Michael Pantalon, PhD, a Yale University assistant professor of psychiatry and director of the Center for Progressive Recovery, discussed how giving clients autonomy -- acknowledging that they have a choice and empowering them to make one -- has helped increase attendance among parolees for meetings with their probation officers and improved outcomes in drug treatment.
Three physicans in the session highlighted the application of this approach in medicine and mental health.
In the session, a cardiologist noted that physicians are trained to be dietetic -- to tell patients what to do -- and noted that she was beginning to finally see why that was not working. A family physician who is a coach highlighted how this coaching model had changed outcomes for his patients. After becoming a coach, he stopped telling clients what to do, and started casually hanging ideas out there. In one example, instead of telling a client who was trying to lose weight what to do, he mentioned that he had lost 130 pounds. The client asked about the diet and adopted all of it except the part about not eating pasta. Instead of telling the client to not eat pasta, he said ok and the client asked what would change. He replied, "You won't lose weight." The client ultimately decided to give it up. In addition, the director of a large psychiatric hospital described a patient who had long been on their inpatient unit who had become so entrenched that she would grab something to hurt herself whenever she was walking in the hallways. He said the staff all wear mitts to try to slow her down. The hospital director mentioned that they had told the patient she should use the tools she's learned on the unit. Pantalon coached the director on how to essentially say, "You can use the skills you've learned if you want to. You can also continue to hurt yourself. It's your choice." I guess we'll see how it works next year. But if Panaton's own examples from working with addiction clients are any indication, my betting money is that empowering the patient will be successful.