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Behavioural Sciences Intro

This document discusses behavioral sciences and introduces several healthcare models including the bio-psycho-social model. It covers topics like psychology, neuroscience, communication skills, counseling, and social/psychological reactions in doctor-patient relationships. The bio-psycho-social model considers biological, psychological, and social factors in disease. Effective communication includes active listening while counseling helps patients make their own decisions through developing understanding and coping skills. Social bonding, dependence, transference, and resistance are some psychological reactions that can occur between doctors and patients.

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37 views31 pages

Behavioural Sciences Intro

This document discusses behavioral sciences and introduces several healthcare models including the bio-psycho-social model. It covers topics like psychology, neuroscience, communication skills, counseling, and social/psychological reactions in doctor-patient relationships. The bio-psycho-social model considers biological, psychological, and social factors in disease. Effective communication includes active listening while counseling helps patients make their own decisions through developing understanding and coping skills. Social bonding, dependence, transference, and resistance are some psychological reactions that can occur between doctors and patients.

Uploaded by

Dodo Junior
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Behavioural Sciences

Dr. Rana M. Arslan PT


DPT (UHS, Lahore)
Ex. House Officer
Ibn-e-Siena Hospital, Multan
Introduction to Behavioural Sciences

 Holistic vs. Traditional Allopathic Medicine


 Healthcare Models and their Clinical Applications
1. Bio-Psycho-Social Model
2. Integrated Model of Health Care
3. Public Health Care Model
Behavioral Science

 Study of human behavior through integrated knowledge of:


Psychology
Neuroscience
Sociology
Anthropology
Psychology & Neuroscience

 Study of human mind and roles played by its various functions, like:
Emotions (strong feeling developed from one’s circumstances)
Thoughts (idea or opinion produced by mind)
Cognitions (mental process of getting knowledge/understanding from thought/experience,
senses)
Motivations (process that starts, guides, or maintain goal-oriented behaviors)
Perceptions (organize, understand, interpret the sensory information)
Intelligence (higher level abilities, problem solving, mental representation)
Development of personality (lasting patterns of behaviors)
Holistic Medicine ( 2+2=5)

 Mind
 Body
 Spirt
Holism ( all living matter is made up of unified wholes that are greater than the
sum of their parts)
Traditional Allopathic Medicine

 Only deals with the diseased part of the human being while holistic medicine
understand the following:
 Person (well integrated elements of mind, body, spirit held in a dynamic balance)
 Environment (external factors that influence health/disease)
 Health (dynamic state of well-being)
 Physician ( a person who supports health)
Characteristics of a Physician

 Belief in the healing act


 Capacity to listen & empathies (difference b/w sympathy & empathy)
 Respect for the dignity of humans
 Tolerance for difference of opinion
 A gentle spirit
 Ability to mix creative thinking and intuition with scientific thoughts
 Will never give up
BIO-PSYCHO-SOCIAL MODEL (George Engel 1977)

 Biological
 Psychological
 Social
Based on:
1. Disease has multiple factors (not biology only)
2. Individual is complexed, have loopholes
3. BPS factors are the determinants of a disease
Clinical Applications of BPS Model

 A patient of dengue fever (poor disposal of water, bad dressing)


 HIV-AIDS, Hepatitis (risk taking behavior, poor protection strategies)
 Heart disease, diabetes mellitus, cancer, depression (has social factors)
 Lifestyle disorders
 Road traffic accidents due to drug and alcohol abuse
Case Scenario

 Hamid & Hassan


 Eustress
Integrated model of health care

 Dynamic function between:


1. Biological
2. Cognitive
3. Behavioral
4. Sociocultural
5. Environmental
Allostasis & Homeostasis

 Negative feedback loops (homeostasis)


 Predicting and adopting (allostasis)
 Stress is considered necessary
 Distress (earliest unpleased state)
 Sickness ( feeling of being sick)
 Sick role (pretending to be sick)
 Illness (when society accept that you are ill)
 (diagnosis on the base of symptoms)
Stress performance curve
Public health care model

 Treatment at primary care level


 Prevention
 Promotion of health
 Basic health units
 Rural health centers
 Health tips/advertisements
Non-pharmacological Interventions

