198


Chapter 11


Box 11.2 Overcoming Patient Objections to Mental Health Care (continued)


• To a patient who does not understand how a counselor can help, you might say, “We have been working together for a while on this issue, and in my experience, when someone wants to change and can’t, there is often something behind it. A counselor is the type of person who can help you find that stumbling block so that our work together will succeed.”


• To a patient who resists seeing a counselor because “things are going fine right now,” suggest one visit, just as a backup plan—“Things are going great now, and I’m glad. How- ever, I’m concerned that eventually life might present more challenges again. So right now, while life is nice and calm, check out a couple of therapists and see who you like. Just go once or twice to get to know them a little. That way if a crisis hits, we’ll be prepared.”


• When a patient adamantly refuses to agree to try a coun- selor, you have three options:


˚ Keep a running list of topics you think the patient could


address in counseling. Keep this list with your patient’s chart and inform the patient each time you add a topic. Your actions will show the patient three things: (a) these are the type of topics appropriate for counseling; (b) you do not intend to discuss these topics; and (c) there really are issues to discuss with a counselor. It is up to you how long you keep this up until you move to the next step.


˚ Set a time limit. For example, tell the patient, “I under-


stand you are hesitant about seeing a counselor and you feel that my help is enough to get through this problem. Let’s make a deal. Let’s give ourselves 3 weeks to keep at it. Then we’ll reevaluate your situation. If things aren’t better, you will agree to meet up with a counselor.” If at the appointed time your patient still refuses, you are left with the last resort.


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