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Consultation and specialised programmes for integrating psychological and psychosocial care into the actual clinical process and for supporting medical teams.
Psychological and psychosocial care in the healthcare facility is not an “optional” addition once the medical problem has already been resolved. It is part of the way in which the patient understands the illness, participates in treatment, goes through difficult decisions and preserves the best possible quality of life.
At the same time, healthcare facilities are also a working environment for professionals exposed to high emotional strain, loss, conflict, urgency and prolonged responsibility. For this reason, the psychosocial approach must include not only the patient but also the teams caring for them.
The Institute works with hospitals, clinics, medical centres and other healthcare structures to build and develop sustainable models for psychological and psychosocial care. The work may be directed towards a specific team, department or problem, but also towards a more comprehensive development of standards, algorithms, screening and professional support.
The approach takes into account the profile of the healthcare facility, patient groups, resources, organisational culture and the actual possibilities for integrating psychological work into the clinical process.
Assessment of the Needs of a Medical Team
What is it?
Before a support programme for a medical team is created, it is important to understand what the specific structure actually needs.
The strain in an oncology ward, for example, differs from that in emergency care, intensive care medicine, paediatrics or outpatient practice. Both the clinical situations and the relationships with patients differ, as do the frequency of losses, conflicts, the pace of work and the opportunities for recovery.
The assessment is not limited to a “burnout” questionnaire. It examines more broadly the emotional and organisational strain, communication, professional roles, difficult clinical situations and the resources the team already possesses.
The aim is for the recommendations to be realistic and applicable in the specific working environment.
Who is it suitable for?
For hospital departments, clinics, medical centres, multidisciplinary teams and the management of healthcare facilities.
When can it be helpful?
- in cases of high professional stress;
- in cases of increasing staff turnover;
- in cases of frequent conflicts within the team;
- in cases of numerous severe clinical cases;
- in cases of emotional exhaustion;
- following organisational change;
- when preparing a psychological support programme;
- when management needs a clearer picture of psychosocial risks.
What does the work involve?
Conversations with team members and management, anonymised questionnaires where necessary, analysis of key professional situations and the formulation of recommendations.
What happens in the first meeting?
The structure, number and professional profile of the team, the main difficulties and the purpose of the assessment are clarified.
Format and frequency
Format
Organisational consultation, interviews, group meetings and, where necessary, a structured assessment.
Duration and frequency
Depending on the size of the structure and the issue raised.
Who conducts the assessment?
Specialists with experience in clinical psychology, psychosocial work and the functioning of medical teams.
Important
The aim is not to individually assess which employee is “coping” and which is not. The organisational assessment must also consider the conditions in which people work.
← All topics in the “For hospitals and healthcare facilities” section
Programme for Psychological Support of a Medical Team
What is it?
A one-off seminar is rarely sufficient when a team works daily under high emotional strain.
A more sustainable approach involves a combination of various forms – individual support, supervision, Balint groups, training, interventions following severe events, and work with professional burnout.
The programme is developed according to the specific profile of the healthcare facility. Not every team needs the same intensity or the same format.
Accessibility is also an important part of this – psychological support must be organised in such a way that specialists can actually use it within their clinical schedule.
Who is it suitable for?
For healthcare facilities that wish to build a permanent model for supporting their specialists.
When can it be helpful?
- in cases of long-term high strain;
- when working with severely ill or dying patients;
- in cases of frequent conflict situations;
- in cases of high staff turnover;
- when new specialists need support;
- as part of a quality policy and care for staff.
What does the work involve?
Following a needs assessment, a combination of the following may be created:
- individual consultations;
- group supervision;
- Balint groups;
- support following severe clinical events;
- training in communication;
- work with professional boundaries;
- burnout prevention;
- consultation with management regarding psychosocial risks.
What happens in the first meeting?
The needs, available resources, work schedule and possible scope of the programme are clarified.
Format and frequency
Format
A long-term programme for a department, clinic or healthcare facility.
Duration and frequency
Determined individually, usually for a pre-agreed period.
Who conducts the programme?
A multidisciplinary team, according to the activities required.
Important
Support for staff must not become a substitute for the necessary organisational changes. When the core problem is a chronic shortage of staff, excessive workload or a dysfunctional organisation, it cannot be resolved through psychological interventions alone.
← All topics in the “For hospitals and healthcare facilities” section
Balint Groups for Medical Teams
What are they?
The Balint group is a specialised format for professionals that places the relationship between the medical specialist and the patient at its centre.
Rather than discussing whether the medical diagnosis or therapy is correct, a participant presents an encounter with a patient that has remained difficult, tense, confusing or emotionally significant.
The group helps in thinking about what happens between the patient and the specialist and how the fears, expectations and reactions of both sides influence the clinical encounter.
This format is particularly valuable in structures where relationships with patients are long-term or emotionally demanding.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For doctors, nurses and other medical professionals.
When can it be helpful?
- in cases of difficult patients or relationships;
- in cases of a strong sense of powerlessness;
- with patients who provoke irritation;
- in cases of excessive emotional involvement;
- when working with severe and chronic illness;
- as a permanent format for professional reflection.
What does the work involve?
Regular group meetings with the presentation and discussion of cases.
What happens in the first meeting?
The framework, principles and rules of confidentiality are presented.
