QUOTE OF THE MONTH:

# 68 October 2005

"Let mystery have its place in you; do not be always turning up your whole ploughshare of self-examination, but leave a little fallow corner in your heart ready for any seed the wind may bring, and reserve a nook of shadow for the passing bird; keep a place in your heart for the unexpected guest, an altar for the unknown God."

Henri Frederic Amiel
(from his journal writings, 1887)


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mental health professional trainings
primary care professional trainings
psychological assessment supervision and consultations
Shawn Christopher Shea
links and recommended readings

INTERVIEWING TIP OF THE MONTH

# 68 October 2005

"Creatively Adapting Psychoeducation to the Needs of the Anxiety Bound Client"

TISA Description of the Problem: As mental health professionals and primary care clinicians, we do our best to inform our clients and patients of the pros and cons of their various treatment options. This approach is sometimes complicated by the fact that education can never be "cook book" in nature. Each person may learn in a different fashion and, curiously, each person may even vary in what it is he or she wants to learn. Specifically, some clients are easily overwhelmed by too much information and some clients - such as patients with hypochondriasis or generalized anxiety disorder - may be unnecessarily frightened by information overload. One way of approaching this dilemma is to collaboratively ask the client how they want to be approached as described in the following sensitive tip provided by Bob Holmes.

Tip: I find that figuring out how much information is too little or too much for clients can sometimes be best resolved in a common sense fashion - by asking them. In this regard I have found the following question to be very useful whether talking about medications or therapy options:

"Mr. Jones, I can tell you all the pros and cons of each of your options for treatment including my own recommendations, or, if you prefer, I can shorten the process and simply tell you what I personally feel is my best recommendation. Either way is fine with me. Which do you think you would prefer?"

TISA Follow-up: This is a very practical tip and is useful with a variety of clients. In my own practice, I sometimes find an even more directive variant to be very useful with clients that I know well, have developed a powerful alliance with, and who openly acknowledge that they fret way too much. In particular - with a well-known client with an anxiety laden disorder such as hypochondriasis - I sometimes recommend that we not go into all of the side-effects of a medication as follows: "You know, Jim, at times as I think we both know, you can worry an enormous amount about getting side-effects and sometimes I think it has prevented you from getting help from medications that could have helped you. My personal belief is that it is probably best if I focus in on only the most common side-effects or potentially problematic ones so that you aren't overwhelmed. I guess it requires that you trust me to tell you what you need to know and I promise to do so, but I just think it gets in our way to go over each and every side effect. What do you think?" Some of my patients even chuckle at this point because they know exactly what I mean. In any case, it gets an important issue out on the table for discussion for joint decision making. Give it a try and see what you think.

Tip provided by:

Bob Holmes
Behavior Management Systems
Rapid City, SD