Evaluation of experts’ clinical practice in crisis unit and psychiatric emergency technical and therapeutic principles to better intervene

Abstract

Introduction

Clinical practice in emergency room and crisis unit is often fraught with pitfalls (Immediate demands, accelerated temporality, difficulties working with family and care network). This practice contains specific clinical therapeutic interventions based on recognized theoretical frameworks. These theoretical frameworks constitute “formal knowledge”. They help to diagnose but have got limitations. In fact, clinical competence requires also technical and interpersonal skills (“know-how”) as well as reasoning skills and clinical intuition (“Informal knowledge”). All these knowledge and skills are built over clinical experience based on trainings and supervisions, continued clinical reasoning and exchanges with colleagues.

Objectives

Our research aims to capture therapeutic processes in clinical crisis intervention by illustrating what experts really do in their clinical practice and above all, how they do.

Aims

Our study illustrates several crisis situations, moment-by-moment, by analyzed experts’ voices.

Method

Our method is grounded in a first person epistemology and used a qualitative methodology focused on explicitation interview. Ten crisis interviews were analyzed in a micro and macro perception.

Results

Our research based on experts’ voices has identified a series of therapeutic techniques and principles who are essential to better intervene in clinical crisis intervention. A model of intervention was developed to train debutant clinician.

Conclusion

We believe that reflexivity is a powerful attitude to understand and transform practices in a lasting way.

Disclosure of interest

The authors have not supplied their declaration of competing interest.