Practioner- Heal Thyself! Challenges in Enabling Organizational Health

In order to elucidate my approach to organizational health, I explore the inter-relationship between organizational health and the consultant’s state of being in the context of writings that have influenced the development of my work as an organizational change consultant over the past 20 years: the behavioral sciences and less traditional sources, such as studies with Moshe Feldenkrais, the writings of GI Gurdjieff and the Fourteenth Dalai Lama, Tenzin Gyatso, and recent research on the impact of meditation on leaders. This is placed in the context of Frost’s (1999, 2001) research on “toxic handlers”

Ethics in health care: “Physician, heal thyself”

Doctors have an obligation, derived from duty to protect patients from harm, to take positive action if a colleague is impaired. In this article, the Health Professions Council of South Africa ethical guidelines concerning the duty of a doctor to report impaired practitioners is reviewed, followed by an overview of the regulations relating to the impairment of students and practitioners. Problems that doctors face, which may contribute to their impairment, will be discussed. Finally, while supporting the ethical duty to report impairment, a suggestion is made that during medication education, more emphasis should be placed on doctors recognising that they are human and fallible

Understanding the Help Seeking Behavior of Accra Polytechnic Students: A qualitative approach

The aim of this study was to explore the barriers to seeking mental health care and to find out if help seeking behavior could be improved.  Six focus group discussions were held using three groups of students from Accra Polytechnic.  Themes emerging from the study indicated that facilitators and barriers to care included factors related to trusted and established relationships, the characteristics of the service provider/psychotherapist, accessibility issues, the characteristics of the condition for which help is being sought for, the characteristics of the person seeking help and other social and economic issues. The study also indicated that strategies like psycho-educational campaigns, outreach programs, the distribution of fliers, making working hours flexible and the use of hot line services could be utilized to promote help seeking behavior. The implications, limitations and recommendations of the study and areas for future research are also discussed in the write up. Keywords: Help seeking behavior, Accra Polytechnic, students, qualitative approach, help seeking model, help seeking pathways, focus group discussion, triangulation, interviews, intervention

Clinician Heal Thyself: Turning the Mirror Inward to Dismantle the Barriers of Psychotherapy

The practice of psychotherapy developed in the United States within and in response to its sociopolitical context. As such it has always been unable to live up to its stated value of being accessible and effective for all people who are willing to seek and accept help. We explore the practice of psychotherapy within the larger field of Psychology and its ongoing commitment to capitalism and the social hierarchy at its center. We consider how Psychology’s intentional avoidance of class identity in the therapy space has allowed the field to justify and maintain this hierarchy while simultaneously ignoring its existence. We detail the ways in which Psychology packaged itself as a valuable tool for capitalism in a rapidly urbanizing and developing United States and explore our country’s historic use of class to create division between those on the lower levels of the social hierarchy in a way that allows power and privilege to remain concentrated at the top. This study sought to address the gap our field of psychology has intentionally ignored by exploring class identity and its influence on distress, attitudes toward therapy, and willingness to help-seek. First, we compared attitudes of working- and middle-class survey respondents regarding their sense of life satisfaction, stability, and expectations for the future to operationalize a definition of class. Next, we used this working definition to examine the impact of class identity on distress, attitudes toward therapy, and willingness to help-seek by comparing survey responses from middle- and working-class respondents. We then used semi-structured interviews to contextualize survey responses and identify overarching themes about attitudes toward therapy both within and across class status. Finally, we offer a model of critical narrative humility as a framework for clinicians interested in decolonizing their own practice and offer suggestions for use of this framework to extend individual dismantling to a systems level

Definition of whole person care in general practice in the English language literature: A systematic review

Objectives: The importance of ‘whole person’ or ‘holistic’ care is widely recognised, particularly with an increasing prevalence of chronic multimorbidity internationally. This approach to care is a defining feature of general practice. However, its precise meaning remains ambiguous. We aimed to determine how the term ‘whole person’ care is understood by general practitioners (GPs), and whether it is synonymous with ‘[w]holistic’ and ‘biopsychosocial’ care. Design: Systematic literature review. Methods: MEDLINE, PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, Proquest Dissertations and Theses, Science. gov (Health and Medicine database), Google Scholar and included studies’ reference lists were searched with an unlimited date range. Systematic or literature reviews, original research, theoretical articles or books/book chapters; specific to general practice; relevant to the research question; and published in English were included. Included literature was critically appraised, and data were extracted and analysed using thematic synthesis. Results: Fifty publications were included from 4297 non-duplicate records retrieved. Six themes were identified: a multidimensional, integrated approach; the importance of the therapeutic relationship; acknowledging doctors’ humanity; recognising patients’ individual personhood; viewing health as more than absence of disease; and employing a range of treatment modalities. Whole person, biopsychosocial and holistic terminology were often used interchangeably, but were not synonymous. Conclusions: Whole person, holistic and biopsychosocial terminology are primarily characterised by a multidimensional approach to care and incorporate additional elements described above. Whole person care probably represents the closest representation of the basis for general practice. Health systems aiming to provide whole person care need to address the challenge of integrating the care of other health professionals, and maintaining the patient–doctor relationship central to the themes identified. Further research is required to clarify the representativeness of the findings, and the relative importance GPs’ assign to each theme. PROSPERO registration number: CRD42017058824

Therapist, Know Thyself: Self-Reflective Practice through Autoethnography

Typically, in a social work graduate program, students are taught human behavioral theories, methods and interventions, ethical practices, policy and cultural competence among other areas. The primary tool used by social workers are themselves. Therefore, it is important the social worker is competent. The academic curriculum ensures that professionally, they are. However, how much does a social work graduate program ensure the social worker is competent personally? Theorists and current literature express the importance of a therapist possessing selfawareness— that essentially to know oneself is to know others. In this autoethnography, I aimed to enlighten the importance of self-awareness by participating in the self-reflective practices of clinical supervision and self-reflective journal writing during my graduate year as a social work intern and student. I took this data and interwove it with personal history and knowledge from social work literature and education. Through the process, I discovered the importance of the therapeutic relationship and its ability to provide relational repair, along with personal issues such as insecure attachment surfacing in order to be acknowledged and begin to be healed. Ultimately, I experienced the reason why self-reflective practice is essential in being a competent therapist. Self-reflective work brings self-awareness. Self-awareness brings self-knowledge. And, self-knowledge enhances the therapeutic relationship and increases a therapist’s overall competence and confidence

Therapist, Heal Thyself? A Study of Self-Care Practices among Therapeutic Service Providers

Missoula, Montana, is the largest city in western Montana and a social service hub for more than 110,000 residents of the surrounding county and beyond. Whether nonprofit, government agency, or individual provider, each social service offering has its own model of change and form of therapeutic services designed to ensure the best life possible for its clients— but how do the leaders of these organizations also try to make the best lives for themselves and their staff? In this research project, I will investigate this question, analyzing and comparing the self-care practices—formal and informal, public and private, personal and institutional—of five Missoula leaders whose professional settings offer therapeutic services