Self of the Therapist in Medical Settings: A Sociocultural and Systemic Perspective

This brief explores how the “person” of the therapist is developed when training and working in medical settings. It highlights important and often unspoken topics such as the personal, professional, cultural, ethical, and competency dilemmas new clinicians regularly face. The brief also addresses how personal experience with illness, death, cultural differences, and stigma may impact professionals in everyday practice.

Topics featured in this Brief include:

• Helpful tips and tricks for new professionals entering a medical setting for the first time.
• Working with patients who suffer from chronic and terminal illnesses.
• Sociocultural norms and values that are often present in a medical setting.
• A new framework for identifying and treating professional burnout.
• How to handle ethical situations in medical organizations.

Self of the Therapist in Medical Settings is a must-have resource for clinicians, professionals, supervisors, and faculty working in medical settings.

• Language: English
• Publisher: Springer
• Release date: May 30, 2020
• ISBN: 9783030392710

Book preview

© American Family Therapy Academy 2020

M. Zubatsky, J. Williams-Reade (eds.)Self of the Therapist in Medical SettingsAFTA SpringerBriefs in Family Therapyhttps://doi.org/10.1007/978-3-030-39271-0_1

Navigating the Culture and Context of Medicine

Max Zubatsky¹   and Jackie Williams-Reade²

(1)

Department of Family and Community Medicine, Saint Louis University, St. Louis, MO, USA

(2)

Department of Counseling and Family Sciences, Loma Linda University, Loma Linda, CA, USA

Max Zubatsky

Email: [e-mail]

Keywords

Behavioral healthCultureIntegrated careMedical settingsPower

Entering the world of medicine for the first time is almost the equivalent to being dropped in the middle of an Amazon rainforest. There is no compass, no guide map, and no one to hold your hand to navigate a new territory. The journey requires instincts and the flexibility to be open to the unknown. The experience can be incredibly rewarding yet pulls at many personal and professional challenges of new clinicians. Many of these challenges not only arise in one’s professional work but also trigger unexpected areas in one’s personal life as well.

Take, for example, a hospitalized patient who is diagnosed with end-stage renal failure, where their breathing capacity is extremely low. The family of the patient has been visiting and talking to the daughter, who is the primary healthcare power of attorney. Several family members have had disagreements about whether to transition the patient back to their home. The Medical family therapist (MedFT) is brought into an emergency family meeting in one of the corner rooms to consult with the family. With little knowledge or background about the case, the MedFT uses circular questioning, contextual interviewing, and shared language to help the family and therapist agree to the best possible option for the patient in a limited timeframe. This therapist balances these skills, all while facilitating a meeting where members must come to terms with the situation in the best way possible.

Where traditional psychotherapy offices generally provide a comfortable environment for providers and patients to meet, a healthcare setting can often present the therapist with unconventional practice situations. Family meetings may take place in a hollow conference room, where overhead pages interrupt the flow of conversation. Brief consultations in the examination room force members to sit in crammed spaces and come near one another. Other providers needing a new room may disrupt the flow of an important conversation between the therapist and family. New interns, trainees, and students must adapt to a different way of providing counseling services. Patient care around certain mental and physical conditions can be just as effective during the 20-minute consultation as the traditional 50-minute psychotherapy appointment. Learning to provide care in shorter timeframes is thereby an important learning curve for trainees to traverse.

Behavioral health is on the cutting edge of providing key services to some of the most vulnerable and underserved populations in healthcare (Cummings, 2016; Doherty, McDaniel & Hepworth, 2014). This chapter will introduce a new world of medicine for beginning behavioral health providers, highlighting some necessary skills and areas to consider regardless of one’s practice setting. The biopsychosocial–spiritual approach will be presented in a novel way, applying these aspects not just to patient and family care, but the parts of the self that impact the therapist’s experience when working in these medical contexts. Specific suggestions on the Do’s and Don’ts when working on a healthcare team will also be