How to recommend Illness Explorer to your patients

People vary greatly in their willingness, desire or capacity to use self-help material. You can expect Illness Explorer (IE) to be helpful for some and not for others.

IE has a lot of front-end, easy to understand information on the links between physical illness and personal story and the practical implications for the person. This builds towards the second half which has practical work zones where the person starts to work systematically on their own connections.

Try going through it yourself–this is the best way to learn how to convey its usefulness to patients. Over the years we have found IE a very useful tool for training clinicians who find it helpful for learning ways of talking with people about these things, and helpful for themselves personally.

There are some things I have observed over the years. It is worth trying to sense where the patient is at in terms of need of support.

There are people who will dive into a pathway like this and find it to be just what they want. They may be very used to taking control of their own health, and ready for this as a new exploration.

There are others who may have been floundering in the health system failing to get answers, feeling not heard and very alone. To be given a self-help tool might be seen as yet another ‘here you go, try this’, a fob-off. We must be sensitive to these things. Talking about IE and wondering with them what would suit them best will usually lead to a wise decision.

Sometimes I have patients who come from afar and cannot come back soon or regularly. It is reasonable to say, ‘look, even though there are hurdles we need to stitch  a way forward, together. I would like to see you again, when it is possible for you. It might help us both a lot if you could look at IE before you come back next time.’

What IE might stir up. I haven’t found this to be a serious issue. But some (perhaps most) people actually do better opening up emotionally-charged material in the presence of a safe and warm ‘other’ person. Of course, you might be that person.

I recall one patient who worked very well on IE but could only do it with her husband in the room with her. She did not actually require him to be involved in the detail, she just needed someone she trusted and loved to be present. In fact she insisted that he sit in a chair in the corner of the room reading a book or the newspaper. That was creative.

I have had others who have started IE and got into it and decided to stop, and came back to see me instinctively preferring to talk it out in direct relationship.

Learning how to introduce IE is a skill acquired over time.

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