You don’t need to be a charismatic healer to make this work
STUDY: Mylod D and Lee TH, Journal of Patient Experience 2023;10:1-3
STUDY TYPE: Practical guide
FUNDING: Independent
Background
You don’t need charisma or false-optimism to instill hope, and it doesn’t depend entirely on the patient’s belief. Clinicians can actively create it through three steps, argues this paper from the aptly titled Journal of Patient Experience:
- Clarify the patient’s goals
- Demonstrate the will and skill to help
- Lay out a specific pathway forward
Optimism is a general belief that things will improve. Hope, in contrast, is tied to a specific, realistic goal, and false hope erodes trust. Even when a cure isn’t possible, patients can still have realistic goals to hope for: more good time, relief from suffering, or in end of life care, a comfortable death.
The article focuses on medical care, and Qing Ng recently applied the framework in a case report of treatment resistant depression. Even if symptomatic recovery is not likely, Ng recommends asking patients to name their own goals, then break those down into gains that a patient can reach: a few more good days a week, or the return of one specific function they miss most.
Ask what a better week would look like in concrete terms, not just “less depressed.” Naming one attainable target, like sleeping through the night or getting back to a hobby, gives us something to work toward together through lifestyle and behavioral change while waiting for symptoms to improve.
Learn More
- We cover more ways to engage patients in recovery when treatments fail in our Carlat interview with Joe Goldberg and Difficult to Treat Depression.
—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
