Readiness to Start Treatment and Obstacles to Adherence

2017 ◽  
Author(s):  
Benjamin Tolchin ◽  
Gaston Baslet
Keyword(s):  
Integrated Treatment ◽  
Mental Health Providers ◽  
Treatment Team ◽  
Health Providers ◽  
Related Factors ◽  
Psychogenic Nonepileptic Seizures ◽  
Patient Dropout ◽  
Systemic Factors ◽  
Nonepileptic Seizures ◽  
Three Stages

Effective evidence-based psychotherapeutic regimens for psychogenic nonepileptic seizures (PNES) are available, but several obstacles still contribute to poor adherence to treatment. This chapter reviews the three stages at which patient dropout tends to occur in clinical practice and in studies. Patient-related, provider-related, and systemic causes of nonadherence are reviewed. Patient-related factors include a failure to accept or understand the diagnosis, psychiatric comorbidities, and ambivalence about change. Provider-related and systemic factors include a shortage of behavioral health specialists, gaps in care between neurologists and mental health providers, a lack of familiarity with the disorder, and stigmatization of patients. The chapter concludes with a review of potential interventions to address obstacles to treatment, including an integrated treatment team with joint presentation of the diagnosis, rapid and streamlined transition into psychotherapy, motivational interviewing, and engagement of patients’ family members and support systems.

scholarly journals Addressing Adherence to Treatment: A Longstanding Concern. The Patients’ Perspective

2014 ◽  
Vol 4 (3) ◽  
pp. 27-28
Author(s):  
Mahmoud Hadipour Dehshal
Keyword(s):  
Health Care ◽  
Care Delivery ◽  
Working Hours ◽  
Well Being ◽  
Point Of View ◽  
Inherited Disease ◽  
Treatment Team ◽  
Health Providers ◽  
Adherence To Treatment ◽  
Related Factors

Adherence to treatment is a great concern for patients who need long-life treatment. Thalassaemia is an inherited disease for whose treatment team-working is of a considerable importance. To logically face the problem of poor compliance patients, all members of the team ought to be aware of the causing factors and the ways to handle the problem. The factors which cause the lack of compliance among patients could be stratified into economic and structural facto. Furthermore, patient-related factors including ethnicity, gender, age, and regimen complexity such as dosing are also noteworthy. The supportive relationship between the health providers and the patients should be also established such as patients’ trust in their doctors. Last but not least, the pattern of health care delivery including the availability of health care requisites and operation of flexible hours and floating working hours. From the patients’ point of view, it is important to be aware of the significance of the adherence to treatment and the importance of providing prompt-routine reminders to patients to understand the consequence of incomplete treatment. Trained and motivated staffs play an effective role to enhance patients’ tendency to pursue the determined treatment. Health decision makers would be better to reinterpret the concept of health to “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. The patients’ role in self-management should not be ignored and “medicalization” has to be altered by the patient centered care.

Stress Incidence and Appraisal in Patients With Psychogenic Nonepileptic Seizures

2008 ◽  
Author(s):  
Mollie R. Sprung ◽  
S. Marc Testa ◽  
Gregory L. Krauss ◽  
Ronald P. Lesser ◽  
Jung Geum Im ◽  
...  
Keyword(s):  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures

Development of a Scale to Assess Mental Health Providers' Mindfulness in Session

2013 ◽  
Author(s):  
Jill Calderon ◽  
Paul E. Hagan ◽  
Jennifer A. Munch ◽  
Crystal Rofkahr ◽  
Sinead Unsworth ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Providers ◽  
Health Providers

Addressing COVID-19 Worry and Social Isolation in Home-Based Primary Care

2020 ◽  
Author(s):  
Rachel Elizabeth Weiskittle ◽  
Michelle Mlinac ◽  
LICSW Nicole Downing
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Social Workers ◽  
Social Isolation ◽  
Mental Health Providers ◽  
Health Providers ◽  
Home Based Primary Care ◽  
Home Based ◽  
Socially Isolated

Social distancing measures following the outbreak of COVID-19 have led to a rapid shift to virtual and telephone care. Social workers and mental health providers in VA home-based primary care (HBPC) teams face challenges providing psychosocial support to their homebound, medically complex, socially isolated patient population who are high risk for poor health outcomes related to COVID-19. We developed and disseminated an 8-week telephone or virtual group intervention for front-line HBPC social workers and mental health providers to use with socially isolated, medically complex older adults. The intervention draws on skills from evidence-based psychotherapies for older adults including Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, and Problem-Solving Therapy. The manual was disseminated to VA HBPC clinicians and geriatrics providers across the United States in March 2020 for expeditious implementation. Eighteen HBPC teams and three VA Primary Care teams reported immediate delivery of a local virtual or telephone group using the manual. In this paper we describe the manual’s development and clinical recommendations for its application across geriatric care settings. Future evaluation will identify ways to meet longer-term social isolation and evolving mental health needs for this patient population as the pandemic continues.

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