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Consultation Models Hasna Begum Bradford GPST Programme.

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Presentation on theme: "Consultation Models Hasna Begum Bradford GPST Programme."— Presentation transcript:

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. 1. What has happened? 2. Why has it happened? 3. Why to me? 4. Why now? 5. What would happen if nothing was done about it? 6. 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 5. Housekeepingxt 1. Connectt 2. Summarise 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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