Script for Adults

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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