title: Understanding emotionally relevant situations in primary dental practice. 3. Emerging narratives.
abstract: OBJECTIVE
  Dentists experience considerable occupational stress. Stressful clinical situations can provoke high levels of negative emotions, and situations which are associated with positive emotions tend to be overlooked by practitioners. Reflection regarding difficult situations is encouraged to facilitate learning. Cognitive behavioural therapy (CBT) formulations may be applied to situations appraised both positively and negatively. Analysis and interpretation of the dentist's coping behaviour and the consequent outcomes facilitate learning and reflection upon individual interactions with patients.
  
  
  METHODS
  Twenty primary care dental practitioners in the greater Lincoln area participated in a semi-structured interview which explored their stressful and positive clinical experiences. Some of the episodes were analysed to create CBT formulations.
  
  
  CONCLUSIONS
  CBT formulations are presented and the learning points highlighted by this structured presentation are discussed. In particular, it is suggested that this structured reconstruction of events, which highlights dentists' emotions, responses and the transactional effects of coping responses, might well facilitate objective reflective learning either individually or as part of peer to peer support. It should facilitate dentists' emotional processing of events and may thus contribute to stress reduction.
  
  
  CONCLUSIONS
  CBT formulations of positive and negative dental scenarios may be constructed. It is proposed that this is a useful technique to foster reflection and learning in clinical situations and should lead to improved communication skills and shared decision-making, resulting in fewer complaints and thereby reduced stress. It should also improve dentists' emotional processing.
authors.affiliation: Paul Lowe Dentistry, 31 Farmhouse Way, Monkspath, Solihull, B90 4EH.
authors.forename: H R
authors.initials: HR
authors.lastname: Chapman
authors.forename: S Y
authors.initials: SY
authors.lastname: Chipchase
authors.affiliation: School of Psychology, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS.
authors.forename: R
authors.initials: R
authors.lastname: Bretherton
mesh_terms: D000223:Adaptation, Psychological; D003729:Dental Care / Q000523:psychology*; D003815:Dentists / Q000523:psychology* / Q000706:statistics & numerical data; D004644:Emotions; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology