to exercise may remove the barrier and lower resistance.
• Understanding of needs

  ·         Clients may perceive something as threatening if they think their perceived needs are not being met

  ·         Eg: an anti vaxer may be susceptible to disease due to not being vaccinated.  But they value acceptance of their social group too much to accept medical advice/care.

  ·         You would have to understand they may experience rejection and need to offer an alternative.
• Safety, security and fear.

  ·         Include clients in the treatments decision making process, so they feel some level of control, hence security/safety.

  ·         It is important to address these fears with factual information, e.g: the side effects are only experienced by 1 in every 100.
• Strengths:

  ·         Considering perceived threats offers a specific way to improve adherence

  ·         Many clients do not perceive enough of a threat from the illness itself

  ·         By emphasizing that the client is a member of a vulnerable group and at risk from the illness, client will realise there are benefits to adherence that outweigh the perceived threats of harm.
• Weakness:

  ·         Perception-behaviour gap

  ·         Reducing threat perception does not always change behaviour.

  ·         Interviews can help clients judge the risk of harm more accurately (eg from side effects). But this does not mean they can go on to be more adherent

  ·         Interventions should target multiple causes of non-adherence, not just reduce the perception of threat.