# 106 December 2008

"Gradually there gathered the feeling of expectation. Christmas was coming. . . . Everywhere was a sense of mystery and rousedness. Everybody was preparing for something."

D. H. Lawrence
from The Rainbow

(continues below)

mental health professional trainings
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Shawn Christopher Shea
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# 106 December 2008

"The Gardener's Tip" for Improving Medication Interest

TISA Description of the Problem: In the Medication Interest Model (MIM), which applies to medications for treating all diseases from congestive heart failure and diabetes to depression, interviewing techniques are described that help clinicians from medicine, nursing, and mental health to transform medication nonadherence into medication interest. The MIM is constantly growing from the never-ending interviewing tips suggested by visitors at TISA and by participants at our workshops on transforming medication nonadherence. Much of the art resides in respecting the perspectives and needs of each individual patient. Language counts. The clinician is always looking for ways to speak with words that are meaningful to the specific patient at hand. In the following interviewing strategy Dave Dean, RNCS offers a delightful insight into the art of tailoring the message to the patient's world view. See what you think.

Tip: With patients who are fascinated by gardening, nature or farming, I sometimes find the following metaphor is particularly meaningful:

"Sometimes when the parts of the brain that regulate mood are not functioning normally, it is a little bit like a garden that has, over time, lost its nutrients. In the same way that you nurture and tend to your garden by adding fertilizer sometimes neurons are low on messengers like serotonin. This particular medication is made to help the cells grow stronger with serotonin so that they can function normally in a healthy way again."

TISA Follow-up: Here is a wonderful example of finding a language that is comfortable for a specific patient when talking about medications in an effort to optimize medication understanding and ultimately, adherence.

Tip provided by:

Dave Dean, RNCS
Inglewood, Colorado

TISA is a site dedicated to advancing the science and art of preventing suicide and teaching clinical interviewing