 Enhance patient satisfaction


 Improve adherence to treatment (compliance)
 Strengthen patient doctor trust bond
1. Communication skills:
 It is important to know patient’s language, avoid medical jargon
 Jargon vs lingo
Effective communication tools

1. Attending and listening


2. Active listening (linguistic/paralinguistic aspects, non-verbal cues, respect
pauses)
3. Verbal techniques (questions, open ended, close ended, leading, funneling,
paraphrasing, selective reflection, empathy building, checking for
understanding)
Factors that obstruct communications

 Lack of exclusivity
 Preoccupied health professional
 Uncomfortable seating
 Lack of attention
 Offensive remarks/ judgements
 Frequent interruptions
 Selective listening
 Day dreaming/dosing off
2. Counselling

 Technique aims to help people help themselves by the development of


therapeutic relationship between the counsellor and the person seeking counsel.
 The process aims at helping a person achieve a greater depth of understanding
and clarification of the problem. This will also mobilizes the personal coping
abilities.
 It is not casual or ordinary opinion of another person.
 It is a limited supportive activity aimed at developing a person’s ability to decide
upon and initiate a constructive change.
Scenarios in which counselling skills can be used:

 Breaking bad news


 Resolving professional conflicts
A counselling session aims to:
 Establish a relationship of mutual trust and care (person feels secure and express)
 Gives chance to seek clarification
 Provides opportunity to express feelings/emotions
 Provide reassurance (action of removing doubts/fears)
 Achieve a deeper and clearer understanding of health related issues based on
evidence.
 Identify various choices along sides pros and cons via discussion.
 Help a person to make a decision suitable for him/her.
 Seek support of the counsellor.
 Mobilize resources required to implement the solution.
 Learn the skills to cope with the issue.
Traits of a counsellor:

 Unconditional positive regard (non-judgmental)


 Empathic understanding
 Warmth and consideration (open minded)
 Clarity
 Here and now thinking (to the point)
Counselling Don’ts:

 Do not use “why” or “should”


 Do not blame the patient
 Do not compare the experiences of the patient with your own
 Do not invalidate the patient’s feelings
Misconceptions about counselling:

 Does not involve giving direct advices


 Does not solve people’s problem for them
 Does nor challenge patient’s feelings and perceptions
 Does not impose counsellor’s own views
 Does not make people less emotional
 Does not work to fulfil counsellor’s need to make people feel better
Psychological reactions in Doctor-Patient relationship

 Primary expectations of the patients is empathy, acceptance, and non-judgment


 Patient also expect their doctor to be their active partner in care
 In Pakistan a doctor is always considered a best person who can take all decisions
on your behalf
 This can leads to feelings of sympathy, over-indentification with patients,
isolation or distancing from the patient
 Both reactions can make relationship complicated or turn them towards
unprofessionalism
Different social & psychological reactions are:

 Social bonding
 Dependence
 Transference
 Counter-transference
 Resistance
 Physician burn-out
 All these reactions can occur in patient as well as in doctor without
consciousness!
Social bonding

Pakistan’s mix culture


Islamic and Arabic culture
Resemblance of modern doctor with British raj
Political affiliations and VIP culture
All of these undermine professionalism and medical ethics
Befriending with patients on social media (Good Morning texts :D)
Treatment become less therapeutic and more social!
That can lead to transference and counter trancefrence
Dependence

 Doctors are asked to take difficult private decisions of the patients


 This can lead to counter productive results
 A dependent patient may cost more and can waste time and energy of the doctor
 Then they may translate their dependence in anger towards the healthcare
professional
 A good doctor can detect this reaction and can refer this to another health care
professional
Transference

 Patient can link their feelings and associations towards the doctor with a
significate figure of their own’s life
 They can demand more time of their favorite doctor and even demand their
personal numbers(especially nurses)
 Transference can be negative of positive
 Patient can show rudeness or anger towards a specific doctor without any
obvious reaseons
Counter transference

 Doctors feelings or extra care towards patients as they remind him/her of their
loved one! (stoke patient who resembles doctors father)
 Can be negative or positive
 Can jeopardies professional duties
Resistance

 Denial
 Displacement
Doctor’s burnout

 Depression
 Frequent job changes
 Outbursts
 Drug use
 Smoking
 Alcohol

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