C M E: Counselling
NATIONAL JOURNAL OF HOMOEOPATHY 1997 Jan / Feb VOL VI NO 1.
Dr C H Asrani
Most doctors, without training, feel Counselling is --- giving advice (as in: to counsel).
Nothing can be farther from truth. Counselling (professional that is) 'stimulates people to use and exploit, their inner, personal resources to overcome psychological problems & attain psychological maturity.'
We know that most of us use only a small percentage of our potential. How often we say 'I treat most of my patient, without really thinking. Only about 20% are worthy of pondering over a prescription.' Same is true for our patient too. Personal Counsellling is a technique, where the professional counselor stimulates the people (patients) to use their potential more & more. This is done by adopting certain attitudes and skills, they have mastered.
Who should Counsel?
Ideally this should be left to the Professional Counsellor, but facing the reservations patients have in India about going to a psychiatrist, it is mandatory that every practicing physician have some working knowledge of Counselling.
What is Counselling, but correcting 'ATTITUDES'. An attitude is a habitual way of thinking or a firm mental belief. (E.g. All practisioners of all alternative sciences feel that theirs is the only Holistic science). One's attitude stays and influences one's behaviour. So it is important that the attitude of the treating physician should also be right.
The most important attitude that a physician must have is EMPATHY - ability to think from other man's viewpoint or to feel other man's pain in your heart. Till we can perceive, what our patient is going through, all attempts at counseling will be futile.
A formula commonly used is IEUA
I - Involved (get)
E - Explore, the problem
U - Understand - the scenario, patient and his environment - both internal and External
A - Action
To get the feel of a situation, a physician must possess the skills of
- Paying attention
- Listening (which is active as opposed to hearing which is passive)
- Responding to the patient's problems
Counselling skills cannot be taught. They have to be developed at a period of time by trying again & again.
Commonest poser by Doctors - 'Counselling is not paying. It takes such a long time!'
My answer - 'If you sincerely feel that your counseling is worth the feel you want to charge ( in terms of quality and not in terms of time spent), call the patient outside practice hours and charge special fee.
A word of caution: Counsel ONLY if you are sure of yourself. Your immaturity in counselling skills may mean disaster for the patient. He has faith in you, he will never think that you don't know your job. He will think Counselling does not work and will never try again with a better-qualified person.