Dealing with difficult patients

Version française General principles for dealing with difficult patients who are cognitively intact As caregivers, we often find ourselves extending ourselves for our patients, “going the extra mile”. This works well when the patient is appreciative of our efforts: we feel good about ourselves. But if our efforts are not…

Read more

Traiter les patients difficiles

English version Principes généraux relatifs aux traitements des patients difficiles dont la fonction cognitive est intacte En tant que soignant professionnel, nous devons souvent nous dévouer “corps et âme” pour nos patients.  C’est très valorisant de savoir à quel point nos patients apprécient et qu’ils nous témoignent leur reconnaissance. Toutefois,…

Read more










Protocol for Management of Depressive Disorders in Cancer Patients

Protocol for Management of Depressive Disorders in Cancer Patients Diagnostic interview & instruments to identify the disorder & to identify key symptoms; include interview with family/caregivers, careful sleep assessment • Major depression • Dysthymia • Subsyndromal Depressive Disorder • Bipolar Affective Disorder, Depressed Phase • Presence of psychosis • Presence…

Read more

Sleep, depression, fatigue, and insomnia

Sleep, Depression, Fatigue, and Insomnia Henry Olders, MD, FRCPC12 August 1998 IntroductionRecent research indicates that an important cause of depression may be sleeping too much; specifically, too much Rapid Eye Movement (REM) sleep. In those individuals without a genetic predisposition to depression, too much REM sleep can cause some depressive…

Read more


The Paradoxical Approach

Two ideas central to treatment: 1. Focusing on observable behavioural interaction in the present 2. Deliberate intervention to alter the ongoing system All theories of psychotherapy have limitations of practice as well as conception, inherent in their own nature (although often attributed to human nature). Basic Premise: the kinds of…

Read more