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Good communication in psychiatry – a conceptual review

Published online by Cambridge University Press:  16 April 2020

S. Priebe ,
S. Dimic ,
C. Wildgrube ,
J. Jankovic ,
A. Cushing  and
R. McCabe
S. Priebe*
Affiliation:
Queen Mary University of London, Newham Centre for Mental Health, Barts and the London School of Medicine and Dentistry, Unit for Social and Community Psychiatry, LondonE13 8SP, United Kingdom
S. Dimic
Affiliation:
East London NHS Foundation Trust, London, United Kingdom
C. Wildgrube
Affiliation:
North Essex Partnership NHS Foundation Trust, London, United Kingdom
J. Jankovic
Affiliation:
Queen Mary University of London, Newham Centre for Mental Health, Barts and the London School of Medicine and Dentistry, Unit for Social and Community Psychiatry, LondonE13 8SP, United Kingdom
A. Cushing
Affiliation:
Queen Mary University of London, Barts and the London School of Medicine and Dentistry, London, United Kingdom
R. McCabe
Affiliation:
Queen Mary University of London, Newham Centre for Mental Health, Barts and the London School of Medicine and Dentistry, Unit for Social and Community Psychiatry, LondonE13 8SP, United Kingdom
*
⁎Corresponding author. E-mail address: [email protected] (S. Priebe).
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Abstract

Background

The communication between clinician and patient is the basis of psychiatric treatment. However, there has been little practical attention to training in it, and no specific theory of what constitutes good communication in psychiatry has been developed. This review aims to identify principles that guide good communication.

Methods

A conceptual review of guiding principles for how clinicians should communicate with patients to achieve clinical objectives in psychiatry.

Results

Five guiding principles for clinicians were identified: a focus on the patient's concerns; positive regard and personal respect; appropriate involvement of patients in decision making; genuineness with a personal touch; and the use of a psychological treatment model.

Conclusions

The principles are mostly generic, but their implementation can be particularly challenging in psychiatry. They may guide further empirical research on effective communication in psychiatry and be utilised using different personal skills of clinicians.

Keywords

Good communicationGuiding principles for good communicationCommunication in psychiatry
Type
Review
Information
European Psychiatry , Volume 26 , Issue 7 , October 2011 , pp. 403 - 407
Copyright
Copyright © European Psychiatric Association 2010

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Footnotes

1

All authors were part of the research team that conducted the review and contributed to the discussion at all stages of the process. All contributed to and approved the final manuscript.

