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J Contin Educ Health Prof. 2019 Winter;39(1):49-53. doi: 10.1097/CEH.0000000000000232.

Therapeutic Presence: Its Contribution to the Doctor-Patient Encounter.

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1
Dr. Krogh: Psychiatrist, Master in Psychodynamic Psychotherapy, Facultad de Medicina, Instituto de Neurociencias Clínicas, Universidad Austral de Chile, Valdivia, Chile. Mr. Schmidt: Psychologist, Master in Clinical Psychology, Escuela de Psicología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile. Dr. Langer: Psychologist, PhD in Clinical Psychology and Health, Master in Functional Analysis in Clinical and Health Contexts, Escuela de Psicología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile, Millennium Institute for Research in Depression and Personality (MIDAP), Macul, Santiago, and Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile.

Abstract

In this article, we propose a model of doctor-patient encounter that integrates the concept of therapeutic presence (TP), derived from psychotherapy research, as an indispensable substrate for the benefit of the therapeutic alliance between patient and doctor. To this end, the concepts of the doctor-patient relationship and doctor-patient communication are revisited to explore their therapeutic dimensions. The concept of TP is defined, and existing literature about the relationship between that concept, the therapeutic alliance, and mindfulness is reviewed, alongside an examination of related concepts that have developed within nursing and medicine. We conclude that TP emerges as a transtheoretical concept that can be integrated into our understanding of the doctor-patient encounter to improve both doctor-patient communication and the doctor-patient relationship. The way in which the biomedical model may limit a present medicine is discussed, and the means of integrating such a model of doctor-patient encounter into medical training and practice is analyzed.

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