Kaplan & Sadock's Synopsis of Psychiatry: Be atry: Behavioral Sciences/Clinical Psychiatry, 10th Edition

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Kaplan & Sadock's Synopsis of Psychiatry: Be atry: Behavioral Sciences/Clinical Psychiatry, 10th Edition EDIT Dr EDIT Dr liza 140 366 660 The Patient-D atient-Doctor Relationship Kaplan & Sad... ock's Synopsis of Psychiatry: Behavioral avioral Sciences/Clinical Psychiatry, 10th Edition EDIT Dr liza 140 366 660 a 140 366 660 RAPPORT  An effective relationship is characterized by good rapport.  Rapport is pport is the spontaneous, conscious feeling of harm of harmonious responsiveness that promotes the development of a constructive therapeutic alliance.  It implies an understanding and trust between the doctor and the patient. Frequently, the doctor is the only person to whom the patients can talk about things that they cannot tell anyone else. Most patients trust their doctors to keep secrets, and this confidence must not be betrayed.  Patients who feel that someone knows them, understands them, and accepts them find that a source of strength. In his essay,Caring for the Patient Francis Peabody, M.D. (1881-1927), a talented teacher and c cher and clinician (Fig. 1-2), wrote: 6 STRATEGI TRATEGIES RAPPORT  Ekkehard O kkehard Othmer and S er and Sieglinde Othmer defined the development of rapport as encompassing six strategies: (1) putting patients and interviewers at ease; (2) finding patients' pain and expressing compassion; (3) evaluating patients' insight and becoming a coming an ally; (4) showing expertise; (5) establishing authority as physicians and therapists; and (6) balancing the roles of empathic listener, expert, and authority. As part of a strategy for increasing rapport, they developed a checklist (Table 1-1) that enables interviewers to recognize problems and refine t refine their skills in establishing rapport.  Empathy  Empathy is a way of increasing rapport. It is an essential ssential character aracteristic of istic of psychiatrists, but it is not a universal human capacity. An incapacity for normal understanding of what other people are feeling appears to be central to certain personality disturbances, such as antisocial and narcissist cissistic personality disorders. Although lthough empathy probably cannot be created, it can be focused and deepened through training, observation, vation, and self-reflection. It manifests in clinical work in a variety of ways. An empathic psychiatrist may anticipate what is felt before it is spoken and can often help patients a patients articulate what they are feeling. Nonverbal cues, such as body posture and facial expression, are noted. Patients' reactions to the psychiatrist can be understood and clarified. Transference  Transference is generally defined as the set of expectations, beliefs, and emotional responses that a patient brings to the patient doctor relationship.  They are based not necessarily on who the doctor is or how the doctor acts in reality but, rather, on repeated experiences the patient has had with other important authority figures throughout life. Transferential Attitudes [Show More]

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