When patient meets doctor, as well as engaging in a transaction with a clinical purpose, they react to one another as people. Their personalities and ability to make relationships in general also affect the professional interaction. As with other relationships, things can go wrong. The outcome of a consultation may not then be what was hoped for or intended on either side. What may be lost, or not even achieved, is a sense of working with one another - hence the 'problem patient' or 'quack doctor'. This book describes the factors that may complicate the clinical transaction between patient and doctor, emphasising and explaining the influence of often unconscious personal aspects. This is encompassed within a readily applied and concise model, which yields a fresh analysis and understanding. The insight gained can help doctors, within their own consultational styles, to better manage their interaction with patients. Plentiful clinical case vignettes illustrate this approach to understanding and managing clinical transactions and will be welcomed by clinical students and doctors in training, as well as by their trainers.

When patient meets doctor, as well as engaging in a transaction with a clinical purpose, they react to one another as people. Their personalities and ability to make relationships in general also affect the professional interaction. As with other relationships, things can go wrong. The outcome of the consultation may not then be what was hoped for or intended on either side. This 1994 book considers the factors which may cause problems in the doctor-patient relationship, emphasising and explaining the often unconscious personal aspects of doctor and patient within a model studied from various perspectives. Through this insight doctors can be helped to manage their interactions with patients within their own consultational style, thereby avoiding many unnecessary professional relationship problems. This analysis, which is well-illustrated by clinical case vignettes, is sure to be welcomed by clinicians, trainees and course organisers in all areas where communication between individuals plays an important role.

Personality Disorder offers a comprehensive and accessible collection of papers that will be practically useful to practitioners working in secure and non-secure settings with patients who have personality disorders. This book brings together fourteen classic papers, which address the impact that working with personality disorder patients can have on staff. It also offers theoretical explanations for personality disorder, and explores other issues such as the concept of boundaries in clinical practice, psychiatric staff as attachment figures and the relationship between severity of personality disorder and childhood experiences. Each paper is introduced with contextual material, and is followed by a series of questions that are intended to be used as educational exercises. This book will be essential reading for clinical and forensic psychologists, psychiatrists, community psychiatric nurses, social workers and students.

This guide for setting up a clinical service in the National Health Service is based on the author's experience of leading a nationally funded project to develop two new specialist services in different parts of the country and involving three separate NHS Trusts. The project successfully delivered two services for personality disordered patients based on the template of Henderson Hospital, a democratic therapeutic community (TC). Kingsley Norton takes the reader, step-by-step, through the entire process of setting up these new services. Unpacking Henderson Hospital's complex interpersonal environment into its ideological, 'cultural' and structural constituents, a development team that included ex-service users from Henderson used these ingredients to imprint the TC model in the newly recruited staff teams. The two replicated products were further supported and evaluated by the development team during their first 18 months of operation. The author reveals the complexity of the developmental task and shows that the process was never a case of 'just adding water'. Dr Norton's wealth of hands-on experience and practical advice makes this book essential reading for anyone interested in management and the NHS or public services and attempting to innovate. It is also useful for those wanting to understand more about TCs and how they operate as institutions.

`[In this book] "difficult clients" is meant as "difficulties with clients"... I like to be challenged in my thinking and there was much about this book that I found thought-provoking and challenging, and which made me re-examine my basic philosophy and approach to counselling... For the newly trained counsellor this book offers organizational, practical and theoretical advice... it gives a good academic overview of understanding how client-counsellor interactions can become difficult, together with some preventative techniques and case-work examples' - Counselling, The Journal of The British Association for Counselling Counsellors and other mental health professionals will inevitably encounter clients who are difficult to work with because they do not comply with the basic requirements of forming a trusting relationship and accepting help or advice. Such clients can place an enormous strain on those who try to help them. This book sets out practical guidelines, backed up by examples and a sound theoretical base, for the management of these difficult, disturbed or disturbing clients. The authors concentrate on the everyday difficulties of the transaction between practitioner and client in their respective social contexts, rather than locating the problems solely within the client, and indicate ways in which these difficulties can be successfully overcome.