A conversational approach to health care provision


A Brief Outline of a Conversational Therapy Service

Working conversationally with the physically ill, the dying and bereaved is arguably a neglected aspect of general health care provision. Healthcare professionals working with people that are physically ill sometimes lack specialised knowledge and experience required to sustain patients through difficult periods of emotional upheaval.

There may be benefits from referral to a trained and registered psychotherapist who can provide specialised conversational therapies for people experiencing life changes in response to those who are dying and bereaved.

How does the Service Work?

In many instances a grieving person will be supported by family and friends and professional help will not be necessary or appropriate. However, when naturally occurring support networks are not available or when trauma is evident professional help may be required.

In such circumstances a service providing people with physical illness and those bereaved opportunities to explore, in safety, dilemmas associated with the experience of illness, loss and change can be helpful. Where appropriate this can include family members. Concerns are listened to closely offering chances to understand and address the emotional dynamics of illness in culturally sensitive ways. In many instances, the benefits include building better supportive networks and stronger internal resources. Some psychological responses to loss and change associated with illness, dying and bereavement include shock, feelings of unreality, denial, anxiety, aggression and depression.

Strong feelings can impact negatively on adaptations to illness and bereavement. It is of course difficult to predict outcomes with accuracy. By talking about experiences however, suffering can be openly expressed and so illness and loss might be better endured. Without the need to direct strong feelings towards others – significant relationships, personal and professional can be beneficially maintained.

Can others benefit from the Service?

Many people gain considerably from opportunities to discuss their feelings confidentially.  For instance, people who are under going change in their lives for whatever reason can benefit from exploring concerns in safety. Airing concerns can help a person to explore possibilities for constructive life changes.

How is the safety of Professional Practice Ensured?

Safety of professional practice and the emotional comfort of the patient and family members are considered of paramount importance.

Regular clinical supervision forms an integral component of therapy. All aspects of clinical work carried out with patients therefore come under the scrutiny of an experienced psychotherapist. This is a requirement for all psychological therapists and is perhaps most helpfully viewed as a means of quality control.

What are the Benefits of the Service?

A part of the healthcare worker’s role is helping people to manage their feelings in times of crisis -sometimes by referring to more specialist services. By means of therapeutic conversations people with illness can be helped to consider aspects of their life that require reorganization. Through a process of collaboration a patient and therapist can identify areas of life-difficulty and plan for realistic changes. Knowledge gained through therapeutic conversations can also help a person with illness and those bereaved to be more responsive to the concerns of their families. The likelihood of secondary distress is therefore lessened within family units, reducing the overall demands made on busy healthcare professionals and health budgets.

Who Might Not Benefit From This Approach?

In some instances, conversational therapies might not be the most appropriate form of therapy. For example, a person who is severely depressed might initially require other forms of treatment. We need also to be mindful that, however we might wish it, reality cannot be changed by conversational therapies, although a person might be helped to address life issues in helpful ways. A detailed assessment is carried out in all instances before engaging in therapeutic work.