Counseling and Communication Skills in Family Practice CEA Method(Catharsis, Education, Action) dr. Isti Ilmiati Fujiati, MSc. CM-FMPublic Health/ Community/ Preventive MedicineMedical School, University of Sumatera Utara

The usual methodGive the diagnosis.Give the treatment.Educate the patient.Give prescription.Goodbye.

but ..Sometimes it doesnt work . because the patient is distractedby his feelings and his thoughts

The more upsetting the feelings or thoughtsThe more distracted the patientThe less effective the medication

CEA Method

Catharsis:Is not about cryingBecoming aware of the feelingsNaming the feelingsKnowing of what is behind the feeling

P F B

R

CP = R

P iF iB

R

C P R (misperception)

If we know the emotionally critical misperception (ECM)of the patient We can sharp-shoot our educationLess timeMore compliance

Steps:When you heard the diagnosis / experienced the symptom, what thought came to your mind?What did you feel when these thoughts entered your mind?What is about these thoughts that makes you feel that way the most?Summarize the thoughts and feelings(give the opportunity to the patient to correct you this is important!)

Then . Correct the misperception.For resistant patient:If there is insufficient anxiety

our role to create sufficient anxiety

If there is insufficient anxiety:

Ask concern questions: Doesnt it concern you that .. (state a life consequence)?Ask future questions:What would happen if ..?(Let the patient answer the questions and then pause)

Then..

Correct the misperceptions

Diagnosis Catharsis (ALS) ECM

Action Educate (correct) TreatmentCatharsisECM

Action Educate (correct)

Thank You .