Health Psychology, 2nd Edition

if the doctor fails to identify the true reason for consulting. Similarly, if the patient fails
to understand the diagnosis in phase 4 this may undermine adherence.
The now more widely used Calgary-Cambridge consultation model provides
a similar guide to structuring consultations (Silverman, Kurtz and Draper, 2005).
Six stages are identified: (1) initiating the consultation, including establishing rapport
(e.g. greetings and introductions) and identifying the reason(s) for the consultation (e.g.
asking the patient what they would like to discuss); (2) gathering information, including
understanding the patient’s perspective (e.g. listening attentively without interrupting
and using open questions to clarify what has been said); (3) building the relationship,
including showing interest using non-verbal cues and communicating appreciation
of the patient’s concerns; (4) providing structureincluding summarizing what has been
said; (5) explanation and planning, including providing the correct amount and type of
information in a manner that aids recall and understanding and achieves a shared
understanding and shared plan; and (6) ending the consultation.
Rather than focusing on sequence, Pendleton et al.(1984) identified seven tasks
that need to be successfully completed in a health-focused consultation. These tasks,
listed in Focus 10.1, overlap substantially with the Byrne and Long and Calgary-
Cambridge models and, while developed as a learning aid for doctors, could be applied
to many consultations between health care professionals and patients (including those
conducted by health psychologists).

RELATING TO PATIENTS 239

Seven key tasks to be accomplished in consultations

Pendleton et al.(1984) identified seven tasks that need to be completed

successfully in a health-focused consultation:

1 Define the reason for the consultation including the nature and history of the

problem, its effects and the patient’s concerns and expectations.

2 Consider other problems including risk factors, which exacerbate the problem.

3 Choose an appropriate action for each problem in negotiation with the patient.

4 Develop a shared understanding of the problem(s).

5 Involve the patient in the management of problems and encourage acceptance

of responsibility by the patient.

6 Use time and resources appropriately.

7 Establish and maintain a relationship with the patient.

Think about how these tasks relate to how a health psychologist would conduct

a consultation with a manager referred because she was suffering serious stress at

work (see Chapter 4).

FOCUS 10.1