It seems that everyone in college has some type of dream; a project or solution to some world-wide, human dilemma. When I was in Graduate School, my colleagues and I had our own dream as well: a mental health clinic with comprehensive coverage of services for a diverse and in-need population. At that time, Albuquerque wasn’t much different than now; most populations were tragically under-served and many struggled to meet with the most basic modicum of human compassion at the various locales that actually offered help. Of course, all of us were broke after spending tens of thousands of dollars on graduate training so we were mostly forced to work for whatever agency would take the neophyte therapist-in-training.
However, this all changed when I started at Sage Neuroscience Center. I recall meeting with the founders, Reuben and Lisa Sutter, one day for an interview. They were looking for a new therapist to replace one that was soon to retire. I was looking for a more team-oriented approach after running a successful private practice for a number of years. What I heard during the interview amazed me… they were talking about the dream I had in grad school and, much to my amazement, were actually implementing this philosophy and it was working.
I walked into a dream; a mental health clinic free of bureaucracy and political backstabbing. A place where patients really did come first and could come to one location to receive every mode of counseling as well as medication management from a highly dedicated and gifted team of well-trained providers. The idea was semi-simple, provide the best care as possible and patients may actually get better. I saw this efficacy even with the patients that I brought over from private practice. They appeared to be making more progress in this setting than when I saw them on my own.
Of course, I would never suggest that private practice is not a wonderful milieu in which to see patients and provide them adequate care; I am simply suggesting that any practitioner in Mental Health needs to understand how the very physical environment in which they practice has an impact on the effectiveness of the treatment they provide. Therapy is a microcosm of life. Whether a patient has an issue with psychosis or anxiety, in the end it boils down to the way it is impacting their interpersonal relationships that lands them in the therapeutic setting. I am suggesting that the relationship between provider and patient is directly influenced by how stable and confident the provider feels in his or her work setting.
I have seen patients react to my bad days. I have seen the inquisitive looks on faces if I haven’t slept or am going through my own personal life crisis while still having to maintain my responsibilities at work. Many can tell when their own personal tragedy strikes a chord with the therapist and run the risk of questioning their providers competence or whether or not this individual is capable of containing the emotional debitage if they are not stable themselves. Having a supportive team around you as a provider can be the difference between success and failure in many therapeutic endeavors.
It is impossible to not be somewhat drawn in to whatever the patient is experiencing. Whether it is called Counter Transference or simply Empathy, it is crucial to manage these incidents to prevent further harm or trauma to the patient. The inclusive and supportive team is one extremely effective way to ensure that the needs of both patient and provider are met. So in conclusion, remember that all we can really do as mental health providers is to lead by example. If we are encouraging our patients to become more socially active and integrate themselves into a more supportive environment, then we better have a stable one of our own or be well on the way in terms of its creation.