Kaplan Sadocks Kaplan Sadocks

Kaplan & Sadock's Kaplan & Sadock's Synopsis of Synopsis of Psychiatry: Behavioral Psychiatry: Behavioral Sciences/Clinical Sciences/Clinical Psychiatry, 10th Psychiatry, 10th EditionEdition EDIT Dr liza 140 366 660EDIT Dr liza 140 366 660

The Patient-Doctor The Patient-Doctor Relationship Kaplan & Relationship Kaplan & Sadock's Synopsis of Sadock's Synopsis of Psychiatry: Behavioral Psychiatry: Behavioral Sciences/Clinical Psychiatry, Sciences/Clinical Psychiatry, 10th Edition10th Edition EDIT Dr liza 140 366 660EDIT Dr liza 140 366 660

RAPPORTRAPPORT

An effective relationship is characterized by An effective relationship is characterized by good rapport.good rapport. Rapport is the spontaneous, conscious feeling Rapport is the spontaneous, conscious feeling of harmonious responsiveness that promotes of harmonious responsiveness that promotes the development of a constructive therapeutic the development of a constructive therapeutic alliance.alliance. It implies an understanding and trust between It implies an understanding and trust between the doctor and the patient. Frequently, the the doctor and the patient. Frequently, the doctor is the only person to whom the patients doctor is the only person to whom the patients can talk about things that they cannot tell can talk about things that they cannot tell anyone else. Most patients trust their doctors to anyone else. Most patients trust their doctors to keep secrets, and this confidence must not be keep secrets, and this confidence must not be betrayed. betrayed.Patients who feel that someone knows them, Patients who feel that someone knows them, understands them, and accepts them find that understands them, and accepts them find that a source of strength. In his essay,Caring for the a source of strength. In his essay,Caring for the Patient Francis Peabody, M.D. (1881-1927), a Patient Francis Peabody, M.D. (1881-1927), a talented teacher and clinician (Fig. 1-2), wrote:talented teacher and clinician (Fig. 1-2), wrote:

6 STRATEGIES RAPPORT6 STRATEGIES RAPPORT

Ekkehard Othmer and Sieglinde Othmer defined Ekkehard Othmer and Sieglinde Othmer defined the development of rapport as encompassing the development of rapport as encompassing six strategies: (1) putting patients and six strategies: (1) putting patients and interviewers at ease; (2) finding patients' pain interviewers at ease; (2) finding patients' pain and expressing compassion; (3) evaluating and expressing compassion; (3) evaluating patients' insight and becoming an ally; (4) patients' insight and becoming an ally; (4) showing expertise; (5) establishing authority as showing expertise; (5) establishing authority as physicians and therapists; and (6) balancing the physicians and therapists; and (6) balancing the roles of empathic listener, expert, and roles of empathic listener, expert, and authority. As part of a strategy for increasing authority. As part of a strategy for increasing rapport, they developed a checklist (Table 1-1) rapport, they developed a checklist (Table 1-1) that enables interviewers to recognize problems that enables interviewers to recognize problems and refine their skills in establishing rapport.and refine their skills in establishing rapport.