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Why some practitioners fail with habit reversal for chronic atopic eczema
Sometimes however failure seems due to the practitioner, rather than the patient.
Here are four important practitioner issues that we discussed:
1. The practitioner fails to understand the programme.
The approach requires more than the typical out-patient consultation, and crucially combines habit reversal with optimised topical treatment in a therapeutic programme that includes follow-up.
2. The practitioner has failed to engage with the patient.
The fundamental part played by the practitioner-patient relationship cannot be over-stated. Success is unlikely unless the right attitude is established from the start.
3. When the practitioner takes a short-cut.
The time constraints in clinical practice are such that it is tempting to give over-simplified habit reversal advice. Leaving out awareness training, or just telling the patient what to do, are common mistakes.
4. Starting with a difficult patient.
Success with all patients is not possible. What is certain in our experience is that most patients do very well, very quickly, and are delighted. Characteristically they easily accept and commit to the programme.
What has your experience been?
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