Near-death experiences and psychotherapy.

Psychiatrists are likely to come into contact with patients who have had near-death experiences, who may have a variety of reactions to the experience, and who may benefit from psychotherapy. We may also have opportunities to work with individuals who are reacting to others who have had such experiences. There is much a psychiatrist can offer to these people, including listening respectfully, being nonjudgemental, normalizing the experience, providing education, and assisting with integrating the experience into their lives to develop or maintain the best possible functioning.

Why psychotherapy helps the patient in chronic pain.

Psychiatrists frequently see patients in their practices who struggle with issues of chronic physical pain. This can present diagnostic and therapeutic dilemmas. These patients require an approach that allows them to talk about their pain and feel supported while simultaneously being nudged to develop a meaningful life alongside their pain.

The Psychiatrist's Guide to Motivational Interviewing.

Motivational interviewing (MI) is a technique that can be used to inspire patients who have virtually any level of enthusiasm for change, from almost none to nearly enough, to move toward improvements that can make their life better. The driving goal in MI is to move the patient from a position of complacency to one of more ambivalence about their particular version of toxic habit and then on to a personal desire for change. The approach of MI is one of collaboration in which the psychiatrist seeks to evoke the patient's own recognition of the desirability of change.

Brief Supportive Psychotherapy for a Patient with Chronic Schizophrenia Who is Dying.

Psychiatrists can offer much in the care of the person who is chronically mentally ill and who is dying of a medical illness. In community psychiatry, the psychiatrist and other members of the treatment team often care for a patient over many years, and gradually learn about a patient's wishes and preferences, strengths and limitations, areas of support, and lack thereof. A psychiatrist can combine this knowledge and understanding with a capacity for empathy in order to provide many of the necessary elements for palliative care, including psychotherapy, during the final phases of our patients' lives.

Good palliative care for a patient with schizophrenia dying of emphysema and heart failure.

Psychiatrists can offer much to the care of people who are chronically mentally ill and who are dying of a medical illness. In community psychiatry, the psychiatrist and other members of the treatment team often care for patients over many years, and gradually learn about patients' wishes and preferences, strengths and limitations, and areas of support and lack thereof. This database joins together with the psychiatrist's capacity for empathy to provide many of the necessary elements for palliative care during the final phases of these patients' lives.