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Countertransference in the general hospital setting: implications for clinical supervision
Xavier F Jiménez1, Xavier Jiménez, Gregory Thorkelson
1Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. jimenezxf@upmc.edu
Psychodynamic Psychiatry
|September 26, 2012
Summary
Psychiatry residents need better training in managing countertransference reactions with medically ill patients. Enhanced guidance is crucial for effective consultation-liaison psychiatry services.
Area of Science:
- Psychiatry
- Consultation-Liaison Psychiatry
- Psychodynamic Psychotherapy
Background:
- Psychiatry residents on consultation-liaison (CL) rotations are expected to manage countertransference but often lack formal training.
- Limited literature examines clinical scenarios from a psychodynamic perspective for these trainees.
Observation:
- A case vignette details a psychotic patient with intellectual disability and renal failure whose care refusal elicited countertransferential reactions.
- These reactions from primary care and CL teams adversely impacted treatment, necessitating administrative intervention.
Findings:
- Literature confirms the importance of CL psychiatrists in managing countertransference.
- There is a notable lack of formal training and guidance for psychiatry residents in this critical skill area.
Implications:
- Formal psychodynamic psychotherapy training guidelines are needed in general hospital settings.
- Clarifying the liaison component of CL psychiatry is essential for improving resident education and patient care.
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