Milton Viederman | PubMed Health

PubMed2006

The therapeutic consultation: finding the patient.

The psychiatric consultation has not been adequately exploited as a therapeutic device. Although, the original abstinent model for psychodynamic psychotherapy has become more flexible, passive listening with interventions to elicit diagnostic "data" remains the prevailing mode in psychiatric consultation. In this paper I develop the idea of the consultation as an active process (Viederman, M., 2002) that engages the patient emotionally for therapeutic effect.

Communication↗

PubMedDate not supplied

Active engagement in the consultation process.

This paper presents a case for the active, dynamic engagement of patients during consultations. Observations and hypotheses about the patient's predominant conflicts are used to formulate interventions early in the consultation process that are designed to convey meanings that make the patient's experience comprehensible to him. This includes attention to his personality and his world view. The activity of the consultant in appropriately communicating aspects of these formulations to the patient is designed to facilitate the process of self-revelation and to permit a co-construction with the patient of a perspective on aspects of his life experience and his current problems. Active, dynamic engagement leads to the development of a bond between consultant and patient that facilitates the implementation of a treatment plan. Numerous case descriptions are included to illustrate this active approach as applied in different contexts.

Humans↗