Chapter 19 - Psychodynamic Consultation to Clinical Teams

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.