Patient counselling

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Patient counselling

Patient counselling is one of the main responsibilities of the pharmacist or physician other than just providing the drug. As the patient is said to have no knowledge about the drug or the treatment, he/she should be rendered proper information, given the best of advice and assistance for the same. It will amplify or maintain the quality of health and life. To obtain patient confidence and to help induce the patient to adhere to the recommended regimen, good communication skill is required.

Classification of counselling:

Problem-solving counselling:

  • The problems concerning the stressful circumstances can be rectified with the help of this structured and systematic approach.

  • This type of counselling method is satisfactory, particularly for patients whose hurdles of life are adversely affecting or sustaining a disorder.

  • Here, the patient is identified and problems are indexed. Then, the practical methods existing to decipher or alleviate the problem are reviewed.

  • For the effective treatment of mild mood disorders.

Interpersonal counselling:

  • It is almost comparable to problem-solving approaches. But, it's key focus relies on the present state of interpersonal relationships at home, work and elsewhere.

  • Headings of loss, interpersonal disputes, role transitions and interpersonal deficits are observed under the problems in relationships.

  • Problem-solving perspective is employed to incite the patient to check out different ways of coping.

  • For the effective treatment of minor mood disorders.

Psychodynamic counselling:

  • In this method, priority is given to past experience and unconscious processes as basis of current behavior.

  • The kind of problems is other relationships can be viewed as a result of patient's emotional reactions to the counsellor and situation.

  • Although, a detailed evaluation needs to be done for this method as was done for the above.

Uses of counselling in various situations:

For mild-to-moderate depression:

The National Institute for Health and Care Excellence (NICE) enquires the adequacy of this compared with other therapies and has downgraded it to second-line therapy in its recent guidance.

For acute distress relieve:

Here, the priority is on emotional release and the approaches of dealing with the problem rapidly. When the procedure is unstructured, nondirective and entails remembering the distressing events, it may be unsuitable for those dealing with traumatic experience and lead to worse results than where the patient receives no counselling. The cognitive procedures may be useful but timing is crucial.

For late effects of trauma like the post-traumatic stress disorder:

As mentioned earlier, it is not appropriate to use nondirective and unstructured approaches since they may cause recreating the emotionality of experience without offering ways to handle it. The cognitive and psychodynamic approaches may be more useful.

The risk counselling:

For those who may encounter the risk of progressing a hereditary disease or acquiring a sexually transmitted disease, productive discussions with the counsellor may help evaluate the description of risks and possible responses to various outcomes.

Terminal or chronic disease:

These type of diseases can be reconciled with the help of counselling. The group psychotherapy has been beneficial.

The counselling skills:

Most of the counselling skills are guided basically by process-experiential, psycho-dynamic and humanistic principles. Some of the instances of therapeutic methods are:

The problem solving therapy:

To taper stress and increase self-efficacy, the generic skills in diligent problem-solving, aiding people to clarify and formulate their life difficulties and apply principles of problem-solving can be useful.

The behavioral therapy:

By changing behavior and environmental factors which influence behavior the problems can be resolved and ease symptoms. The most frequent behavioral treatment methods like graded exposure to feared situations are employed in a variety of anxiety conditions.

The non-directive counselling:

It motivates the patient to share his or her issues with the counsellor. By listening to his patient, the counsellor affirms the patient's worth thus allowing him or her to take time to express his or her thoughts.

Cognitive behavior therapy:

The combination of cognitive and behavioral therapy is considered under this therapy. It gazes upon how a person's self-perception can affect his or her behavior. It brings forward some of the possible problems and how these can pave way to destructive or damaging behavior. According to a study, it was found helpful in managing depressive disorder in elderly. Another study revealed that online real time therapy remitted by a counsellor over the internet was effective although access has always been the matter of concern in primary care.

The Psycho-dynamic counselling:

In order for the client make sense of forgotten or oppressed experiences, multiple methods are used which are based on the view that former and unresolved conflicts and events lead to current emotional distress.

Advantages of counselors in primary care:

This has rather been baffling and controversial. According to the Cochrane review of counselling in primary care:

  • Counselling has led to potentially higher clinical effectiveness in short-term mental health results as compared to usual GP care in UK, however in the long term, it imparts no additional advantages.

  • The participants were contented with the counselling.

  • Counselling does not seem to contract overall healthcare costs.

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