Maria Rostworowska | PubMed Health

PubMed2002

[Systemic consultation--about possibilities and limitations].

The paper presents the role of systemic consultation in the diagnostic and therapeutic process of the people hospitalised for the first time because of a psychotic episode. The following questions are going to be put: What is the role of systemic family consultation in the diagnostic and therapeutic process on the inpatient ward? What are the differences between systemic consultation and others forms of family interventions f.e. family interviews, psycho--education, systemic therapy? What are possibilities and limitations of consultation? What does it invite to? These are only some of those questions, which are typical for daily clinical practice, in which the family consultation takes an important part. In this paper according to our clinical experience, we would like to share some of our thoughts on the questions put. In spite of difficulties the family consultation confronts us with, we are deeply convinced that it has an important part in therapeutic and diagnostic process.

Communication↗

PubMedDate not supplied

[Role of systemic consultation in the psychiatric diagnosis].

Basing on the example of one patient and her family, the advantages and disadvantages of a systemic consultation are presented. The patient was hospitalised due to schizophrenia. In the given example the psychiatrist was an observer of the consultation conducted by a therapist from the ward. A systemic consultation allowed a "multiple-picture" to be obtained: the family members and the patient presented their own understanding of the situation, their "stories" This new and multi-perspective description, showing the patient's symptoms functionality caused diagnostic uncertainty in the psychiatrist--how far is the diagnosis of schizophrenia a justifiable one. The possibility to empthasize with the existential, psychological and family problems of the patient caused a scepticism in the psychiatrist, towards the stigmatizing diagnosis. The authors stress the danger arising in the systemic consultation, which broadens and deepens the knowledge on the patient's situation. According to the authors, the systemic consultation is necessary to understand the social context of the patient and to formulate a complex treatment plan. At the same time however, the multiple layered perspective (which contains the psychological, social and existential domains of the patient) should not over-shadow the psychopathological domain. For the therapeutic team, the consideration of the given levels of systemic reality description remains a challenge.

Adult↗