References

Askm, J.Alison, C.Patient – Centered medical professionalism: towards an agenda for research and action. Picker Institute:2006Google Scholar
Barker, P.Person – centered care: the need for diversity.Barker, P.Psychiatric and mental health nursing. The craft of caring. London:Arnold; 2003 p. 3–9Google Scholar
Beach, M.C.Roter, D.Larson, S.Levinson, W.Ford, D.E.Frankel, R.What do physicians tell patients about themselves? A qualitative analysis of physician self-disclosure. J Gen Intern Med 2004; 19: 911–916CrossRefGoogle ScholarPubMed
Beisecker, A.Beisecker, T.Patient information-seeking behaviours when communicating with doctors. Medical Care 1990; 28: 19–28CrossRefGoogle ScholarPubMed
British Medical Association. Communication skills education for doctors: a discussion paper. London: British Medical Association; 2003.Google Scholar
Castonguay, L.G.Constantino, M.J.Grosse Holtforth, M.The working alliance: where are we and where should we go? Psychotherapy Theory Research Practice Training 2006; 43: 271–279CrossRefGoogle Scholar
Chadwick, P.Person – Based cognitive therapy for distressing psychosis. Chichester: John Wiley & Sons: 2006CrossRefGoogle Scholar
Charles, C.Gafni, A.Whealan, T.Shared decision making in medical encounter: what does it mean? (Or, it takes two to tango). Soc Sci Med 1997; 44: 681–692CrossRefGoogle ScholarPubMed
Deber, R.Physicians in health care management: the patient-physician relationship. Changing roles and the desire for information. Can Med Assoc 263 1992 441Google Scholar
Fallowfield, L.Hall, L.Maguire, G.P.Baum, M.Psychological outcomes in women with early breast cancer. BMJ 301 1990 1394CrossRefGoogle ScholarPubMed
Farber, B.A.Lane, J.S.Positive Regard. Psychotherapy Theory Practice Training 2001; 38: 390–395CrossRefGoogle Scholar
Frank, A.F.Gunderson, J.G.The role of therapeutic alliance in treatment of schizophrenia. Arch Gen Psychiatry 1990; 47: 228–236CrossRefGoogle ScholarPubMed
Freeth, R.Humanizing Psychiatry and Mental Health Care. Abingdon: Radcliffe Medical Press: 2007Google Scholar
Geller, J.Self-disclosure in psychoanalytic-existential therapy. J Clin Psychol 2003; 59: 541–554CrossRefGoogle ScholarPubMed
Goonsen, A.Zijistra, P.Koopmanschap, M.Measuring shared-decision making processes in psychiatry; skills versus patient satisfaction. Pat Educ Couns 2007; 67: 50–56CrossRefGoogle Scholar
Goss, C.Moretti, F.Mazzi, M.A.Del Piccolo, L.Rimondini, M.Zimmermann, C.Involving patients in decisions during psychiatric consultations. Br J Psychiatry 2008; 193: 416–421CrossRefGoogle ScholarPubMed
Gray, R.E.Doan, B.D.Church, K.E.Empowerment and persons with cancer. Politics in cancer medicine. J Palliat Care 1990; 6: 33–45CrossRefGoogle ScholarPubMed
Greenberg, J.Self-disclosure: Is it psychoanalytic? Contem Psychoanal 1995; 31: 193–205CrossRefGoogle Scholar
Hall, J.A.Dornan, M.C.What patients like about their medical care and how often they are asked: a meta analysis of the satisfaction literature. Soc Sci Med 1988; 27: 935–939CrossRefGoogle ScholarPubMed
Hamann, J.Cohen, R.Leucht, S.et al.Shared decision making and long term outcome in schizophrenia. J Clin Psychol 2007; 68: 962–997Google Scholar
Hamann, J.Mendel, R.T.Fink, B.Pfeiffer, H.Cohen, R.Kissling, W.Patients’ and psychiatrists’ perceptions of clinical decisions during schizophrenia treatment. J Nerv Ment Dis 2008; 196: 329–332CrossRefGoogle ScholarPubMed
Hanson, J.Should your lips be zipped? How therapist self-disclosure and non-disclosure affects clients. Couns Psychoth Research 2005; 5: 96–104CrossRefGoogle Scholar
Hansson, L.Berguld, M.Stability of therapeutic alliance and its relationship to outcome in short-term inpatient psychiatric care. Scand J Psychol 1992; 20: 45–50Google ScholarPubMed
Jaspers, K.General Psychopathology 1 Baltimore:Johns Hopkins Press; 1998Google Scholar
Kaplan, S.A.Greenfield, S.Ware, J.E.Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care 27Suppl 31989 S1 10–27CrossRefGoogle ScholarPubMed
Knight, Z.G.Conceptual considerations regarding self-disclosure: a relational psychoanalytic perspective. South African J Psychiatry 2009; 3: 75–85CrossRefGoogle Scholar
Laugharne, R.Priebe, S.Trust, choice and power in mental health: a literature review. Soc Psychiatry Psychiatr Epidemiol 2006; 41: 843–852CrossRefGoogle ScholarPubMed
Laugharne, RMcCabe, RPriebe, S. Trust, choice and power in mental health care: experiences of patients with psychosis. International Journal of Social Psychiatry [in press].Google Scholar
Lazarus, A.A.Clinical therapeutic effectiveness.Zeig, J.The Evolution of Psychotherapy New York:Brunel/Mazel; 1992Google Scholar
Levine, M.N.Gafni, A.Markham, B.A.et al.A bedside decision instrument to elicit patient preferences concerning adjuvant chemotherapy for breast cancer. Ann Intern Med 117 1992 53CrossRefGoogle ScholarPubMed
Levinson, W.Roter, D.L.Mullooly, J.P.Dull, V.T.Frankel, R.M.Physician – patient communication. The relationship with malpractice claims among physicians and surgeon. JAMA 1997; 277: 531–535CrossRefGoogle Scholar
Lilford, R.J.Richardson, A.Stevens, A.Fitzpatrick, R.Edwards, S.Rock, F.et al.Issues in methodological research: perspectives from researchers and commissioners. Health Technol Assess 5 2001 8CrossRefGoogle ScholarPubMed
