Complementary
and alternative medicine (CAM) has struggled in the minds of some to earn credibility,
although studies have demonstrated a high level of effectiveness (Freeman,
2009). However, in some cases, physicians have begun
to notice these positive studies, and have even used alternative medical
practices for their own health in addition to referring patients for similar
treatments.
Many CAM centers have developed referral relationships with a number of doctors in their areas. These relationships are based on a
professional understanding that the centers will screen potential patients very
carefully. The goal is to ensure that
patients who begin with the CAM programs have a high potential for success. Below is an example of the type of questions
that CAM centers may use for entrance assessment from referrals.
Questionnaire
Although potential patients may be referred to a CAM center from other physicians, and the centers can request the patient’s records from the other offices, most prefer to gather their own patient history. This helps to validate the
information from the other office, and also helps the patient to feel that the office is professional and thorough (Lichstein, 1990).
After
the initial medical history, the first portion of the provider interview
includes introductions. This helps to
facilitate positive first impressions for the patient and the caregiver as well
(Whitehead, Noller, & Sheehan, 2008). For example, a hypnotherapist would courteously introduce themselves,
ensure that the patient is comfortable, and then ask the patient what brought
them to the center, other than their physician’s recommendation, in order to
hear the patient's situation in their own words (Lichstein, 1990).
The next
questions will depend somewhat on the response of the patient to the first
question. However, the caregiver will try
to ensure his or her own full understanding of the issues that the patient is
struggling against. These questions
would expand on the statements from the patient, and could include questions
such as, “when did this start?” and “Was there any kind of precursor to the
issue?” (Lichstein, 1990). Other
questions would include any family history of similar issues, and if there were
any diet or other lifestyle changes that could possibly cause some form of an
allergic reaction.
Once a
comprehensive medical and family history is completed, and the hypnotherapist
has a thorough understanding of the issue or issues, the questions will begin
to move into the area of alternative medicine.
One initial question in this direction could be to ask the patient for
their thoughts concerning alternative medicine and specifically hypnosis.
If the
patient needed further leading for their thoughts on alternative medicine, the
caregiver could specifically ask them if there was any reason other than their
doctor’s recommendation that caused them to consider alternative medicine
(Caspi, Koithan, & Criddle, 2004). Additional
questions could be asked in order to determine the true level of understanding
and commitment of the patient to the effectiveness of alternative medicine. For example, the hypnotherapist could ask what
other treatment options the patient has tried or considered and if they have
done any of their own study or research concerning alternative medicine and specifically
hypnosis (Caspi, et al, 2004).
With these
general questions covered, the hypnotherapist would then gather information
specific to hypnosis. These questions
would include the patient’s thoughts concerning hypnosis and help determine their
hypnotizability. An initial question in
this direction might be to ask what the patient’s expectations are concerning
hypnosis (Caspi, et al, 2004). Depending
on the response to the questions up to this point the hypnotherapist would
begin to ask questions such as, “do you often daydream?” (Stojakovich, 2009). These questions are designed to determine if
the client is a strong candidate for hypnosis.
Additional questions could be, “does it almost seem like you
re-experience emotions when looking at some photographs?” (Stojakovich, 2009),
and, “have you ever been traveling and got caught up in conversation and lost
track of time, even if the trip takes hours? (IMDHA, n.d.).
With these questions covered, the hypnotherapist can make
a reasoned recommendation for the client.
The rationale should be discussed in order to confirm that everyone is
in agreement.
Conclusion
Asking
open-ended questions, and using active listening are key skills in the art of
medical interviews (Lichstein, 1990).
Helping caregivers to assess their patients, and helping patients to
assess the treatment options available to them within the same conversation can
be a challenge, and yet, especially in the initial consultation, the first
impressions created for both parties can have lasting effects (Whitehead, et al, 2008).
Due to
some of the recent history concerning complementary and alternative medicine,
clinical interviews may be even more important.
Providers have this opportunity to plant a seed for a positive impression
toward alternative care options even with patients who choose to decline the
offer of treatment.
References
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