The Expanded Four Habits Model—A teachable consultation model for encounters with patients in emotional distress

Abstract

ObjectiveThe study aims to develop a teachable consultation model for encounters with patients in emotional distress. MethodsThe Expanded Four Habits Model is designed for improving the consultations with patients in emotional distress or with other psychosocial concerns. The model represents an integration between the concept of Six Skills (Stensrud T, Gulbrandsen P, Mjaaland T, Skretting S, Finset A. Improving communication in general practice when mental health issues appear: piloting a set of six evidence-based skills. Patient Educ Couns 2014;95:69–75) and the Four Habits Model (Frankel RM, Stein T. Getting the most out of the clinical encounter: the four habits model. Permanente J. 1999;3:79–88). ResultsThe proposed new model includes an expansion of the original Four Habits within three key psychological domains: emotion, cognition and coping. There is one explorative and one elaborative skill in each domain. The theoretical foundation of the model is presented. The six specific skills are described and research findings and literature supporting the model reviewed. As is the case with the original Four Habits model, the expanded model represents both a model of the consultation and a scheme for communication skills training. ConclusionThe Expanded Four Habits Model is a simple and teachable scheme to help the clinician to structure consultations with patients in emotional distress. Practice implicationsThe model should be tested as a communication skills training program based on training principles developed in the Four Habits training courses.