CEA Skills

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The key takeaways are that patients consult doctors for physical symptoms or due to anxiety about symptoms, and the CEA method uses active listening, catharsis, education and action to address both the physical and emotional concerns of patients.

Patients consult doctors for two main reasons - they have physical symptoms, or they are anxious about the physical symptoms.

The steps of the CEA method are catharsis, education and action. Catharsis involves becoming aware of hidden emotions and perceptions. Education involves identifying misperceptions and providing information to allay or increase anxiety. Action involves proposing a treatment plan with goal setting.

CEA skills

Milagros Neri, MD
 Patients consult for two reasons:
 They have physical symptoms

 They are anxious about the physical symptoms


 Upsetting
 Distracted
 Physical symptoms
 Diagnosis and treatment

 Anxiety
 Education
 If not addressed
 They are not really treated
 Difficulty of absorbing our attempts at educating them
 Correct Misperception
 Perception ≠ reality

 Through the use of active listening skills, the


physician can identify the perceptions that are most
anxiety- provoking
- Emotionally Critical Misperceptions
 CEA Method
 Active listening skills and health education

 Catharsis, Education and Action


Catharsis
 Emotions
 Becoming aware of hidden emotions
 Be able to name the feeling
 Mad
 Sad

 Glad

 Afraid

 Perceptions
 Becoming aware of what’s behind the feeling
 Four Steps to promote catharsis
 What came to your mind when you started feeling
the symptoms?
 What feelings came out when these thoughts came
to your mind?
 What do you think is the worst thing that can
happen to you?
 Summarize the ECM and the emotions associated
with it.
Active Listening Skills
 Paraphrasing
 Saying in 10 words what the patient said in a
hundred
 Doctor, a month ago, I had this sore throat, so I
went to a doctor and he gave me penicillin for it.
So I took it seven days and it went away. But a
week later, I had the sore throat again. The
doctor gave me amoxicillin this time and I took
it and the sore throat went away. But a few days
ago, the sore throat came back. I just can’t
understand what’s happening.
 Attending Skills
 Non-verbal- body language
 L- lean forward
 O- open stance

 V- voice of compassion

 E- eye contact- facial expression

 R- relax position

 S- sitting position at right angle


 Reflecting feeling
 Articulate for the patient the emotions
 Mad, sad, glad, afraid
Educate
 ECM identified and should be prioritized
 Doctor has been listening and understands the
patients concerns
 “Emotional connection”

 Perception > reality- allay the anxiety

 Perception < reality- increase the anxiety


 Pathophysiology and pharmacology
 Speak in the language of the patient
 Use analogy and metaphors

 Use anecdotes or testimonies


Action
 Propose an action plan
 Goal setting and behavioral contracting
 Address ECM about treatment
Good physician cures sometimes, palliates often
but comforts always

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