Positive Psychology in Practice: Patient Care Management
How can providers help patients take a more proactive role in their own care? Patient engagement is proving to be an elusive goal as health care professionals, technology experts, and family caregivers struggle to find a way to get patients actively involved in preventative and maintenance care at home. Providers are noticing a strange paradox: the more technology is introduced to help patients remember to take pills or teleconference with their care provider, the more providers see how low engagement rates are and it confounds them.
Positive psychology, or the study of happiness and personal growth, has been gaining influence in the world of mental health as well as in the development of a new approach to patient care management and technology. In Part 1 of this two-part interview, Sean Slovenski, CEO of Care Innovations, discusses the role of positive psychology in patient care and how it can help change patients’ attitudes and behaviors toward their health..
Q: WHAT IS POSITIVE PSYCHOLOGY?
Slovenski: The science of Psychology, to date, has been focused on people’s deficits – let’s figure out what your weaknesses are and let’s try to improve those. So in other words, on a scale of -10 (meaning you feel horrible) to a +10 (meaning you’re “perfect” and loving life), the goal of psychology was to treat pain to get you from a -3 to maybe a +1 or 2, which was considered success.
What positive psychology set out to do was help people understand their core character strengths and how to apply them in their daily lives; many people are amazingly good at 1-2 things that fall into their strengths. What they found through research is that if you apply those strengths to their fullest, you can overshadow those deficits. So instead of going from a -3 to a +1, you can get to a +6 on the scale by focusing on developing your strengths in this positive approach.
Dr. Martin Seligman, former President of the American Psychological Association and current Director of the University of Pennsylvania Positive Psychology Center and my partner in a former business, Dr. Neal Mayerson founder and CEO of the Values In Action Institute ...pulled together the best psychologists in the world and created an entirely new discipline within the field of human psychology, Positive Psychology, that in turn created a common nomenclature, common measurement tools, and spawned a new line of scientific inquiry into human happiness and potential. . The epicenter of this new Positive Psychology discipline is the University of Pennsylvania Positive Psychology Center run by Dr. Seligman and the core center of the research around human character strengths is located in Cincinnati, Ohio, The Values in Action Institute.
The new discipline of Positive Psychology is a real science, and it’s having a profound impact on people’s ability to improve their happiness and achieve goals. One of the things they’ve discovered is that people are significantly more likely to achieve their goals if they apply their strengths than if they do not. To do that, you have to understand human beings a little bit more and understand core strengths and how to apply them. It’s a different paradigm of thinking than what is typical in the technology and clinical world, but the outcomes are profound and merit their due attention.
Q: HOW DOES POSITIVE PSYCHOLOGY IMPACT BEHAVIOR CHANGE?
Slovenski: What I typically find is that clinicians focus on the clinical variables involved in healthcare and dabble into “how is the person feeling.” Technologists focus on the technology and a dip hair into behavior, basically just trying to figure out how to have the least cumbersome tool so that more people who might be pre-disposed to trying something might try to do it. In other words, they have their colored glasses on and can’t see past their traditional paradigms. What they don’t realize, most times, is that if you actually understood human being’s motivations for doing things, then you could devise a plan to get more people to engage with devices and programs than you can with traditional thinking even if they aren’t the most user friendly gadgets.
For us at Care Innovations, we’re trying to take these principles of what we know about Positive Psychology and apply them to how we are teaching people about their health and to the development of the technology that they’re using in the home, to help nurses and doctors understand more about what’s really going on with their patients at home.
Q: Why People Don’t Adhere To Their Medication Regimes
Slovenski: Setting aside finances, two of the biggest reasons, we have found, why people don’t adhere to their medication regimes isn’t because they need another text message reminder or need another piece of mail sent to their home. People aren’t that stupid. Two of the biggest reasons are:
1) Disbelief in diagnosis and
2) Irrational fear.
An Irrational fear, for example, I had a patients that I’ve dealt with say “My Aunt Tilly took a blue pill and she died a few weeks later. The pill the doctor just gave me for my health issue is blue. I’m going to die because my Aunt Tilly took a blue pill.” And I say, “Well the blue pill your aunt took was for bipolar disorder and isn’t why she died, and your pill is for overactive bladder.” But it doesn’t matter because people have irrational fears.
They also disbelieve their diagnosis. It’s “I can’t believe I have that, so taking this medication is confirming that I have that thing now and I am not going to take it.” Or “I’ve been like Hoss Cartwright from Bonanza, I’m a big burly guy, – here I am, diabetic and suffering from diabetes related ED plus I’m gaining weight.” So what the patient translates their diagnosis into is I’m less the guy I use to be and view myself as, and to take the pills reminds me of that fact and to top that off, they don’t feel different in the first couples of days so they assume its not working. So by and large it’s psychological reasons why people don’t adhere to medication routines not simply they “forgot.”
But what do you see coming from the tech space? Light up glow caps to remind you to take your pill. But that’s not necessarily the underlying reason people aren’t taking their meds. So when we’re going into the home, we’re asking questions, “Why do you actually want to get better? How does this make you feel now that you’ve had this diagnosis and been prescribed these medications?” And we have a brief counseling session that does wonders, before we ever get to pushing buttons on a tablet and putting blood pressure cuffs on their wrists.
So the way we go about engaging the patient is in large part due to these new findings from the field of positive psychology.
Check back soon for part 2 of our interview.