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Managing myopia with psychology

Dr Claire Hallas explored the belief systems that influence decisions made by parents and how practitioners can identify them

16 Jul 2018 by Andrew McClean

BCLA UK delegates heard how identifying the belief systems that influence a parent’s decision-making are key to ensuring successful myopia management for their children.

The ideas, beliefs and motivations behind the decisions parents make when thinking about managing their child’s myopia were explored by practitioner health psychologist, Dr Claire Hallas, at the event on 4 June.

Speaking at Conference Aston, Dr Hallas discussed why parents say yes or no to contact lens use for their children and asked if beliefs held by parents about vision drive decisions taken when managing myopia.

Dr Hallas highlighted that not all people think alike, explaining that although there are similar patterns, factors such as families and culture influence decision-making and this should be taken into account in practice.

“Often we’re quite wedded to the way that we want to think,” Dr Hallas explained, adding: “We’ve built up a lot of evidence about why that’s the best way to think and if it has actual positive actions or outcomes for us.”

“Sometimes it might be challenging for practitioners to think about how to move this parent from being so focused on ‘myopia’s not a problem and contact lenses are just there to treat vision problems’ – and to think about how we fill that gap” she shared.

A case study of a mother who is unfamiliar with vision problems was presented by Dr Hallas. She explained that the child has been diagnosed with myopia, which is a new condition to the parent. Dr Hallas asked attendees to think about the way the parent conceptualises myopia through increasing their understanding of the condition and exploring the available options.

“Parents, or anybody that’s been confronted with a new health condition or diagnosis, would want to jump from ‘If I’ve got this, what can be do about it.’ Sometimes there is a large gap between what can be done about it and the position of the person in that point of time,” Dr Hallas said.

The psychologist discussed the balance between necessity beliefs and concern beliefs in order to identify belief systems and understand what is driving the decision-making process.

Dr Hallas explained that the “here and now” vision problem and the long-term risk of myopia need to be tied together and explained by the practitioner. She added that practitioners should not devalue the experiences of the patient in order to form trust with the parent.

Beliefs, coping and outcomes are the three stages to working with parents’ beliefs in practice, Dr Hallas said.

On the first consultation, the psychologist suggested adding questions relating to their understanding of myopia during consultation in order to identify parents’ beliefs and the barriers to successful management.

At the fitting appointment, questions about past experiences could be useful to determine if compliance will be an issue and if alternative methods might be more beneficial.

A parent or child diary system to monitor pre and post-implementation of the management option will help address new concerns and beliefs about efficacy, Dr Hallas concluded. 

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