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Related Experiment Video

Updated: Feb 1, 2026

E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
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Counseling Patients in Primary Care: Evidence-Based Strategies.

H Russell Searight1

  • 1Lake Superior State University, Sault Sainte Marie, MI, USA.

American Family Physician
|December 12, 2018
PubMed
Summary

Family physicians can improve patient counseling efficiency using structured strategies like the transtheoretical model, five A

Area of Science:

  • Primary Care Medicine
  • Behavioral Health
  • Health Psychology

Background:

  • Family physicians dedicate significant time to counseling patients on psychiatric conditions, unhealthy behaviors, and medical adherence.
  • Efficient counseling is a major challenge in primary care settings.
  • Effective, structured counseling strategies are available for primary care.

Purpose of the Study:

  • To outline effective counseling strategies for family physicians.
  • To guide the selection of appropriate counseling approaches based on patient motivation and condition.

Main Methods:

  • Utilizing the transtheoretical (stages of change) model to assess patient motivation.
  • Applying structured counseling strategies: five A's (ask, advise, assess, assist, arrange) and FRAMES (feedback, responsibility of patient, advice to change, menu of options, empathy, self-efficacy enhancement) for health risk behaviors.

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  • Employing motivational interviewing for ambivalent patients and the BATHE (background, affect, troubles, handling, and empathy) strategy for psychiatric and psychosocial issues.

    • Main Results:

    • The transtheoretical model helps tailor counseling to patient motivation.
    • Five A's and FRAMES are effective for patients receptive to health risk behavior education.
    • Motivational interviewing is successful for patients ambivalent about change.
    • The BATHE strategy is useful for patients with psychiatric conditions and psychosocial issues.

    Conclusions:

    • Structured counseling strategies enhance efficiency and effectiveness in family medicine.
    • Tailoring interventions based on patient motivation and condition is key.
    • Referral to subspecialty care is necessary for patients not responding to brief interventions.