Phenomenological Psychopathology and Clinical Decision-Making

2018 ◽  
pp. 1030-1041
Author(s):  
Eduardo Iacoponi ◽  
Harvey Wickham
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Public Mental Health ◽  
Clinical Decision ◽  
Phenomenological Approach ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Clinical Encounters ◽  
Phenomenological Psychiatry ◽  
Phenomenological Psychopathology

This chapter examines how the phenomenological approach to psychopathology contributes to clinical decision making in psychiatry. It first considers competing forces in psychiatric clinical decision making, focusing in particular on the barriers that patients face in their search for a clinician to make their stories real. It then discusses factors that have contributed to the decline of phenomenological psychopathology, including the increase in importance of diagnostic classifications in psychiatry such as the Diagnostic and Statistical Manual, 3rd edition (American Psychiatric Association 1980); changes in the delivery of public mental health services; and increased attention to risk assessment for severe mental illness. It also describes clinical encounters with two patients that illustrate how phenomenological psychiatry can still contribute to sound clinical decision making.

Introduction

2018 ◽  
Author(s):  
John R. Peteet ◽  
Mary Lynn Dell ◽  
Wai Lun Alan Fung
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Ethics Committees ◽  
Clinical Decision ◽  
Cultural Formulation ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Religious Professionals ◽  
The Relationship

Historical tensions between psychiatry and religion continue to hinder dialogue and restrict consensus on how to approach areas of overlap in clinical decision making. In Part One, contributors to this volume discuss concerns arising in the general areas of values, religious and psychiatric ethics, diagnosis and treatment, and the work of religious professionals and ethics committees. In Part Two, chapter authors consider these issues as they arise within various subspecialties of psychiatric practice, often using the Jonsen Four Topics (or Four Quadrants) Model. The theme of the relationship between religion and culture runs throughout and is addressed more directly than in the Outline for Cultural Formulation in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

scholarly journals Correction to: Using behavioral insights to design implementation strategies in public mental health settings: a qualitative study of clinical decision-making

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Briana S. Last ◽  
Simone H. Schriger ◽  
Carter E. Timon ◽  
Hannah E. Frank ◽  
Alison M. Buttenheim ◽  
...  
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Qualitative Study ◽  
Clinical Decision Making ◽  
Public Mental Health ◽  
Implementation Strategies ◽  
Clinical Decision ◽  
Mental Health Settings

An amendment to this paper has been published and can be accessed via the original article.

scholarly journals A values-based phenomenology for substance use disorder: a new approach for clinical decision-making

2021 ◽  
Vol 38 ◽  
Author(s):  
Guilherme MESSAS ◽  
Kenneth FULFORD
Keyword(s):  
Decision Making ◽  
Substance Use ◽  
Cultural Values ◽  
Substance Use Disorders ◽  
Clinical Decision Making ◽  
Clinical Care ◽  
Clinical Decision ◽  
New Approach ◽  
Mental Health Treatments ◽  
Phenomenological Psychopathology

Abstract Phenomenological psychopathology has been defined as a human science that is concerned with the object on which clinical psychology and psychiatry act. How psychopathological experiences are understood is an important factor determining decision-making in clinical care. An accurate understanding of psychopathology is fundamental to the effectiveness of mental health treatments. This is even more important in a field such as substance use disorders in which social and cultural values influence both diagnosis and decision-making. In this article, we offer a contribution to clinical decision-making in substance use disorders by suggesting the association of Phenomenological Psychopathology and Values-Based Practice, constituting a Values-based Phenomenology We present a fictitious clinical case (to preserve confidentiality), illustrating a three-step practical application of Values-based Phenomenology. We conclude that although still a nascent discipline, Values-based Phenomenology offers a promising approach to reducing the gap between services and patients’ needs in clinical decision-making, and thus to improving clinical care in substance use disorders.

scholarly journals Who knows best? Negotiations of knowledge in clinical decision making

2015 ◽  
Author(s):  
Charlotte Bredahl Jacobsen ◽  
Helle Max Martin ◽  
Vibe Hjelholt Baker
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Health Professionals ◽  
Patient Involvement ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Shared Decision ◽  
Structured Interviews ◽  
Knowledge Domains ◽  
Clinical Encounters

 This article examines the conflicts which arise when patients with chronic disease engage in decision making with health professionals about their medication. These are conflicts in the sense of discrepancies or incompatibilities between perceptions or opinions of different people engaged in a common endeavour. The paper is based on three qualitative research studies and presents one case from each study to illustrate analytical findings. Data collected in the original studies consisted of observations of clinical encounters and semi-structured interviews; in total 45 interviews with patients and 23 with health professionals. The analysis shows different conflicts, which arise during the process of making decisions about medication. These conflicts arise when: 1) Patients deliberately hold back information about their medication for fear of challenging clinicians’ authority; 2) The decision making process takes place in an environment, which does not support patient involvement; and 3) Patients refer to pharmacological knowledge, but are considered ill-equipped to understand and apply this knowledge by health professionals. The article shows that these conflicts typically revolve around the legitimate access to and use of pharmacological knowledge. These results have important implications for the current discussions of shared decision making. In shared decision making, knowledge about medication is typically regarded as the domain of the doctor. We argue that there is a need for a widening of the concept of partnership, which is central to shared decision making, to encompass breadth of patient knowledge about his/her situation, disease and treatment. Patients with chronic diseases need to be actively invited to disclose the extensive clinical knowledge they acquire over time, thereby creating a legitimate space for this knowledge in clinical consultations, and avoiding that conflicts over knowledge domains lead to unnecessary suffering and wasted resources.

scholarly journals Understanding the Lived Experiences of Patients: Application of a Phenomenological Approach to Ethics

2010 ◽  
Vol 90 (8) ◽  
pp. 1185-1197 ◽  
Author(s):  
Bruce H. Greenfield ◽  
Gail M. Jensen
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Clinical Decision Making ◽  
Ethical Decision Making ◽  
Clinical Decision ◽  
Phenomenological Approach ◽  
Phenomenological Inquiry ◽  
Ethical Decisions ◽  
Moral Context ◽  
The Everyday

This perspective article provides a justification, with an overview, of the use of phenomenological inquiry and the interpretation into the everyday ethical concerns of patients with disabilities. Disability is explored as a transformative process that involves physical, cognitive, and moral changes. This perspective article discusses the advantages of phenomenology to supplement and enhance the principlist process of ethical decision making that guides much of contemporary medical practice, including physical therapy. A phenomenological approach provides a more contextual approach to ethical decision making through probing, uncovering, and interpreting the meanings of “stories” of patients. This approach, in turn, provides for a more coherent and genuine application of ethical principles within the “textured life-world” of patients and their evolving values as they grapple with disability to make ethical and clinical decisions. The article begins with an in-depth discussion of the current literature about the phenomenology of people with disability. This literature review is followed by a discussion of the traditional principlist approach to making ethical decisions, which, in turn, is followed by a discussion of phenomenology and its tools for use in clinical inquiry and interpretation of the experiences of patients with disabilities. A specific case is presented that illustrates specific tools of phenomenology to uncover the moral context of disability from the perspective of patients. The article concludes with a discussion of clinical, educational, and research implications of a phenomenological approach to ethics and clinical decision making.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

Sign in / Sign up

Export Citation Format

Share Document