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Consultation Models

Consultation Models. Hasna Begum Bradford GPST Programme. What is a model?. A certain way of doing something We all have models for tasks that we have done more than once eg Tying shoelaces. Why learn about consultation models?. Toolbox Framework for learning to consult

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Consultation Models

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  1. Consultation Models Hasna Begum Bradford GPST Programme

  2. What is a model? • A certain way of doing something • We all have models for tasks that we have done more than once • eg Tying shoelaces

  3. Why learn about consultation models? • Toolbox • Framework for learning to consult • Easier to pinpoint where difficulties occur • Offers alternatives

  4. Think about the way you consult and try to map your own consultation model

  5. Consultation Models • Stott & Davis • Byrne & Long • Heron's (Six Category Intervention Analysis) • Helman's Folk Model • Transactional Analysis • Pendleton, Schofield, Tate & Havelock • Neighbour • Disease-Illness • Calgary-Cambridge • BARD • Balint • Narrative-based

  6. Task vs Process • Doctor-Centred vs Patient-Centred

  7. Task Orientated • Traditional medical interview • Pendleton • Helman folk model

  8. Pendleton • TASK 1: Find out why the patient is here • TASK 2: Consider other problems • TASK 3: Choose (with patient) an appropriate action for each problem • TASK 4: Achieve a shared understanding of the problem • TASK 5: Involve the patient in management, encourage acceptance of responsibility • TASK 6: Use time and resources appropriately • TASK 7: Establish or maintain a relationship with the patient that helps to achieve other tasks

  9. Helman Folk Model • Every patient comes to a doctor seeking the answers to SIX questions. To be effective, the doctor needs to help the patient verbalise the questions so they can be addressed. • What has happened? • Why has it happened? • Why to me? • Why now? • What would happen if nothing was done about it? • What should I do about it / who should I ask?

  10. Process Orientated • Balint - the dr, his patient and the illness • Byrne & Long's 6-stage model • Neighbour • Transactional analysis • Calgary-Cambridge

  11. Balint • "The Doctor, his Patient and the Illness" • Emotional relationship between dr and patient - collusion • Clinician may feel what patient feels - counter transference • Attentive listening helps patients feel better • Doctor as a therapeutic agent in the consultation - "doctor as the drug" • Consultations extending over years - mutual investment company • Listening as a skill that needs to be learned

  12. Neighbour 1. Connectt 2. Summarise 5. Housekeepingxt 3. Handover 4. Safety net

  13. Calgary-Cambridge • Initiating the session • Gathering information • Building the relationship • Providing structure • Explanation and planning • Closing the session

  14. Think about a recent consultation • Try going through the same scenario using one of the models mentioned today

  15. References • Moulton, L. (2007). 'The Naked Consultation'. Abingdon: Radcliffe Publishing. • Usherwood, T. (1999). 'Understanding the Consultation'. Maidenhead: Open University Press.

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