Clinical Psychology & Communication in Medicine

By Christa Zimmermann

The unit has developed and standardized instruments and methodologies to analyze doctor patient interactions both in Primary Care and in Psychiatry. On the basis of the research held by the unit and the already existing material, trainings for health care providers (doctors, nurses, etc.) aimed to improve their use of communication skills have been carried out. In particular, through the use of a learner centred approach, participants learn how to collect and give information, the relationship building process and patients' involvement and how to deal with patients' emotions. The efficacy of these courses has been confirmed in General Practice and Psychiatry.
Currently, the unit is involved in of 2 multicentre studies: an international study on the citizens perception of doctors communication skills (Verona, Liverpool, Utrecht, Gent); and a national study on the informative needs of breast cancer patients and their involvement in treatment decisions (Verona, Brescia).


Prof. Lidia Del Piccolo, Psicologist, Assistant Professor
Dr. Claudia Goss, Psychiatrist, Research Fellow
Dr. Maria Angela Mazzi, Statistician
Dr. Michela Rimondini, Psychologist, Research Fellows


Guliver. A good doctor patient communication: which are the essential ingredients for the general population? A multicentre study.
Giuseppe Deledda, Michela Rimondini, Mariangela Mazzi, Christa Zimmermann
Description and aims: The study aims to identify through the method of the focus groups the key elements followed by citizen when evaluating doctors' communication skills in four different countries: Italy, Belgium, Oland and England. Each country set up 8 focus groups, collecting a sample of 160 subjects balanced for gender and age. Their verbal expressions have been analyzed with quantitative and qualitative systems, specifically developed for this study.

Informative and emotive needs of psychotic patients and their involvement in treatment decisions
Claudia Goss, Michela Rimondini, Mariangela Mazzi,  Christa Zimmermann, Lidia Del Piccolo
Description and aims: This study is part of a multicenter randomized trial that took place in Mental Health Centers across northern Italy, called Get up-Genetics, Endophenotypes and Treatment: Understanding early Psychosis. The aims of this research project are to investigate informative needs and expectations of psychotic patients and their relatives, associated with an "empowerment " intervention on patients (prompt sheet), on patients involvement in treatment decisions.  

The involvement of breast cancer patients in the informative and decisional processes during oncological consultations. a clinical multi-centre control trial.
Claudia Goss,  Giuseppe Deledda, Mariangela Mazzi,  Christa Zimmermann, Lidia Del Piccolo
Description and aims of the study: The main aim is to assess if a pre-consultation intervention (prompt-sheet) facilitates greater participation of patients in the consultation process by determining an increase in questioning and/or in the number of different illness related issues (diagnosis, treatment, prognosis) being discussed with the oncologist. Other aims are to assess: a) the effect of the intervention  on the level of patient involvement by the oncologist during the consultation, b) the verbal doctor patient interactions, c) the role of key persons accompanying the patient, on shared decision making process. The hypotheses are  that patients of the experimental group ask a greater number of questions, are  more involved in information exchange and decisional processes, more satisfied with the achievement of their needs and that consultations are characterized by greater patient-centeredness.

Evaluation of the effects of a training in communication skills in Psychiatry
Michela Rimondini, Claudia Goss, Mariangela Mazzi,  Lidia Del Piccolo, Christa Zimmermann
Description and aims: The aim of the present study is to evaluate the effects played by a training in communication skills specific for  psychiatric setting. The 16-hour course is divided in 4 interactive encounters, where participants through role-play, videofeedback and brainstorming recognize and correct their communication style. The study is based on an "Interrupted time series design" where each psychiatrist (10 residents) interviews 8 different simulated psychiatric patients (4 males e 4 females)  before and other 4 (2 males e 2 females) after the training, all balanced for disorder portrait (anxiety or mood disorders).

Emotional cues and concerns in psychiatry: the way they arise and the way they are responded to by health providers
Lidia Del Piccolo, Michela Rimondini, Claudia Goss, Francesca Moretti, Mariangela Mazzi, Christa Zimmermann
Description and aims: The Verona Coding Definitions of Emotional Sequences (VR-CoDES) is a consensus based  system available to interested researchers free of charge on The system has been developed by an international group of  researchers (the Verona Network on Sequence Analysis), to code patient expressions of emotional distress (defined as cue or concern) in medical consultations. The study is based on the application of the VR-Codes to a set of psychiatric consultations to verify its reliability and to examine in detail how patients' emotions arise during the consultation. Also psychiatrists' immediate (lag1) responses are analysed and described. The aim of the study is to describe how emotions come out and how they are handled by health providers, to have an accurate picture of the abilities and the gaps in this important topic of communication skills.

Patient Education and Counseling


25-26 February 2010, Verona. IX  Meeting VERONA NETWORK ON SEQUENCE ANALYSIS