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Importance of the trialogue

Common decision-making

Author: R., an individual experienced with bipolar illnesses

In the field involving those who are active in psychiatry, we still frequently find a gradient of knowledge and power between the patient and the professional. The perception of the doctor is based on symptoms and signs, investigations, techniques and therapies with a view on the elements responsible for illnesses instead of on the conditions which are seen to further promote wellness. The perception of the patient, on the other hand, is based on ideas, assumptions, expectations, feeling or thinking. Therapists should be interested in those who they handle, listen to them, be able to accept and to wait, exchange information mutually, advise and educate. Therapists should assist their patients in weighing out the individual therapeutic possibilities and help them in the decision process. For making such decisions, preventive, diagnostic or therapeutic measures can stand in the midpoint.

Deliberation can mean

  • Asking for information and then taking the time to consider the possibilities
  • To examine one's experiences
  • To formulate values actively
  • To make a decision mutually

The goal is the independent decision made by the informed patient. Both of those active in reaching this decision then think and act at an "eye-to-eye level". This strengthens the self-help and independence of the patient.

The following abilities develop step by step

  • Confront yourself with the health problem
  • Formulate effective goals
  • Consider both your own as well as other abilities
  • Take your personal characteristics into consideration
  • Follow your goals concerning health autonomously

Long-term, while we are healthy, we can care well and independently for our good health in order to prevent crises. The application of medical knowledge cannot occur without individual collaboration. The patients must compile the tools themselves, to question therapeutic actions and assess their efficacy. Together with the therapist, scientific details can then be critically evaluated mutually and important questions can be clarified. The best perspectives for bringing about a cure exist if the patients understand what they are doing and why. Their doing so, however, must be manageable and significant for themselves. In this way, patients can take over as much personal responsibility in the course of the possibilities without causing themselves to be overloaded.

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