Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Resistance to Recovery: Secondary Gain Concerns

Secondary Gain Concerns Perhaps too little concern has been directed toward those instances in which the attention, affection, nurturance and support received by a patient has effectively potentiated their seeking a disability role. Unquestionably for some patients the gains inherent in the patient role are palpable. There is income for work no longer produced. There …

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Resistance to Recovery: Education

Educational Foundation for Understanding the Physical Diagnosis Patient education procedures vary according to age and academic background. The process of educating the patient is also impacted by the academic training, philosophies and standards of the clinicians involved in treatment. The patient may be provided with clinical nosology regarding the disease or condition without clarification sufficient …

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Resistance to Recovery: Fear of Diagnosis

Fear of the Clinical Diagnosis For the acutely ill patient who begins to confront the concept of chronicity of complaints, there are four sources of emerging fear. The patient fears that the diagnostic studies are incomplete, that treatment has been insufficient, that residual complaints will be unmanageable and that the support system upon which they …

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Resistance to Recovery: Introduction

Resistance to Recovery: IntroductionDespite appropriate and timely care, there are patients who fail to recover. While this failure can, in many cases, be traced to patient noncompliance, there are more often exogenous factors which impede the course of recovery. These are neither simple nor benign factors which exceed the boundaries of cost-contained and effective treatment, …

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Anti-Depressants

Many back injured patients become depressed. Some would say that most become depressed. However, very few seek treatment for their depression. Even if they were depressed prior to injury, and, again, there are data to support that pre-existing depression increases the risk of injury, there is a responsibility for treating the exacerbation of the depression …

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The Dangerous Patient

First, obviously you must consider all threats credible. Dangerousness has always been very difficult to predict. However, …
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"Medication vs. Medicating"

Prescribing an anti-depressant does not guarantee that the patient will be adequately medicated. Injured workers, like most …
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Why Referrals are Declined

There are doctors who refuse referrals of injured workers. They most often claim that workers’ comp patients treat …
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