[Difficult doctor-patient interactions in the psychiatric consultation-liaison service: the use of attachment-based models].

Abstract

Background: In the psychiatric consultation-liaison service (CL service) in hospitals a rapid classification of the interaction behavior of patients is often essential for a successful consultation.

Objective: This article gives an abridged and practical overview of how models from the attachment theory can be meaningfully implemented in the CL service.

Material and methods: Based on the relevant literature the foundations of attachment theory are briefly explained and appropriate recommendations for action for the construction of medical relationships are derived. A case study is used to illustrate this pragmatic approach.

Results: According to the 4‑category model of Bartolomew and Horowitz a clear classification into 4 different attachment styles can be achieved in adulthood. Furthermore, the derived recommendations for action can be used in the CL service to adapt the construction of relationships.

Discussion: Models from the attachment theory can be helpful to establish a functional physician-patient relationship. This is helpful for a successful contact in counselling and these models can also mediate the primary treating physician and contribute to positive medical outcomes.