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Chapter 19 - Psychodynamic Consultation to Clinical Teams

from Beyond 1:1 Therapy: Working Psychodynamically with Clinicians, Teams, and Organisations

Published online by Cambridge University Press:  25 August 2023

Adam Polnay
Affiliation:
The State Hospital, Carstairs and Royal Edinburgh Hospital, Edinburgh
Victoria Barker
Affiliation:
East London NHS Foundation Trust, London
David Bell
Affiliation:
British Psychoanalytic Society
Allan Beveridge
Affiliation:
Royal College of Psychiatrists, London
Adam Burley
Affiliation:
Rivers Centre, Edinburgh
Allyson Lumsden
Affiliation:
NHS Greater Glasgow and Clyde
C. Susan Mizen
Affiliation:
Devon and Exeter NHS Foundation Trust, Exeter
Lauren Wilson
Affiliation:
Royal Edinburgh Hospital, Edinburgh
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Summary

A psychodynamic consultation for clinicians can help preserve and support existing therapeutic relationships with patients. A team might ask for some assistance in trying to understand a particular patient they are involved with, where interactions are experienced as stressful, challenging, or difficult in some way. In consultation work with a team, the psychotherapist is interested and curious about various dimensions of the system at play in order to understand as fully as possible the clinical interactions the team is struggling with. Using a case example, we illustrate how it is often an interaction between a particular clinical situation and the service’s history and functioning that culminates in the presenting team’s distress, confusion, or a struggle to care. We focus particularly on bringing to light the interpersonal dynamics between clinicians and a patient, drawing on the structured approach developed by Reiss and Kirtchuk. This chapter is addressed primarily for psychodynamic therapists starting out in consultation work, to provide some orientation. This chapter may also be of interest to professionals and teams who are consulting a psychotherapist about their clinical work or are contemplating requesting a consultation.

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Publisher: Cambridge University Press
Print publication year: 2023

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References

Hinshelwood, B, Chiesa, M. Organisations, Anxiety and Defence. 1st edition. London: Wiley; 2001.Google Scholar
Lyth, IM. Containing Anxiety in Institutions: Selected Essays, Vol. 1. Oxford, UK: Free Association Books; 1988.Google Scholar
Moore, E. Personality disorder: its impact on staff and the role of supervision. Advances in Psychiatric Treatment 2012;18(1):4455.CrossRefGoogle Scholar
Reiss, D, Kirtchuk, G. Interpersonal dynamics and multidisciplinary teamwork. Advances in Psychiatric Treatment 2009;15(6):462–9.CrossRefGoogle Scholar
OPD Task Force, Kernberg, OF, Clarkin, JF, Cierpka, M et al. Operationalized Psychodynamic Diagnostics (OPD), Foundations and Practical Handbook. Seattle: Hogrefe & Huber; 2000.Google Scholar

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