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Winter 2014

More Books

Date: February 1, 2014

A Clinician’s Guide to Helping Children Cope and Cooperate with Medical Care
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A Clinician’s Guide to Helping Children Cope and Cooperate with Medical Care
Keith J. Slifer, PhD (Johns Hopkins, 2013)

More than 9 million children in the United States live with chronic or recurrent health conditions that require regular medical visits—visits that frequently involve unpleasant experiences such as needle sticks, wound cleaning, nausea, pain, anesthesia, and more.

Keith J. Slifer explores how adults can help children better handle these visits with his exceptionally useful Clinician’s Guide to Helping Children Cope and Cooperate with Medical Care.

As director of the Pediatric Psychology Clinic and Consultation Service at the Kennedy Krieger Institute, Slifer has become an expert at “translating the practical and procedural riches that have arisen from the field of applied behavior analysis” into helpful clinical practices, as he writes in the book’s introduction.

His book focuses on children who receive treatment for chronic or recurrent conditions, and specifically on those whose constant contact with health care professionals can make them “unusually distressed, uncooperative, or disruptive.”

These are the kids who have asthma, cancer, cerebral palsy, and epilepsy; or those being rehabilitated after traumatic injuries or surgery, including brain tumor removal, hemispherectomies, burns, and orthopedic or spinal cord injuries.

Such chronic medical problems often are associated with an increased risk of developmental, learning, emotional, and behavioral difficulties, Slifer writes, and in turn can affect adversely the young patients’ ability to cope with the medical procedures they must undergo, potentially jeopardizing their medical care.

In a dozen comprehensive chapters, Slifer addresses such issues as parent-child interactions during medical procedures, including fundamentals of general child behavior management; how to help young, developmentally delayed, or highly anxious children cooperate with routine physical exams and immunizations; and strategies to ensure cooperation and control-of-motion when children must remain still for diagnostic tests, as well as for vision and hearing tests, breathing treatments, and respiratory assistance.

Slifer, an associate professor of psychiatry and behavioral sciences in the School of Medicine, devotes 31 pages alone to teaching children to swallow pills and capsules, along with 27 pages on teaching those with chronic conditions to cope with repeated injections and other painful procedures. NAG


Talking to Your Doctor: A Patient’s Guide to Communication in the Exam Room and Beyond
Zackary Berger, MD (Rowman & Littlefield, 2013)

Time in a physician’s office is precious—both figuratively, in terms of the value to the patient, and literally, when considering how much it costs. With his latest book, Zackary Berger aims to help both patients and physicians make the most of these encounters.

Miscommunication is a daily problem in physicians’ offices across the country, according to Berger, an internist and epidemiologist who is an assistant professor in the Department of General Internal Medicine and has published frequently on the importance of doctor-patient communication to both patient satisfaction and strong health outcomes.

As much as Berger’s book is designed as a patient’s guide to making the most of encounters with physicians, it can just as easily be of use to clinicians. Indeed, one of the subsections in the first chapter is “How Best to Talk to Patients: Learning to Listen.” 

In a personal reflection, Berger writes that when he was a medical student in New York, he observed that “some doctors, the worst of the lot, spoke to patients in a way that I hoped they would never speak to their mother.” They rarely if ever sought to explain their diagnoses, offered options for treatment, explained the potential effect of prescribed medication, or determined if any financial or other constraints would prevent the patient from following their instructions.

Berger’s conversationally written 14 chapters provide diagrammed depictions of failed and successful encounters between patients and physicians, as well as the “sometimes surprising answers” to the question: What do we want from our doctor?

Berger offers advice to patients on how to prepare for their visit to the doctor’s office; finding common ground with the physician to ensure the visit’s maximum benefit; and how to “negotiate the agenda” to ensure that what the patient wants to discuss is addressed. He also deals with how to discuss tricky subjects that “might be gross, impolite, or just things we’re not ready to talk about in public, whether they’re bowel functions, mental health, or sex.”

And he addresses “the poorly hidden secret more and more people are finding out about: Our health care system is afflicted by a severe case of doing too much”—meaning unnecessary tests, treatments, and studies.  NAG