ON Chiropractic Fall 2014 - Page 12

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[