Counselling first hand: Understanding the patient and yourself through mentalizing

Background. One of the core activities at community pharmacies is counselling patients about medication to support implementation of correct use and to contribute to health promotion. Dialogue is known to be the key to ensure patient-centered counselling, but studies show that pharmacy staff rarely seem to include patients’ perspectives in counselling especially if they sense the patient or themselves get emotionally affected. A theory-driven education program was developed, with the aim to increase pharmacy workforce’s mentalizing abilities for them to attend to and navigate their own and patients’ emotions during counseling. The topics in the education are the mentalizing mindset, mentalizing communication and pharmacy practice. The education was developed in Denmark by researchers from The University of Copenhagen and Pharmakon and tested in both Denmark and the Netherlands. The development was done in a user-driven workshop format, including perspectives from patients, pharmacy workforce and proprietors. The extent of the education is 2.5 ECTS.
Purpose. The aim was to evaluate participants’ knowledge of mentalizing in a pharmacy practice context and their competencies in transferring this to knowledge about how to communicate in mentalizing ways in pharmacy encounters with the potential of establishing patient-centered counseling.
Methods. 28 participants from 11 community pharmacies participated. A mixed methods design based on Kirkpatrick levels of evaluation inspired the evaluation. Data comprised written reports comprising 36 qualitative questions completed after ending the education, and quantitative measure of Level of Emotional Awareness, Job Satisfaction Measure and Course Experience Questionnaire before and after the education.
Findings. The qualitative evaluation revealed three themes 1) Awareness of emotions and communication skills are important elements when mentalizing is the goal, 2) It’s far more than just an expedition – I tune into the patient, 3) Don’t have to hide behind the screen any longer. The quantitative evaluation showed 1) a significant increase in awareness of mental states (p<0,001), 2) a significant improvement in job satisfaction with regards to pay (p = 0.01), prospects (p= 0.04) and standards of care (p= 0,004); and 3) that most participants agreed (48.8%) and strongly agreed (39.1%) being satisfied with the education.
Conclusion. The education promoted the participants awareness of mental states and mentalizing communication skills making them able to center the interaction around the patient’s perspectives. The results are promising to support pharmacy workforce to act truly patient-centered in counselling desk meetings and to prevent or reduce job related stress and burnout.