Alcohol and drug services have been patient centred for years

doi:10.1136/bmj.323.7304.111

BMJ 2001;323:111 ( 14 July )

Letters

Alcohol and drug services have been patient centred for years

The first 150 words of the full text of this article appear below.

EDITOR $---$ Stewart's summary of and enthusiasm for a patient centred approach is most welcome.¹ I believe that one additionalfeature of this approach should be added $---$ namely, that it acknowledgesthe reality of patients accepting or rejecting our advice or treatment.Clinicians working with patients with alcohol and other drug problems,particularly those working in the harm reduction model, have knownthis foryears.

The work of W R Miller, for example, has shown that the more confrontational (non-empathic, non-patient centred) the clinicianthe poorer the outcome. Previously, poor outcomes were taken asa sign of the patient's denial or unwillingness to change $---$ nowmost clinicians (those working in the field of alcohol and otherdrug problems, at least) accept that these problems usually representfailure on the part of the therapist. The increasing evidencethat most humans do not always "comply" with our treatments mustsurely make us . . . [Full text of this article]