Counseling in Optometry
No matter how objective Optometry tests become and no matter how technologically advanced diagnostics evolve in Optometry, the most effective eye care is that the patient and the optometrist work together to help the patient get the best treatment and see better. The most effective optometrists know that to help the patient, the patient needs to help us by providing the right information and feedback. Those optometrists are skilled in allying with the widest range of patients’ personalities and characteristics and get the patient to collaborate in the process. Effective optometrists have a systematic perception of what needs to be understood by listening to each patient and by knowing how to communicate effectively to convey the right message and get the patient to comply. They know how to follow up with patients’ visual needs and know how to handle problems every step of the way.
When we talk about Counseling in Optometry, the first thing that comes to mind is that counseling is a fundamental competency for family physicians who employ it for counseling patients on lifestyle and unhealthy behavior change and medical adherence difficulties. However, effectiveness in providing eye care increases with the adoption and application of some structured counseling strategies that physicians use that don’t take more than few minutes to perform. Counseling could be important to help patient stop smoking, reduce alcohol consumption, or adopt contact lenses care methods. According to the patient’s motivation for change, a practitioner would select the optimal counseling approach. Patients who are aware and responsive to awareness about the eye problems that can occur with unhealthy behavior are approached with structured sequential strategies like the five A’s and FRAMES. Patients less aware of unhealthy behavior effects or care less about the consequences, motivational interviewing is employed to help initiate behavioral change.
The five A’s technique has been associated with reducing alcohol and smoking and consists of ask, advise, assess, assist, arrange. The five A’s technique pertains of a stepwise protocol to efficiently assess and counsel the patient asking about the behavior as if the practitioner don’t know about it, advise on how this behavior is currently affecting his health, assess his behavior with general metrics and norms, assist him in achieving a change, and finally arrange a plan of action or when to see him again for follow up.
The FRAMES technique has been associated with reducing alcohol-related risks and cannabis use and consists of feedback about personal risk, responsibility of patient, advice to change, menu of options, empathy, self-efficacy enhancement.
The employment of motivational interviewing has been associated with weight loss, blood pressure, and alcohol use. It consists of establishing rapport and eliciting patient values based on asking open-ended questions, affirmation of information, reflection on the situation outcomes, and summarization.