BRIEF IN-OFFICE INTERVENTION FOR GENERAL DISTRESS
Available at: https://www.aafp.org/fpm/2017/0300/p30.html
(Managing Behavioral Health Issues in Primary Care: Six Five-Minute Tools; Sherman et al., Fam Pract Manag. 2017 Mar-Apr;24(2):30-35.)
General Guidelines:
- Be present and allow yourself to be emotionally available,
- Use appropriate physical touch and open body language (turning away from the computer, for example),
- Listen without interruption and judgment, and employ active listening skills such as paraphrasing and reflecting patients' feelings,
- Instill hope and empower the patient by eliciting how he or she successfully coped with similar challenges in the past,
- Express empathy in a genuine, natural manner, thereby fostering a stronger patient-provider relationship.
Below are 4 options to consider using with your patient:
- Instill hope and empower the patient.
- “How have you successfully coped with similar challenges in the past?”
- Encourage use of social supports.
- “Who do you have in your life to support you in dealing with [fill in the issue]?”
- Help them to focus on gratitude.
- “What are you grateful for?” “What positive things have happened for you lately?” Could be past day, past week, past year. Big or small.
- Ask them to keep a daily/weekly list of positive events (gratitude journaling)
- Teach them a breathing or mindfulness exercise.
- 4-square breathing:
- Breathe in for 4 counts, hold breath for 4 counts, blow out gently for 4 counts, hold the empty breath for 4 counts
- A simple mindfulness exercise:
- “Close your eyes. Take four deep breaths. Focus on the sound of your breath. Imagine that you are in a place where you feel calm and safe. Connect to the emotions that you are experiencing.”
Prescribe physical exercise.
- “What are you doing for exercise?”
- Set specific goals
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