L'éducation thérapeutique : une partie qui se joue à quatre

Therapeutic education is today officially recognised. It is however subject to different interpretations and practices. It is not just informations delivered to the patient, nor coaching of the patient. It is not only learning skills. Therapeutic education is first of all therapeutic. It aims at transferring skills to the patient, negotiating therapeutic goals and constraints, and providing a support to modify behaviours. Therefore, being a therapeutic educational team involves threefold competences: first therapeutic, second pedagogic, third psychologic. The patient, as any human being, is a trinity with three structures in himself governed by principle of homeostasis laws linked and organised into a hierarchy. He is first an animal governed by principal of biological homeostasis, second a rational person aiming at universality according to the principles of normative homeostasis, third a person with an irreducible singularity governed by a principle of thymic homeostasis in order to assure his well-being or in any case to avoid suffering. Therapeutic education is a kind of partnership with the patient. Nevertheless, it is an asymmetric relation, far from a postmodern one dominated by the relativism, in which the doctor-patient relationship is reduced to a joint venture between two experts (the layman and the scientist) giving the opportunity to mix two speeches to reach a new truth. On the contrary, this relationship implies that, thanks to health care providers empathy and therapeutic education of the patient, each can take the place of the other one while keeping his own status: neither too near nor too far.