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Psychological support and professional formats for specialists who work daily with illness, suffering, uncertainty, loss and high responsibility.
Work in healthcare requires high professional competence, but also a constant encounter with human suffering, uncertainty, loss, conflict, urgency and responsibility.
Medical specialists often have to function effectively precisely in moments when the patient and their relatives are frightened, angry, confused or desperate. To the clinical workload are added administrative pressure, lack of time, staff shortages, difficult team relationships and the need to repeatedly make decisions with high costs.
Psychological support for medical specialists does not imply weakness or an inability to cope. It creates a professional space in which difficult encounters, emotional strain, boundaries, relationships with patients and one's own professional role can be thought through.
The Institute offers individual and group formats of work, supervision, Balint groups and specialised training in medical communication.
Individual psychological support for medical specialists
What is it?
The medical profession places a person in prolonged contact with pain, fear, dependence, death and situations in which not all outcomes can be controlled.
Sometimes the professional continues to function well outwardly, but gradually accumulates fatigue, irritability, a sense of powerlessness or emotional withdrawal. In other cases, a particular patient, clinical event or conflict remains especially difficult and continues to be present even outside working hours.
Individual psychological work creates a protected space in which the specialist can speak freely about their own experience, without needing to maintain the professional role of a person who always knows what to do.
The focus can be on a specific professional situation, as well as on the broader impact of the work on personal life, relationships and mental wellbeing.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For doctors, nurses, midwives, medical specialists, rehabilitation therapists and other professionals working in healthcare.
When can it be helpful?
- in cases of prolonged professional tension;
- in cases of a sense of emotional exhaustion;
- after a difficult clinical case;
- in cases of strong work-related anxiety;
- in cases of conflict with a patient, relatives or colleagues;
- in cases of feelings of guilt after a medical event;
- when work begins to significantly affect personal life;
- in cases of difficulty "switching off" after work;
- in cases of loss of meaning or satisfaction in the profession.
What does the psychological work involve?
Discussion of the current workload, professional situations and the individual's way of coping. Depending on needs, the work can be consultative or psychotherapeutic.
How does the first session proceed?
The specialist presents the reason for seeking support and the situations currently causing them the greatest strain. The goals and the appropriate format of work are clarified.
Format and frequency
Format
Individual, in person or online, when appropriate.
Duration and frequency
From one or several consultations to longer-term psychotherapeutic work.
Who conducts the consultations?
Psychologists and psychotherapists with competence in working with medical specialists, professional workload and severe illness.
Important
Individual psychological support is conducted under professional confidentiality and is not a form of assessment of the medical specialist's professional competence.
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Support for professional burnout
What is it?
Professional burnout does not arise from a single difficult day. It usually develops gradually under conditions of prolonged workload, high responsibility and insufficient opportunities for recovery.
It can manifest through emotional exhaustion, cynicism, irritability, distancing from patients, a sense of ineffectiveness or loss of meaning in the work.
In medical specialists, it is sometimes precisely distancing that becomes a defence mechanism. A person begins to function increasingly automatically, because emotional involvement seems unbearable. This does not mean a lack of empathy, but may be a signal of excessive workload.
Psychological work examines both individual reactions and the actual organisational conditions. Burnout should not be presented as a personal failure of the specialist when it also stems from systemic factors.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For medical specialists showing signs of prolonged professional exhaustion.
When can it be helpful?
- in cases of constant fatigue;
- in cases of loss of motivation;
- in cases of irritability towards patients or colleagues;
- in cases of a sense of meaninglessness;
- in cases of emotional withdrawal;
- in cases of sleep disturbances;
- in cases of difficulty recovering after work;
- in cases where a person feels they can no longer work the way they used to.
What does the psychological work involve?
Assessment of professional workload, individual reactions, resources and organisational factors, and the development of an appropriate support plan.
How does the first session proceed?
The working environment, workload, changes in professional functioning and their impact on personal life are discussed.
Format and frequency
Format
Individual or as part of a team programme.
Duration and frequency
Determined individually.
Who conducts the consultations?
A psychologist or psychotherapist with competence in professional burnout and work in healthcare.
