Psychology team supporting patients through their treatments

Drugs can’t work for patients who don’t take them.

Statistics over many years have shown that around half of all patients don’t take their medication as prescribed. That leaves them at risk of continuing pain or even of more serious harm or death – and it’s also costly for the NHS as patients are likely to need further appointments and more potentially wasted treatment.

Clinical Psychologist Dr Jessica Dean has worked in Salford Royal’s kidney department since 2008. Her role includes supporting patients through treatment that can be demanding and demoralising, as well as helping them to keep to their treatment.

She has trained colleagues on motivational interviewing, using techniques that draw out what is important to the patient so they feel engaged and motivated about their treatment. This was initially developed by experts working in addiction, who found simply telling people what to do didn’t work but that they could influence patients’ behaviour if they found out what mattered to them.

Kidney patients face drastic changes to their lifestyle, restrictions on what they can eat and drink­, large amounts of medication to be taken on a strict timetable and some need dialysis several times a week – all of which can be difficult to manage, particularly when you’re feeling very ill.

The renal team has found using motivational interviewing techniques has made a big difference to consultations with patients, making them more personal and focused on what they care about. The result has been that patients are more engaged with their treatment and feel more in control of it.

Jessica has published a number of research papers on her work in the renal department. She said: “There’s been a tendency in the past to look at a ‘one size fits all’ approach but that doesn’t work. We’ve found that thinking about the individual and how we can react to what they want – it might be more energy to play with their grandchildren, for instance, or a better night’s sleep – is very important. It makes it more of a collaboration, with staff giving patients the right information and allowing them to make choices about their treatment.”

This personalised approach also applies to Jessica’s recent work looking at how clinical staff can encourage patients to adhere to their medical treatments by responding to their personality type and tailoring their approach to suit it. Jessica and colleagues in Birmingham and Switzerland have worked with author Gretchen Rubin and used her ‘four tendencies’ framework which characterises people as  upholders, questioners, obligers and rebels. They have called for more research in this area.