ABSTRACT

Since emotional problems often manifest as physical problems, and physical problems usually have emotional consequences, primary care practitioners are advised to assess patients’ psychosocial issues as part of the routine office consultation. The letters “BATHE” provide a framework for handling the context of the visit. “B” stands for Background: “What is going on?” “A” stands for Affect: “How do you feel about it?” “T” stands for Trouble: “What about it bothers you most?” “H” stands for Handling: “How are you dealing with that?” “E” stands for Empathy: “That must be very difficult for you!” BATHEing the patient early in the interview structures an effective and efficient psychotherapeutic intervention into the consultation. BATHE has been shown to improve patient satisfaction with a visit. Multiple problems can be handled by sequentially applying the simple technique. BATHE can also be used to structure a return visit and to determine whether a problem is chronic or acute. The time constraint inherent in the brief session prevents overloading the patient. Attentive listening is a prerequisite for positive outcomes. If a practitioner feels overwhelmed by the extent of a patient’s problems, a psychiatric consult should be considered.