Important
In cases of significant depressive symptoms, substance use, suicidal thoughts or another severe condition, additional clinical or psychiatric assessment is necessary.
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Support after the loss of a patient
What is it?
The death of a patient is part of medical practice, but this does not mean it remains without psychological impact on the professional.
It can be especially difficult when the patient is young, when the relationship has been a long one, when the death has occurred suddenly, or when the medical specialist is left with doubt about whether more could have been done.
Professional culture sometimes leaves little space for the grief of medical specialists. After the death of one patient, the next clinical case usually follows, and the emotional reaction has to be quickly set aside.
But the accumulation of unprocessed losses can contribute to exhaustion, distancing and feelings of guilt.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For medical specialists after the death of a patient which has left a significant emotional impact.
When can it be helpful?
- after a sudden death;
- after a long-standing relationship with a patient;
- in cases of the death of a child or young person;
- in cases of strong feelings of guilt;
- when the case keeps returning to mind;
- in cases of difficulty for the specialist to begin working with other patients;
- when the loss activates personal experiences.
What does the psychological work involve?
A space for making sense of the clinical event, the relationship with the patient, the sense of responsibility and one's own emotional reactions.
How does the first session proceed?
The specialist may present the case to the extent necessary, while preserving the patient's confidentiality.
Format and frequency
Format
Individual, group, or within the framework of supervision.
Duration and frequency
From a single session to longer-term support.
Who conducts the consultations?
A psychologist, psychotherapist or supervisor with experience in a medical and clinical context.
Important
An emotional reaction after the death of a patient is not a sign of insufficient professional distance. The ability to be affected is part of the human dimension of medical work.
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Support after a severe clinical event
What is it?
Some clinical situations can be especially difficult for the specialist – sudden deterioration, resuscitation, unexpected death, a medical error or suspicion of one, a severe conflict, violence from a patient or relative, or another event with high emotional intensity.
After such an experience, intrusive thoughts, insomnia, anxiety, feelings of guilt, fear of repetition or loss of professional confidence can arise.
In some specialists the reaction is immediate, while in others it appears later. It is important that there is an opportunity for the event to be processed, rather than simply suppressed for the sake of a quick return to work.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For medical specialists after a clinical event experienced as highly stressful or traumatic.
When can it be helpful?
- after an unexpected death;
- after resuscitation;
- after a serious incident;
- after a medical error or fear of one;
- after aggression from a patient or relative;
- in cases of a strong media or institutional reaction to a case;
- when the specialist begins to avoid similar situations;
- in cases of loss of professional confidence.
What does the psychological work involve?
Assessment of the current state, reactions after the event and support options. If necessary, subsequent individual or team work is included.
How does the first session proceed?
The focus is first on the current state and safety, and then on making sense of what has been experienced.
Format and frequency
Format
Individual or with a team, depending on the nature of the event.
Duration and frequency
Depending on the severity and consequences.
Who conducts the consultations?
A specialist with clinical experience in working with traumatic and professionally difficult events.
Important
Psychological support does not replace the necessary clinical, administrative, legal or organisational analysis of the event.
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Balint groups
What are they?
The Balint group is a specialised group format created for medical and other helping professionals. At the centre of the work is the relationship between the specialist and the patient, rather than the search for a correct medical diagnosis or therapeutic solution.
A participant presents an encounter or case that has troubled, puzzled, angered, burdened, or otherwise remained significant to them. The group explores what may be happening in the relationship between the patient and the professional, and how this relationship affects the clinical encounter.
The Balint group gives the specialist the opportunity to see the case from different perspectives and to recognise their own emotional reactions, which sometimes go unnoticed in the dynamics of daily work.
It is not a clinical conference and is not intended to evaluate the participant's medical decisions.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For doctors, nurses and other specialists who work directly with patients.
When can it be helpful?
- in cases involving patients with whom the specialist feels powerless;
- in cases of strong irritation towards a particular patient;
- in cases of excessive emotional involvement;
- when it is difficult to set a boundary;
- in cases that continue to preoccupy the specialist;
- in cases of recurring difficult relationships with patients;
- as part of the prevention of professional burnout.
