Collaboration

The therapeutic relationship is one that requires empathy, unconditional positive regard and should not be judgemental. The patient has to trust the health care worker and follow recommendations that are evidence based. The tasks are complementary. Both the health professional’s and the patient’s perspectives need to be considered and, where appropriate, the views of the carer. An agreement needs to be reached about:

• the nature of the problem
• the specific disabilities that result for the patient and carers
• the specific problems that are most urgent to deal with at this time.

For self-management to be effective in chronic mental illnesses, collaboration with other professionals and with the patient’s family and friends is very important. Within a positive collaborative environment, the continuum of care could enhance a very positive result.

This requires the psychiatrist to negotiate with the patient which information to keep private and which information can be shared with others.

 

Collaborating with other health care professionals⁽¹⁾

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This short video excerpt provides an example of how other health professionals are involved in the self-management care plan.

Key principles for collaborating with patients and carers

 

 

Responsibilities and collaboration

A good example of perceptions of collaboration is provided by bipolar disorder patients. They perceive the ideal collaborative model one in which the individuals involved have specific responsibilities such as the patient being responsible for attending appointments and sharing information and the psychiatrist’s responsibility being good listening skills and updating knowledge on current medications. Flexibility to the interaction within the relationship is considered significant to account for changes in illness severity and other stresses of life.⁽³⁾ Twelve key ingredients for a positive collaborative experience with their mental health provider are shown in the table.⁽³⁾

Patient-centred	Provider-centred	Interactional
Takes medication	Prescription practices	Weight of provider’s opinion
Keeps appointments	Expertise	Trust
Shares information	Humaneness	Flexibility
Assertive	Listening skills
	Sensitivity to clients’ feelings
	Availability

The overall objective here is building a very trusting partnership with the patient. It will take time but by taking that time you may find that recovery for the patient will move forward. It is so important to listen and walk alongside the patient at this time. Do remember what the patient has been through; it may be that the illness is still trying to protect itself at the cost of the well-being of the patient.

 References

1. Flinders Human Behaviour & Health Research Unit Self-Management Program. The Flinders Model DVD.
2. Leggatt M. Working Together. A short, practical guide for consumers, family carers and mental health professionals to work together in collaboration and partnership. Southern Mental Health Association, 2006.
3. Sajatovic M, Davies M, Bauer MS, McBride L, Hays RW, Safavi R, Jenkins J. Attitudes regarding the collaborative practice model and treatment adherence among individuals with bipolar disorder. Comprehensive Psychiatry 2005;46(4):272–7.

Continue to Module 3.3: Including the Carer