Brenner Adam M
University of Texas Southwestern Medical Center, Dallas, TX, USA,
Acad Psychiatry. 2014 Aug;38(4):497-501. doi: 10.1007/s40596-014-0068-0. Epub 2014 Mar 25.
Trainees in psychiatry sometimes become tearful during supervision, and this presents the supervisor with significant challenges and also opportunities for the development of professionalism. This paper describes two major anxieties of trainees: first, that they will be unable to control their feelings during their clinical work and that this will derail the fulfillment of their duties; second, that that their feelings stem from an identification with some aspect of the patient or the patient's circumstances and may fear that this exposes them to the stigma of mental illness. The author describes how the trainee's potential for shame can be greatly mitigated by supervisory interventions that treat this as a 'teachable' moment and opportunity for growth in professionalism. The author outlines effective interventions including didactic instruction and education, role modeling of empathic connection in the context of a boundaried relationship, and sensitive referral to mental health services for unresolved emotional issues or psychiatric symptoms. Suggestions of specific wording of interventions are provided throughout.
精神病学专业的实习生在督导过程中有时会落泪，这给督导人员带来了巨大挑战，同时也为职业素养的培养提供了契机。本文描述了实习生的两大主要焦虑：其一，他们担心在临床工作中无法控制自己的情绪，进而影响职责履行；其二，他们觉得自己的情绪源于对患者或患者处境的某种认同，可能担心这会让自己背负精神疾病的污名。作者阐述了如何通过督导干预将实习生的羞耻感降至最低，将这视为一个“可教”时刻以及职业素养成长的机遇。作者概述了有效的干预措施，包括讲授式指导与教育、在明确界限的关系中进行共情连接的示范，以及针对未解决的情绪问题或精神症状敏感地转介至心理健康服务机构。文中还给出了干预措施的具体措辞建议。
