Rethinking Causality, Complexity and Evidence for the Unique Patient : : A CauseHealth Resource for Healthcare Professionals and the Clinical Encounter.

• Author: Anjum, Rani Lill.
• TeilnehmendeR: Copeland, Samantha.; Rocca, Elena.
• Place / Publishing House: Cham : : Springer International Publishing AG,, 2020.; ©2020.
• Year of Publication: 2020
• Edition: 1st ed.
• Language: English
• Physical Description: 1 online resource (252 pages)

Table of Contents

Rethinking Causality, Complexity and Evidence for the Unique Patient -- Preface -- The Story of CauseHealth -- Reference -- Abbreviations -- Contents -- List of Figures -- Contributors to Part II -- Editors and Contributors to Part I -- Notes on Editors and Contributors -- Part I: Philosophical Framework -- Chapter 1: Introduction: Why Is Philosophy Relevant for Clinical Practice? -- Chapter 2: Dispositions and the Unique Patient -- 2.1 The Similar and the Unique -- 2.2 Empiricism: Causality Requires Repeated Observations -- 2.3 Dispositionalism: Causality Happens in the Single Case -- 2.3.1 Causes Are Dispositions -- 2.3.2 Causes Are Intrinsic -- 2.3.3 Causality Is Complex -- 2.3.4 Causality Is Context-Sensitive -- 2.3.5 Modelling Causality -- 2.3.6 Two Types of Causal Interference -- 2.3.7 Degree of Tendency -- 2.3.8 Threshold Effects and Tipping Points -- 2.4 Philosophy of Causality Influences Scientific Methods -- 2.5 Practical Implications for the Clinic -- 2.5.1 Causal Evidence Comes from the Patient -- 2.5.2 There Is No Standard or Average Patient -- 2.5.3 Unexpected Outcomes Are Valuable Causal Lessons -- 2.6 To Sum Up… -- References and Further Readings -- Chapter 3: Probability for the Clinical Encounter -- 3.1 Uncertainty and Probability in the Single Case -- 3.2 Probability from Statistics: Frequentism -- 3.2.1 Frequentism and Evidence Based Approaches -- 3.2.2 Randomisation, Inclusion Criteria and Exclusion Criteria in Population Trials -- 3.2.3 Internal and External Validity of Causal Claims from Randomised Controlled Trials -- 3.3 Probability as Degree of Belief: Subjective Credence -- 3.3.1 Updating Belief -- 3.3.2 Understanding the Basic Bayesian Formula -- 3.3.3 Uncertainty as Lack of Knowledge -- 3.4 Probabilities as Dispositional and Intrinsic: Propensities.

3.4.1 Individual Propensities Are Not Always Seen Through Frequencies -- 3.4.2 Propensities as Qualities -- 3.4.3 Propensities and Prediction -- 3.5 Propensities and the Clinic -- 3.5.1 The Importance of Local Knowledge -- 3.5.2 Person Centered Clinical Analysis -- 3.5.3 Focus on Theories of Causal Mechanism -- 3.5.4 Multidisciplinarity and Networking -- 3.5.5 The Potential of Clinical Experience for Advancing Medical Knowledge -- 3.5.6 What Does N = 1 Mean, Within the CauseHealth Project? -- 3.6 To Sum Up… -- References and Further Readings -- Chapter 4: When a Cause Cannot Be Found -- 4.1 The Clinical Challenge of Medically Unexplained Symptoms (MUS) -- 4.2 The Problem of Uniqueness -- 4.2.1 The Patient Context: What Was There Before -- 4.2.2 Qualitative and Quantitative Approaches to Causal Inquiry -- 4.2.3 Dispositional Take On Perfect Regularity: Is It Causality or Something Else Entirely? -- 4.3 An Important Lesson from Medically Unexplained Symptoms (MUS) -- 4.3.1 We Need Many Methods to Establish Causality -- 4.4 Patient Narratives as a Way Forward -- 4.5 Using Patient Narratives -- 4.5.1 Narrative as a Tool for Causality Assessment -- 4.5.2 Narrative as a Tool for Understanding the Causal Story -- 4.5.3 Narrative as a Collaborative Tool in Healthcare -- 4.6 To Sum Up… -- References -- Chapter 5: Complexity, Reductionism and the Biomedical Model -- 5.1 The Biomedical Model of Illness -- 5.1.1 Reductionism in Medicine and Science -- 5.1.2 Critical Reflections Concerning the Biomedical Model -- 5.2 The Bio-psychosocial Model of Illness -- 5.2.1 Bottom Up and Top Down Causality in Medical Research: Two Views on Cancer Aetiology -- 5.3 The CauseHealth Approach: Change Must Start from Ontology -- 5.4 What Is Causal Complexity and How Should It Be Investigated? -- 5.4.1 Mereological Composition -- 5.4.2 Genuine Complexity and Emergence.

