Case 9- domestic abuse and empathy Flashcards

Question

What factors influences the use of touch in a consultation

Answer 1

Age of patient, gender of doctor and patient, level of distress, clinical context and personality. Generally touch on the hand or forearm is accepted

Answer 2

* Acceptance- accepts legitimacy of patients views and feelings, is non-judgemental. * Empathy- uses empathy to communicate understanding and appreciation of the patients feelings. Overtly acknowledge patients views and feelings * Support- express concern, understanding, willingness to help. Acknowledge coping effort and appropriate self care * Sensitivity- deal sensitively with embarrassing and disturbing topics and physical pain.

Answer 3

First you recognise the emotions or feelings from their cues. You then respond to the emotion in some way, you acknowledge the emotion, invite further exploration as appropriate and using a non-verbal and verbal empathic response.

Answer 4

Changing your posture, expression and tone of voice to suit the mood of the session

Answer 5

A state of wellbeing in which an individual realises their ability, can cope with the normal stresses of life, can work productively and is able to contribute to their community.

Answer 6

- Public is more accepting of a person with depression than they are with schizophrenia - Public less willing to interact with someone with a mental illness in a personal setting (marrying into family or providing child care) - Majority think an employee with depression is less likely to be promoted - Negative stigma with mental illness, stereotyped views so people may be subject to discrimination - Stereotype that someone with a mental illness is dangerous/violent and unable to live a normal life

Answer 7

``` Psychological- genetic, resilience Personality- low self esteem Social adversity- housing, poverty Family- parental loss, child abuse Social reasons- few social contacts ```

Answer 8

Good parenting Happy relationship High self esteem

Answer 9

Largely based on history taking Symptoms very subjective and individual - they vary depending on situation Limited investigations to diagnose Requires clinical judgement - interpret symptoms in the context of that individual Comprehensive biopsychosocial assessment

Answer 10

Biogenetic risk factors= genetic factors, temperamental predisposition, gender Psychological risk factors= early and recurrent trauma, poor coping styles

Answer 11

Somatic risk factors= somatic disease, substance misuse, | Social and cultural risk factors= instability, environmental factors

Answer 12

1) Stigma 2) Negative perception of mental illness 3) Fear of discrimination 4) Avoidance of help and recourses 5) Untreated mental illness, perpetuating misconceptions

Answer 13

People may have a disproportionate response to a life event, like a break up. Can be not having a big enough response ie to death.

Answer 14

Mixed anxiety and depression

Answer 15

Women are more likely to present than men, can be direct or indirect. May present with low mood, insomnia, weight loss and irritability. Can be hand on door.

Answer 16

Lethargy, poor sleep, loss of appetite, poor libido

Answer 17

Palpitations, chest pain, breathlessness, sweating, dizziness and diarrhoea

Answer 18

An illness where emotional factors produce physical symptoms. For example, abdomen pain, headache and dizziness. Underlying anxiety and mood drives exacerbations. It is challenging to explain and treat.

Answer 19

Neurology (epilepsy), chronic pain clinics and obstetrics (post-natal depression)

Answer 20

Online forums Mood gym Self guided CBT online Self referred for counsellor by GP

Answer 21

``` Talking therapy which helps you manage your problems by changing the way which you think and behave Breaks problems into smaller parts Stop negative thought cycle Often used alongside SSRIs Key non pharmacological intervention ```

Answer 22

``` RELATE - relationship therapy Family therapy DBT and MBT Anger management Art therapy Music therapy Bereavement counselling EMDR (eye movement desensitisation and reprocessing) ```

Answer 23

``` Financial services Employment services Housing services Social care and social workers Safeguarding team ```

Answer 24

Assessment, support, psychoeducation, referral

Answer 25

Low intensity psychosocial, psychological interventions, medication, referral

Answer 26

Medication, high intensity psychology, combined treatment, referral

Answer 27

Medication, high intensity psychology, combined, ECT, crisis, MDT, inpatient care

Answer 28

Reducing caffeine, weekly Pilates, listening to music to de-stress, meeting up with friends and giving up smoking.

Answer 29

1) Improves patient satisfaction and concordance with treatment 2) Patients feel less anxious with an empathetic doctor 3) The patient is more likely to trust the doctor and reveal more information, this improves diagnostic accuracy and prediction of treatment pitfalls 4) Patients are more likely to make a positive lifestyle choice