FEATURE STORY / CBT AND CHIROPRACTIC – PART 2
is a barrier to treatment plan progression.
The foundation of this process is known as
guided discovery. Guided discovery is best
explained with an example. (See "Guided
Discovery" on page 11.)
What this fictional example
demonstrates is that within a couple
of moments in the course of an
appointment, a chiropractor can develop
an understanding of what might be
holding the patient back and begin the
work of encouraging an emotional recovery
concurrent with a physical one. The critical
components of guided discovery are
summarized by the authors of Mind Over
Mood as:
more likely to experience suicidal ideation
or attempt suicide than individuals in the
general population,” Dr. Rogojanski notes.
“As such, suicidality should be monitored
on an ongoing basis and individuals
reporting suicidal ideation should be
referred for a comprehensive psychological
evaluation and risk assessment.”
Additional warning signs to look for
include:
• Significant comorbidity (e.g., depression
or anxiety),
• Catastrophic thinking about the pain
and level of impairment,
1
Asking a series of questions to
• Rumination (e.g. hyper focused attention on the symptoms of one's distress
and its causes), and,
2
Accurate listening and reflection by
• Chronic and/or marked functional
impairment (e.g., few activities of daily
living).
uncover relevant information outside
the patient’s current awareness,
the practitioner,
3
Summarizing the information
discovered, and,
4 synthesizing question that asks the
A
patient to apply the new information
discussed to his or her original belief.
A
dditional training and practice in
therapeutic approaches like this
can be very helpful. This article
will also cover that subject. But first, it is
important to develop a sense of when a
patient’s psychological need is outside of
your capacity as a chiropractor and requires
referral to another practitioner who
specializes in mental health care.
Drs. Vorstenbosch and Rogojanski
provided some specific advice on the
warning signs to look for when trying to
gauge if a pat Y[