What does the psychological work involve?
Regular group meetings with a qualified Balint leader, in which participants present and discuss cases from their practice.
What happens at the first meeting?
At the outset, the framework, the rules of confidentiality and the way of working are presented. Participants gradually become involved with clinical situations from their own practice.
Format and frequency
Format
A small professional group, in person or online in a suitable format.
Duration and frequency
Balint work is regular and is most beneficial as an ongoing process rather than a single meeting.
Who conducts the groups?
Qualified Balint leaders with experience in the medical context.
Important
The Balint group is not psychotherapy for the participants and is not a place for testing clinical competence. The focus is on the professional encounter and the relationship with the patient.
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Individual supervision for medical professionals
What is it?
Individual supervision is a professional space for reflecting on clinical practice, difficult encounters and the specialist's own position.
It is particularly useful in areas where the medical decision is closely linked to a long-term relationship with the patient, serious illness, palliative care, psychological suffering or complex communication situations.
Supervision does not mean that the specialist does not know how to work. On the contrary, it implies acknowledging that clinical practice involves a complexity that cannot always be adequately reflected upon in solitude.
The supervisor does not offer ready-made solutions, but helps to explore the case, the professional role, ethical issues and the relationships with the patient and the team.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For doctors and other medical professionals who need an individual professional space for examining cases and their practice.
When can it be helpful?
- in cases of a complex clinical case;
- in cases of an ethical dilemma;
- in cases of a difficult relationship with a patient;
- in cases of a strong emotional reaction of one's own;
- in cases of feeling blocked or powerless;
- in cases of difficulties with professional boundaries;
- when working with severely ill or dying patients.
What does the psychological work involve?
A detailed examination of specific clinical situations, professional relationships, ethical issues and the specialist's own reactions.
What happens at the first meeting?
The professional context, expectations and the topics on which the specialist wishes to work are clarified.
Format and frequency
Format
Individual.
Duration and frequency
It may be a single consultation on a specific case or regular supervision.
Who conducts the supervision?
A qualified specialist with experience in clinical supervision and the medical context.
Important
Supervision does not replace a medical consultation with another specialist when a clinical second opinion is required.
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Group supervision and supervision of medical teams
What is it?
The work of a medical team is not merely the sum of the individual activities of different specialists. Decisions, communication, relationships and the way responsibilities are distributed affect the functioning of the whole team.
Group supervision creates a space for reflecting on clinical cases and professional relationships together with colleagues.
In team supervision, the focus may also include the way the team itself functions – conflicts, roles, communication, boundaries and the impact of difficult cases on the relationships between professionals.
It is important that supervision is not used as a disciplinary tool or a hidden form of assessment by the employer.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For medical teams, departments, clinics and multidisciplinary groups.
When can it be helpful?
- when working with severe clinical cases;
- in cases of prolonged high emotional strain;
- in cases of conflicts within the team;
- in cases of difficult communication;
- after a difficult event;
- in cases of change in the team's structure;
- when a sustainable space for professional reflection is needed.
What does the psychological work involve?
Regular group meetings, examination of clinical cases, professional relationships and factors affecting the functioning of the team.
What happens at the first meeting?
The aims, expectations, rules of confidentiality and the boundary between supervision and management functions are clarified.
Format and frequency
Format
Group format, with a specific medical team or an interprofessional group.
Duration and frequency
Most often as regular meetings for a pre-agreed period.
Who conducts the supervision?
A supervisor with competence in clinical and organisational work with healthcare teams.
Important
In order to be effective, supervision must be a space for professional reflection, not a tool for administrative control.
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Training: Breaking bad news
What is it?
Breaking news of a serious diagnosis, progression, unfavourable prognosis or another serious medical outcome is one of the most difficult communication tasks in medicine.
It requires not only medical accuracy but also the specialist's ability to assess what the patient knows, what they are ready to hear, how much information can be provided at the given moment, and how to respond to their emotional reaction.
Neither excessive avoidance nor the mechanical listing of facts constitutes good communication.
