Psychosocial Concepts and Support Systems
Person-centered psychosocial assessment
Assess the whole person: biological, psychological, social, cultural, spiritual, financial, and environmental factors. Core concepts include health literacy, patient activation, readiness to change, motivational interviewing, stages of change, trauma-informed care, cultural humility, family systems, caregiver burden, grief and loss, coping, resilience, and social determinants of health. Screen for depression, substance use, suicide risk, abuse/neglect, and unmet basic needs. Match intervention to readiness: precontemplation needs rapport and information; contemplation needs ambivalence exploration; preparation and action need concrete planning and support.
Traps
Questions reward assessing before advising. Do not confuse case management counseling and support with psychotherapy. Avoid stereotyping culture as fixed; ask about preferences. Do not assume family is available or willing. Missing caregiver burnout, financial toxicity, or safety risk is a common error. Confidentiality applies unless law requires reporting.
Worked example
A patient with diabetes misses insulin because of cost and irregular work. Instead of lecturing, use open questions, affirmations, reflections, and summarizing; assess readiness, barriers, insurance, and literacy; then offer choices. Rule: assess, collaborate, and match the intervention to stage-not to the clinician's urgency.