Robertson J M, Robison B D, Carter B D
School of Medicine, University of Louisville, Kentucky, USA.
Int J Psychiatry Med. 1996;26(1):93-104. doi: 10.2190/FWVM-38C3-F4QN-XNHX.
Although the concepts of splitting and projective identification have been useful in explaining certain group phenomena on adult psychiatric and medical wards, their application to pediatric settings has not been addressed in the literature. The authors demonstrate that early identification, staff conferencing, and family/staff conferencing can diffuse these dynamics in an academic pediatric setting.
The existing literature on splitting and projective identification is reviewed. Case vignettes are then used to illustrate the manifestations of splitting and projective identification in a pediatric setting and to demonstrate intervention strategies modified for children and their families from the adult literature.
Splitting and projective identification can be interrupted in pediatric settings with early identification, staff conferencing, and family/staff conferencing. The cooperation of pediatric clinicians is critical in the implementation of these intervention strategies.
The development of liaison support groups for pediatric residents and interdisciplinary treatment teams will enlist their cooperation in identifying splitting early, and in employing staff conferencing and family/staff conferencing to diffuse this group dynamic which, if left unchecked, can disrupt professional relationships and compromise the treatment of pediatric patients.
尽管分裂和投射性认同的概念在解释成人精神科和内科病房的某些群体现象方面很有用，但它们在儿科环境中的应用在文献中尚未得到探讨。作者证明，早期识别、 staff会议以及家庭/工作人员会议可以在学术性儿科环境中缓解这些动态情况。
回顾了关于分裂和投射性认同的现有文献。然后使用病例 vignettes来说明分裂和投射性认同在儿科环境中的表现，并展示从成人文献中为儿童及其家庭修改的干预策略。
通过早期识别、 staff会议以及家庭/工作人员会议，儿科环境中的分裂和投射性认同可以被打断。儿科临床医生的合作对于实施这些干预策略至关重要。
为儿科住院医师和跨学科治疗团队建立联络支持小组，将促使他们合作，尽早识别分裂情况，并采用 staff会议和家庭/工作人员会议来缓解这种群体动态，如果不加以控制，这种动态可能会破坏专业关系并损害儿科患者的治疗。