The training examines structured models for breaking bad news, including principles from the SPIKES model, but the emphasis is on real clinical application.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For doctors and other medical professionals who take part in conversations about diagnosis, treatment, prognosis or a significant change in condition.
When can it be helpful?
When working in oncology, intensive care, surgery, palliative care, chronic diseases, genetics and other areas where difficult conversations are part of the practice.
What does the training involve?
- preparation for the conversation;
- assessing what the patient already understands;
- providing information in understandable language;
- responding to shock, crying, anger or silence;
- balancing realistic information with maintaining a sense of possibility for action;
- involving relatives;
- working with examples and clinical situations.
What happens at the first meeting?
When the training is for a team, the clinical context, professional roles and typical communication situations are clarified in advance.
Format and frequency
Format
A seminar, practical workshop or training for a medical team.
Duration and frequency
Depending on the specific programme.
Who conducts the training?
Specialists with experience in medical psychology, psycho-oncology and clinical communication.
Important
Good communication does not mean concealing the medical reality. The aim is for accurate information to be conveyed in a professional, understandable and humane manner.
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Training: Communication with a "difficult" patient
What is it?
The term "difficult patient" often describes not so much the person themselves as an encounter that has become difficult for the specialist.
The patient may be insistent, distrustful, anxious, verbose, refusing recommendations or constantly seeking reassurance. Such behaviour can provoke irritation and a feeling of powerlessness.
The training helps the specialist recognise what is happening in the communication and how to maintain clear professional boundaries, without the relationship turning into a power struggle.
The focus is not on "techniques for controlling" the patient, but on effective clinical communication.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For medical professionals who work directly with patients.
When can it be helpful?
In cases of frequent conflicts, highly anxious patients, recurring complaints, distrust, refusal of treatment or situations that provoke a strong emotional reaction in the specialist.
What does the training involve?
- recognising various communication difficulties;
- active listening;
- working with anxiety and distrust;
- professional boundaries;
- responding to repeated requests for reassurance;
- managing one's own emotional reaction;
- analysis of clinical situations.
Format and frequency
Format
A practical seminar or training for a team.
Duration and frequency
Depending on the programme.
Who conducts the training?
Specialists in the field of medical psychology and communication.
Important
The term "difficult patient" should not become a label. At the centre of the work is understanding the difficult clinical encounter.
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Training: Working with anger and aggression from patients or relatives
What is it?
Anger is a common reaction to fear, powerlessness, uncertainty and a sense of loss of control. In healthcare, it may be directed at the doctor, the nurse, the system or a specific decision.
Not every expression of anger is aggression, and not every instance of aggression can be managed by good communication alone.
The training examines how the specialist can recognise escalation, communicate clearly and maintain professional boundaries, while placing safety first at all times.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For medical teams working in environments with frequent conflictual or emotionally charged situations.
When can it be helpful?
When working in emergency care, hospital wards, oncology, intensive care, outpatient care and other clinical contexts.
What does the training involve?
- the difference between anger, threat and aggression;
- early signs of escalation;
- de-escalating communication;
- clear boundaries;
- language that reduces tension;
- actions in cases of a threat to safety;
- working with the specialist's own reaction.
Format and frequency
Format
A practical workshop with clinical situations and role-play exercises.
Duration and frequency
Depending on the specific programme.
Who conducts the training?
Specialists with experience in medical communication and working with crisis situations.
Important
In cases of immediate risk of violence, priority is given to physical safety and the implementation of established organisational procedures, rather than continuing a psychological conversation.
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Training: Conversations about prognosis and advanced illness
What is it?
Conversations about prognosis are difficult both for the patient and for the doctor. They require medical accuracy, but also sensitivity to how the patient understands the situation and how much information they wish to receive.
Uncertainty is an inevitable part of prognosis. Therefore, good communication does not mean promising precise timeframes when medicine cannot provide them, nor does it mean avoiding the topic altogether.
Patients may have different needs. One person wants maximally precise information, another prefers the conversation to unfold gradually.
The training helps specialists to talk about the limitations of treatment, possible scenarios and the goals of care in a way that remains honest and humane.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For doctors and medical teams working with severe and advanced illnesses.
When might it be useful?
