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Redirecting Difficult Patients

In a recent eNewsletter I presented a real psychiatry oral board case sent in by a reader. One issue he had was that the patient was difficult to direct during the course of the interview. Redirection Techniques are my focus today.

Before you redirect a patient you need to do a little "diagnosis" first. There are several very different reasons that a patient may be difficult to direct and a technique that works nicely for one type of patient can blow up with another type of patient.

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Mentalization Therapy

Anthony Bateman & Peter Fonagy, the developers of Mentalization Therapy, define mentalization as “the process by which we implicitly and explicitly interpret the actions of ourselves and others as meaningful on the basis of intentional mental states (e.g., desires, needs, feelings, beliefs, & reasons).”

What this means is that …

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Schema Therapy

There are several exciting "new" proven-effective psychotherapies now available to mental health patients with Borderline PD. I place "new" in quotations because, for instance, Schema Therapy has been around since the early 1990′s. However, Schema Therapy as well as Mentalization Therapy, Transference-Focused Therapy and Dialectical Behavior Therapy have either just recently been shown to be effective in patients with Borderline PD, or their effectiveness has been reconfirmed through replication studies.

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