By Kristi Webb, PsyD
Dr. Helpful, a solo psychologist, has been feeling very fatigued, starting appointments later and later, not getting around to paperwork, noticing herself nodding off in sessions, and feeling like she’s working for the insurance company (except she hasn’t filed in several months). She compares herself to her patients and certainly doesn’t consider herself depressed. She wonders to herself, do other therapists ever feel this way?
Clearly, Dr. Helpful does not have a peer consultation team. If she did, colleagues would be providing supportive listening, proactively challenging her to implement self-care measures, and the team as a whole or individually would be offering suggestions for additional resources such as therapy or supervision. A team is not a clinical case conference. How does one go about getting a peer consultation team?
We all actually know how to go about setting up such a group. Do you work out with friends? That’s a peer consultation team; the topic is exercise and its pains and delights. Are you a member of a support group or a 12-step program? Those are both consultation teams, with a particular focus on a specific challenge. Perhaps you’re a member of a singles’ group or a group for divorced folks; perhaps you are working on a political campaign. In their own way, each of these is a peer consultation team: a group of people who share a set of skills and interests, who want to receive guidance and are willing to provide it, in turn. It follows, then, that the first step in setting up a consultation team of psychologists is to find a bunch of them.
Some sources of psychologists are your office mates or business partners, anyone who refers to you or to whom you refer. Pay attention to the geographic location of those you meet at workshops since that is another source of team members. If you are a recent graduate, ask friends from your psychology program to join you. You’ll want to identify people whose approach to this work you respect (someone you think little of won’t be very helpful to you) but not anyone who so intimidates you that you won’t be honest. You may also want to consider whether everyone on the team is willing to devote the time to it; waiting three days for a response to a distressed message is also not going to be very helpful to you.
Dr. Compassionate is a young African-American psychologist. One of his patients makes a racist remark about African-Americans to him, during the course of a therapy session. Dr. Compassionate is stunned and finds himself using coping mechanisms of distancing and distracting to manage his distress. He recognizes that this doesn’t make for very effective therapy.
It has been my experience that just any group of psychologists may not meet my needs. I am on a couple of peer consultation teams. One has a general focus and our members have a variety of specialties, from career counseling to neuropsychology to chemical dependence treatment. The other is a monthly DBT team for those working with severely emotionally dysregulated patients. The keys to the success of both teams are regular meetings with at least some structure (so that members don’t end up talking about movies they’ve seen or how to prepare tasty dishes of kale); members’ willingness to tell the truth about their own stress and distress as well as what they observe in their fellow team members; and, most of all, mutual trust and respect. The teams I am on work for me because I trust and respect every person on them and am willing to take their feedback and suggestions. I have left teams that did not meet my needs. Dr. Compassionate may find that other psychologists of color are most helpful to him in navigating the turbulence he is feeling after his patient’s racist remark.
We want to provide more than a basic level of care. Both of the psychologists in our vignettes wanted to be of maximum benefit to those who sought their assistance. Self-care and wellness are personal matters, but maintaining competence is an ethical obligation. Peer consultation teams help us improve our care of ourselves, and can lead to enjoying our work again.
For more help with peer consultation, contact NCPA’s Colleague Assistance Committee (CAC). Call the helpline at 919/785-3969. We also have a link at the NCPA website.
Previously printed in the North Carolina Psychologist, Vol 60, N. 5, all rights reserved.