When discussing progression, limited therapeutic options, changes to treatment goals, or a shift towards a palliative focus.
What does the training include?
- how to assess the patient's desire for information;
- communicating uncertainty;
- talking about probabilities;
- responding to the question "How much time do I have left?";
- discussing the goals of treatment;
- involving relatives;
- working with hope without giving unrealistic promises.
Format and frequency
Format
Practical training with analysis of clinical situations.
Duration and frequency
According to the programme.
Who conducts the training?
Specialists in the field of medical communication, psycho-oncology and palliative care.
Important
Hope and realistic medical information are not necessarily opposites. The way in which the conversation is conducted matters for how the patient can participate in decisions about their own care.
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Training: Communication at the End of Life
What is it?
Conversations at the end of life are among the most emotionally charged situations in medical practice. They may involve fear of death, practical decisions, relationships with relatives, care preferences and questions about how a person wishes to be supported.
Sometimes medical specialists avoid these conversations for fear of taking away the patient's hope. In other cases, the conversation happens too late, when the opportunity for the patient to actively participate in decisions is already limited.
The training examines how such topics can be introduced gradually and with respect for whether and to what extent the patient wishes to talk about them.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For doctors and medical specialists in oncology, palliative medicine, intensive care medicine and other fields with severely ill patients.
When might it be useful?
When caring for patients with a limited prognosis, changing treatment goals, or the need to discuss preferences for subsequent care.
What does the training include?
- how to begin the conversation;
- how to assess the patient's readiness;
- working with silence and strong emotions;
- involving relatives;
- talking about priorities and values;
- communication when there are differences between the patient, relatives and the team;
- the professional burden on the specialist themselves.
Format and frequency
Format
Seminar or practical workshop.
Duration and frequency
According to the programme.
Who conducts the training?
Specialists with experience in psycho-oncology, medical psychology and communication in palliative care.
Important
The goal is not for the patient to be forced to talk about death or to "accept" a particular perspective. Their autonomy, readiness and needs take precedence.
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Training: Professional Boundaries and Emotional Burden
What is it?
Closeness with the patient is part of care, but the medical specialist must at the same time maintain a clear professional position.
Sometimes the difficulty is excessive distance. In other cases, the specialist begins to take on responsibilities beyond their role, remains constantly available, experiences the patient's decisions as a personal failure, or feels that they must "save" a particular person.
The professional boundary does not mean coldness. It creates a framework within which empathy can exist without the specialist losing their own role and resilience.
The training examines emotional involvement as an inevitable part of the medical encounter and helps it to be considered in a professional manner.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For doctors, nurses and other healthcare professionals.
When might it be useful?
- when the specialist finds it difficult to say "no";
- with an excessive sense of responsibility;
- with prolonged thinking about patients outside of work;
- with strong personal identification with a patient;
- with feelings of guilt;
- with excessive distance and emotional withdrawal;
- with difficulties with contacts outside the professional framework;
- as part of burnout prevention.
What does the training include?
- professional role and boundaries;
- empathy and distance;
- recognising one's own emotional reactions;
- excessive assumption of responsibility;
- difficulties with refusal;
- relationships with patients and relatives;
- the link between boundaries and professional burnout.
Format and frequency
Format
Practical seminar, team training or part of a longer-term programme.
Duration and frequency
According to the specific programme.
Who conducts the training?
Psychologists, psychotherapists and supervisors with experience in the medical context.
Important
The professional boundary is not the opposite of a humane attitude. A good boundary allows the specialist to remain engaged with the patient without becoming the sole person carrying their suffering.
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The Institute's approach
Working with medical specialists is not aimed at making them "more resilient" at any cost and able to continue bearing unlimited strain.
Some of the difficulties are individual, but others stem from the organisation of work, the shortage of resources, professional culture and the way the healthcare system functions. Good psychological work does not erase this distinction.
The Institute regards support for medical specialists as part of the quality and safety of medical care. Space for reflection, supervision and work with professional burden benefits not only the specialist themselves, but also relationships with patients and the functioning of the team.
Being a professional does not mean remaining unaffected by human suffering.
Caring for the specialist is also caring for the patient.