Schizophrenia and communicative strategies

Question 1

What are the differing opinions on communication with people with schizophrenia? (3)

Answer 1

1. Client-centred approach: clients often want to talk about the content of their psychotic symptoms
2. Not to encourage as this involves collusion about their ‘non-reality’
3. Engaging in this enables the professional to share and learn from the client’s experiences

Question 2

McCabe, Heaht, Burns & Preibe (2002): conversation anaylsis of engagement of patients

Answer 2

Investigated how doctors engage with patients with psychotic anaylsis via a conversation anaylsis method

Question 3

What were the findings of McCabe et al (2002) study? (3)

Answer 3

1. Patients attempted to talk about their symptoms by asking direct questions, repeating questions and utterances and producing these utterances in the conclusion of the consulation
2. Psychiatrists responded with hesitation, a question instead of an answer, smile and laughed
3. Clients are often aware that professionals are reluctant to/uncomfortable to engage in talk about symptoms (may be institutional)

Question 4

What are the implications of McCabe et al (2002) study? (3)

Answer 4

1. Non-engaged patients are more unwell and socially impaired than successfully engaged patients (Bergman, 1992)
2. Addressing concerns about psychotic symptoms may faciliate better engagement, increased compliance, improved satisfaction and decreased burden of symptoms (Rotter, Hall & Katz, 1987)
3. Importance of patient-centred skills and approaches

Question 5

What was the purpose of McCabe & Priebe’s (2008) study?

Answer 5

1. Describe effective communication strategies to use with schizophrenia patients in order to positively impact the therapeutic relationship

Question 6

What is the client-centred approach of interacting with schizophrenia patients?

Answer 6

1. Might respond to the emotional content of the statement

Eg. ‘you feel misunderstood and puzzled’

Question 7

What is the cognitive approach of interacting with schizophrenia patients?

Answer 7

1. Might ask for evidence about the belief

Eg. ‘why should people believe you?’

Question 8

What are the 7 benefits of effective communication with patients with schizophrenia?

Answer 8

1. Positively impact the therapeutic relationship
2. Increase engagement in treatment
3. Increase likelihood of following treatment suggestions
4. Increase satisfaction
5. Reduce symptom severity
6. Improve referral to other services
7. Reduce willingness to file law suits

Question 9

What communication strategy did Van et al (2004) investigate? What did they find?

Answer 9

1. A simple communication checklist completed prior to seeing their clinician
2. Improved communication and resulting in treatment changes

Question 10

What communication strategy did Hamann et al (2008) investigate? What did they find?

Answer 10

1. An intervention designed to increase medical shared-decision making
2. Did “not take up more of the doctors time, increased psychoeducation uptake and improved shared decision making”

Question 11

According to Dobbinson (2010) how should a person interact with someone with paranoid, odd ideas, manic and heightened arousal? (6)

Answer 11

1. Avoid emotionally charged words
2. Calm tone
3. Slow rate
4. Supportive listening
5. Work hard to follow meaning
6. Avoid collusion

Question 12

According to Dobbinson (2010), how should a person interact with someone who is thought-disordered, medicated or confused? (5)

Answer 12

1. Simple, clear sentences
2. Repetition
3. Avoid information overload
4. Support messages if possible
5. Take time to decode the meaning

Question 13

According to Dobbinson (2010), how should a person interact with someone who is isolative and withdrawn?

Answer 13

1. Careful use of questions
2. Reflect
3. Interact rather than talk
4. Patience
5. Meet patient on own terms