5.4.3 Practice Is Motivated by Ontological Bias -- 5.5 We Need an Ecological Turn in Medicine and Healthcare -- 5.5.1 Whole Person Healthcare in Practice -- 5.6 To Sum Up… -- References and Further Readings -- Chapter 6: The Guidelines Challenge -- 6.1 The Tension Within -- 6.1.1 Evidence Based Medicine and the Rise of Guidelines -- 6.1.2 Guidelines in Practice -- 6.2 Guidelines and Tramlines -- 6.2.1 Guidelines and Evidence Based Policy -- 6.3 The Ontology of Guidelines -- 6.3.1 Logically Speaking, Guidelines Cannot Be Rules -- 6.3.2 What Does This Mean for Guidelines in Practice? -- 6.4 The Epistemology of Guidelines -- 6.4.1 Transparency and the Tension Between Flexibility and Standardization -- 6.4.2 When Should the Particular Be Engaged? -- 6.5 Guidelines in the Dispositionalist Way -- 6.5.1 So, What Should We Do with Guidelines? -- 6.6 To Sum Up… -- References and Further Readings -- Part II: Application to the Clinic -- Chapter 7: The Complexity of Persistent Pain - A Patient's Perspective -- 7.1 Introduction -- 7.2 The Injury I Haven't Recovered From -- 7.3 Being Treated Within a Narrow View of Pain -- 7.4 Starting to Learn About the Complexity of Pain -- 7.5 Learning About Causality and Dispositionalism -- 7.6 A Smallholding Analogy -- 7.7 The Analogy Explained -- 7.8 Combining Causality, Dispositionalism and Predictive Processing -- 7.9 A Simple Understanding of My Pain -- 7.10 How Has Understanding Pain in This Way Helped Me? -- 7.11 The Complexity of Persistent Pain -- Chapter 8: Above and Beyond Statistical Evidence. Why Stories Matter for Clinical Decisions and Shared Decision Making -- 8.1 Musculoskeletal Disability -- 8.2 Evidence Based Healthcare: The Heart Is in the Right Place, But… -- 8.3 Therapeutic Alliance: A Dispositional View -- 8.4 Bringing the Totality of Evidence Together -- References and Further Readings.

Chapter 9: Causality and Dispositionality in Medical Practice -- 9.1 Some Background -- 9.2 Considering Causality -- 9.3 Diagnosis and Decisions -- 9.4 Overview of Important Dispositional Insights in Clinical Care -- 9.5 Conclusion -- References and Further Readings -- Chapter 10: Lessons on Causality from Clinical Encounters with Severely Obese Patients -- 10.1 Introduction -- 10.2 A Framework for the Clinical Encounter -- 10.2.1 The Person in the Role of the Patient - What Are the Goals of Healthcare? -- 10.2.2 A Group Seminar Before the Clinical Encounter: Setting the Stage -- 10.2.3 The Consultant's Understanding in Advance of the Clinical Encounter -- 10.2.4 The Clinical Encounter -- 10.2.5 As a Child, Did You Feel Safe at Home? -- 10.2.6 The Consultant's and Patient's Understanding After the Clinical Encounter -- 10.3 Case Stories -- 10.3.1 Olav Olsen, a Severely Obese Man -- 10.3.2 Alma Almas, a Severely Obese Woman -- 10.3.3 Ebba Eskil, a Severely Obese and Depressed Woman -- 10.4 Where Do We Go from Here? -- 10.4.1 "What the Hell Is Going on Here?" -- 10.4.2 Is This How the System Works? -- 10.5 Outlook -- References and Further Readings -- Chapter 11: Reflections on the Clinician's Role in the Clinical Encounter -- 11.1 Introduction -- 11.2 Reflections on How Values Affect Clinical Encounters -- 11.3 The Work I Did with Marie -- 11.3.1 Presentation of the Client -- 11.3.2 Presenting Problems -- 11.3.3 Diagnosis -- 11.3.4 The I-Thou Process -- 11.3.5 Key Episode 1 -- 11.3.6 Key Episode 2 -- 11.4 Reflections -- References and Further Readings -- Chapter 12: The Relevance of Dispositionalism for Psychotherapy and Psychotherapy Research -- 12.1 Introductory Preface -- 12.2 Misleading Statement on Evidence Based Psychological Practice -- 12.3 Questioning the Medical Model -- 12.4 The Challenge from Dodo-Birds and Meaning-Makers.

12.5 The Philosophical Bias of the Medical Model -- 12.6 Dodo-Birds Must Take the Bull by Its Horns -- 12.7 Meaning-Makers Must Target the Right Enemy -- 12.8 Humeanism Must Be Replaced by Dispositionalism -- 12.9 Implications for Psychotherapy Research -- 12.10 Implications for Psychotherapy -- 12.11 As Statistics Don't Get It, Try Getting the Vectors Right -- References and Further Readings -- Chapter 13: Causal Dispositionalism and Evidence Based Healthcare -- 13.1 Complexity in Practice -- 13.2 Evidential Hierarchies Expose Causal Theory -- 13.3 A Dispositionalist Response -- 13.3.1 Explain the Causal Role of Content from Particular Research Methods -- 13.3.2 Motivate a Viable Epistemology -- 13.3.3 Account for Causal Processes in Individual Level Clinical Decision Making -- 13.3.4 Help Understand and Assess Additional Premises and Assumptions Needed to Bridge the Inferential Gap Between Population Level Evidence and Clinical Decisions -- 13.4 Conclusion -- References and Further Readings -- Chapter 14: The Practice of Whole Person-Centred Healthcare -- 14.1 A Woman with Skin Disease -- 14.2 A Professional Evolution -- 14.3 Somatic Metaphors -- 14.4 Whole Persons in the Clinic -- 14.5 Reactions from Colleagues -- 14.6 Dualist Psychotherapy -- 14.7 Publications -- 14.8 Human Infant Development -- 14.9 Mindbody Healthcare -- 14.10 I Was Conflicted -- 14.11 Being Looked at or Being Seen? -- References and Further Readings -- Chapter 15: A Broken Child - A Diseased Woman -- 15.1 Cecily Cramer -- 15.2 Crisis Onset -- 15.3 Two In-Patient Psychiatric Hospital Ward Admissions -- 15.4 Follow-Up Care -- 15.5 Reflections -- 15.5.1 Recently Acquired Knowledge -- 15.5.2 Updating the Concept of Causality -- References and Further Readings -- Chapter 16: Conclusion: CauseHealth Recommendations for Making Causal Evidence Clinically Relevant and Informed.

16.1 Practical Recommendations for Change.