Ross James, Watling Chris
, MD, MHPE, FRCPC, Department of Psychiatry, Western University, Victoria Hospital, London, Ontario, Canada.
, MD, PhD, FRCPC, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Centre for Education Research and Innovation (CERI), Western University, London, Ontario, Canada.
BJPsych Open. 2017 Feb 9;3(1):26-33. doi: 10.1192/bjpo.bp.116.004242. eCollection 2017 Jan.
Psychiatry has faced significant criticism for overreliance on the (DSM) and medications with purported disregard for empathetic, humanistic interventions.
To develop an empirically based qualitative theory explaining how psychiatrists use empathy in day-to-day practice, to inform practice and teaching approaches.
This study used constructivist grounded theory methodology to ask (a) 'How do psychiatrists understand and use empathetic engagement in the day-to-day practice of psychiatry?' and (b) 'How do psychiatrists learn and teach the skills of empathetic engagement?' The authors interviewed 17 academic psychiatrists and 4 residents and developed a theory by iterative coding of the collected data.
This constructivist grounded theory of empathetic engagement in psychiatric practice considered three major elements: relational empathy, transactional empathy and instrumental empathy. As one moves from relational empathy through transactional empathy to instrumental empathy, the actions of the psychiatrist become more deliberate and interventional.
Participants were described by empathy-based interventions which are presented in a theory of 'empathetic engagement'. This is in contrast to a paradigm that sees psychiatry as purely based on neurobiological interventions, with psychotherapy and interpersonal interventions as completely separate activities from day-to-day psychiatric practice.
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© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
精神病学因过度依赖《精神疾病诊断与统计手册》（DSM）和药物治疗，而被指忽视了共情的、人文主义的干预措施，饱受批评。
建立一个基于实证的质性理论，解释精神科医生在日常实践中如何运用共情，以为实践和教学方法提供参考。
本研究采用建构主义扎根理论方法，提出以下两个问题：（a）“精神科医生在日常精神病学实践中如何理解和运用共情参与？”以及（b）“精神科医生如何学习和教授共情参与的技巧？”作者采访了17名学术精神科医生和4名住院医生，并通过对收集到的数据进行迭代编码得出了一个理论。
这个关于精神病学实践中共情参与的建构主义扎根理论包含三个主要要素：关系性共情、交互性共情和工具性共情。随着从关系性共情到交互性共情再到工具性共情的转变，精神科医生的行为变得更加刻意和具有干预性。
参与者采用了基于共情的干预措施，这些措施在“共情参与”理论中有所体现。这与一种将精神病学视为纯粹基于神经生物学干预，而心理治疗和人际干预与日常精神病学实践完全分离的范式形成了对比。
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©皇家精神科医学院2017年。本文是一篇开放获取文章，根据知识共享非商业性、无衍生作品（CC BY-NC-ND）许可协议分发。
