@article{ref1,
title="Negative stance towards treatment in psychosocial assessments: The role of personalised recommendations in promoting acceptance",
journal="Social science and medicine (1982)",
year="2021",
author="Bergen, Clara and McCabe, Rose",
volume="290",
number="",
pages="e114082-e114082",
abstract="People presenting to the emergency department with self-harm or thoughts of suicide undergo a psychosocial assessment involving recommendations for e.g. contact with other practitioners, charity helplines or coping strategies. In these assessments, patients frequently adopt a negative stance towards potential recommendations. Analysing 35 video-recorded liaison psychiatry psychosocial assessments from an emergency department in England (2018-2019), we ask how these practitioners transform this negative stance into acceptance. We show that practitioners use three steps to anticipate and address negative stance (1) asking questions about the patient's experience/understanding that help the patient to articulate a negative stance (e.g., &quot;what do you think about that&quot;); (2) accepting or validating the reasons underlying the negative stance (e.g., &quot;that's a very real fear and thought to have&quot;); and (3) showing the patient that their reasons were incorporated in the recommendation (e.g., &quot;it's telephone support if you're a bit more uncomfortable with face to face&quot;). These steps personalise the recommendation based on the patient's specific experiences and understanding. When practitioners followed all three of these steps, the patient moved from a negative stance to acceptance in 84% of cases. When practitioners made a recommendation but did not follow all three steps, the patient moved from a negative stance to acceptance in only 14% of cases. It is not the case that each communication practice works on its own to promote patient acceptance, rather Steps 1 and 2 build on each other sequentially to develop and demonstrate shared understanding of the patient's negative stance. In this way, acceptance and validation play an indispensable role in addressing a patient's concerns about treatment.<p /><p>Language: en</p>",
language="en",
issn="0277-9536",
doi="10.1016/j.socscimed.2021.114082",
url="http://dx.doi.org/10.1016/j.socscimed.2021.114082"
}