Little, P.Everitt, H.Williamson, I.et al.Preferences of patients for patient centred approach to consultation in primary care: observational study. BMJ 2001; 322: 468–472CrossRefGoogle ScholarPubMed
Maguire, P.Piceathly, C.Key communication skills and how to acquire them. BMJ 2002; 325: 697–700CrossRefGoogle Scholar
McCabe, R.Heath, C.Burns, T.Priebe, S.Engagement of patients with psychosis in the medical consultation. A conversation analytic study. Br Med J 2002; 325: 1148–1151CrossRefGoogle Scholar
McCabe, R.Priebe, S.The therapeutic relationship in the treatment of severe mental illness: a review of methods and findings. Inter J Soc Psychiatry 2004; 50: 115–128CrossRefGoogle ScholarPubMed
McGuire, R.McCabe, R.Priebe, S.Theoretical frameworks for understanding and investigating the therapeutic relationship in psychiatry. Soc Psychiatry Psychiatr Epidemiol 2001; 36: 557–564CrossRefGoogle Scholar
McGuire-Snieckus, R.McCabe, R.Catty, J.Hansson, L.Priebe, S.A scale to assess the therapeutic relationship in community mental health care: STAR. Psychol Med 2007; 37: 85–96CrossRefGoogle ScholarPubMed
Mitchell, S.A.Hope and dread in psychoanalysis. New York: Basic Books: 1993Google Scholar
Orlinsky, D.E.Grawe, K.Parks, B.K.Bergin, A.E.Garfield, S.L.Process and outcome in psychotherapy: Noch einmal. Handbook of psychotherapy and behavior change Oxford:John Wiley & Sons; 1994Google Scholar
Power, M.Brewin, C.R.The transformation of the meaning in psychological therapies. Chichester: John Wiley & Sons: 1997Google Scholar
Priebe, S.Gruyters, T.Patients’ assessment of treatment predicting outcome. Schizophr Bull 1995; 21: 87–94CrossRefGoogle ScholarPubMed
Priebe, S.McCabe, R.Bullenkamp, J.Hansson, L.Lauber, C.Martinez-Leal, R.et al.Structured patient-clinician communication and 1-year outcome in community mental healthcare. Cluster randomized controlled trial. Br J Psychiatry 2007; 191: 420–426CrossRefGoogle Scholar
Rachman, A.W.Judicious self-disclosure by the psychiatrist. Inter Forum Psychonal 1998; 7: 263–269CrossRefGoogle Scholar
Roberts, J.Transparency and self-disclosure in family therapy: dangers and possibilities. Fam Process 2005; 44: 45–63CrossRefGoogle ScholarPubMed
Rogers, C. A client-centered/person centered approach to therapy. In: The Carl Rogers reader. Constable; 1990.Google Scholar
Rogers, C.The necessary and sufficient conditions of therapeutic personality change. J Consult Psychology 2121957 95–103CrossRefGoogle ScholarPubMed
Roter, D.L.Stewart, M.Putnam, S.M.Lipkin, M. Jr.Stiles, W.Inui, T.S.Communication patterns of primary care physicians. JAMA 1997; 277: 350–356CrossRefGoogle ScholarPubMed
Silverman, J.Kurtz, S.Draper, J.Skills for communicating with the patients. Abingdon: Radcliffe Publishing: 1998Google Scholar
Silverman, J.Kurtz, S.Draper, J.Skills for communicating with the patients. Oxford: Radcliffe Publishing: 2005Google Scholar
Simpson, M.Buckman, R.Stewart, M.Maguire, P.Lipkin, M.Novack, D.et al.Doctor-patient communication: the Toronto consensus statement. BMJ 1993; 303: 1385–1387CrossRefGoogle Scholar
Siverstein, M.D.Stockling, C.B.Antel, J.P.et al.Amyothrophic lateral sclerosis and life sustaining therapy: Patients’ desire for information, participation in decision-making and life sustain therapy. Mayo Clinic Proc 66 1991 906CrossRefGoogle Scholar
Skelton, J.R.Everything you were afraid to ask about communication skills. Br J Gen Pract 2005; 55: 40–46Google ScholarPubMed
Starfield, B.Wray, C.Hess, K.et al.The influence of patient-practitioner agreement on outcome of care. Am J Public Health 1981; 71: 127–132CrossRefGoogle ScholarPubMed
Stark, F.M.Siol, T.Expressed emotion in the therapeutic relationship with schizophrenic patients. Eur Psychiatry 1994; 9: 299–303Google Scholar
Stewart, M.Towards global definition of patient – centered care. Br Med J 1994; 322: 444–445CrossRefGoogle Scholar
Stewart, M.A.Effective physician-patient communication on health care outcomes: a review. Can Med Assoc J 1996; 152: 1423–1433Google Scholar
Strull, W.M.Lo, B.Charles, G.Do patients want to participate in medical decision making? J Am Med Assoc 1984; 252: 2990–2994CrossRefGoogle ScholarPubMed
Swanson, K.A.Bastani, R.Rubinstein, L.V.et al.Effect on mental health care and shared decision making in a community sample of patients with depression. Med Care Research Rev 2007; 64: 416–430CrossRefGoogle Scholar
Tuckett, D.Boulton, M.Olsen, C.Williams, A.Meetings between experts. London: Tavistock: 1986Google Scholar
Van Os, J.Altamura, C.Bobes, J.Gerlad, J.Helwell, J.Kasper, S.Evaluation of the Two-Way Communication Checklist as a clinical intervention. Br J Psychiatry 2004; 184: 79–83CrossRefGoogle ScholarPubMed
Von Fragstein, M.Silverman, J.Cushing, A.Quilligans, S.Salisbury, H.Wiskin, C.UK consensus statement on the content of communication curricula in undergraduate medical education. Med Educ 2008; 42: 1100–1107CrossRefGoogle ScholarPubMed
Wampold, B.E.The great psychotherapy debate: models, methods and findings. Mahwah, NJ: Lawrence Erlbaum Associates: 2001Google Scholar
Weiss, M.Gaston, L.Propst, A.Wisebrod, S.Zicherman, V.The role of alliance in the pharmacologic treatment of depression. J Clin Psychol 1997; 58: 196–204Google ScholarPubMed
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