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WORKING WITH ADULTS AND OLDER CHILDREN 4.1 Introduction Age range The approach described here for adults is appropriate also for teenagers and older primary school attenders, but it is necessary to involve the parents of younger patients. The programme for very young children is described separately in Chapter 5. Fig 4.1 Key Messages

Activate involvement Encourage realistic optimism Promote biological understanding •

Increase behavioural awareness

Themes and process The structure of the programme naturally breaks down into a series of consultations, between which the patient assesses their condition at home, reads their handbook (Appendix 2), practises new behaviours, and discusses the programme with others both at home and elsewhere. The treatment process has several inter-related themes described below and highlighted in Fig 4.1.

Achievable goals Discussion is needed on what can and what cannot be changed. While the constitutional state of atopy remains unavoidable, long-standing atopic skin disease is definitely avoidable for the great majority of patients. Complete remission of chronic disease, with only shortlived episodes of acute relapse, will become possible. Taking trouble in dealing with long-standing atopic skin disease is therefore a good investment of time and energy. 49

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Atopic Skin Disease - A Manual For Practitioners  

An account of a new behavioural approach to the treatment of atopic eczema, written for practitioners, but also for patients

Atopic Skin Disease - A Manual For Practitioners  

An account of a new behavioural approach to the treatment of atopic eczema, written for practitioners, but also for patients