Format and frequency
Format
A small group of medical specialists.
Duration and frequency
A regular process, not a one-off event.
Who leads the group?
A qualified Balint group leader.
Important
The Balint group is not psychotherapy for the team and must not be used for the administrative evaluation of employees.
← All topics in the “For hospitals and healthcare facilities” section
Regular Supervision of Medical Teams
What is it?
Supervision provides a protected space in which the medical team can reflect on complex clinical situations, professional relationships and difficulties in their own functioning.
It is particularly useful in fields where specialists are exposed to prolonged emotional strain – oncology, palliative medicine, intensive care, psychiatry, paediatrics, work with chronically ill patients and others.
Supervision may be focused on specific clinical cases or on the interaction within the team itself.
The aim is not to control the professionals, but to create a space in which the complexity of the work can be reflected upon before it turns into chronic conflict, burnout or professional withdrawal.
Led by: Prof. Orlin Todorov
Who is it suitable for?
For departments, clinical teams and multidisciplinary structures.
When can it be helpful?
- in cases of complex clinical cases;
- in cases of high emotional strain;
- in cases of professional conflicts;
- in cases of difficulties with boundaries;
- when working with patients with a poor prognosis;
- in cases of strong reactions within the team following a loss;
- as part of continuing professional development.
What does the work involve?
Regular meetings, case presentations, analysis of relationships and the professional framework, and discussion of ethical and communication dilemmas.
What happens in the first meeting?
The purpose, participants, rules of confidentiality and the boundary between the supervisory and administrative function are clarified.
Format and frequency
Format
Group supervision with a specific team.
Duration and frequency
Usually regular meetings over a defined period.
Who conducts the supervision?
A qualified supervisor with clinical and organisational experience.
Important
Supervision must be clearly distinguished from disciplinary control and staff appraisal.
← All topics in the “For hospitals and healthcare facilities” section
Intervention Following a Severe Clinical Event
What is it?
An unexpected death, a serious medical error or suspicion thereof, violence, resuscitation, an incident with multiple casualties, or another extraordinary event can have a significant impact on the entire medical team.
Following such a situation, some specialists may react immediately, while others may react days or weeks later. There may be insomnia, intrusive thoughts, feelings of guilt, anger, fear of recurrence, or tension between team members.
The organisational response in the first few days matters. It is not enough simply to state that people must continue working “professionally”.
The intervention must be tailored to the nature of the event and must avoid compulsorily forcing everyone to recount what they experienced in the same way.
Who is it suitable for?
For medical teams following a severe or potentially traumatic professional event.
When can it be helpful?
- following an unexpected death;
- following a serious medical incident;
- following aggression towards a member of staff;
- following a crisis event involving multiple patients;
- following the death of a child;
- in cases of intense public or media pressure surrounding a case;
- when the event leads to significant conflicts or anxiety within the team.
What does the work involve?
Assessment of immediate needs, group and, where necessary, individual support, identification of specialists in need of additional help, and recommendations to management.
What happens in the first meeting?
First, the event, the organisational context and the immediate needs of the team are clarified.
Format and frequency
Format
Team intervention with the option of individual meetings.
Duration and frequency
Depending on the nature of the event – from short-term crisis work to subsequent follow-up.
Who conducts the intervention?
Specialists with experience in crisis psychology, traumatic stress and the medical context.
Important
Psychological intervention does not replace the necessary medical, administrative, legal or organisational investigation of the event.
← All topics in the “For hospitals and healthcare facilities” section
Programme for the prevention of professional burnout
What is it?
Burnout in healthcare should not be regarded solely as the personal problem of the individual specialist.
Working hours, number of patients, staff shortages, lack of autonomy, conflicts, administrative burden and organisational culture can all play a significant role.
For this reason, effective prevention is not limited to a seminar on “stress management”. Both individual and organisational factors need to be addressed.
The programme may include risk assessment, group forms of support, supervision, training for managers, and proposals for changes in work organisation.
Who is it suitable for?
For healthcare institutions and structures seeking a systemic approach to the professional wellbeing of their staff.
When may it be helpful?
- in cases of high staff turnover;
- in cases of frequent sick leave;
- in cases of emotional exhaustion;
- in cases of increasing cynicism;
- in cases of conflict;
- in cases of deteriorating team communication;
- in structures with chronically high clinical workload.
What does the work include?
- assessment of psychosocial risks;
- work with teams;
- individual support;
- supervision and Balint groups;
- training for managers;
- recommendations for organisational changes;
- monitoring of outcomes.
How does the first meeting proceed?
The organisational context, the main signs of a problem and the possible scope of the programme are clarified.
Format and frequency
Format
Organisational programme.
Duration and frequency
Medium-term or long-term, depending on the size and needs of the healthcare institution.
Who conducts the programme?
A team of specialists, depending on the specific scope.
Important
The burnout prevention programme should not shift responsibility onto employees with the message that they simply need to become “more resilient” to unlimited workload.
← All topics in the “For hospitals and healthcare facilities” section
Training in medical communication
What is it?
A large proportion of difficult situations in medicine result not only from insufficient medical knowledge, but from the complexity of communication between specialist, patient and relatives.
Disclosing a diagnosis, discussing prognosis, refusal of treatment, anger of relatives, fear of a procedure, or end-of-life conversations all require specific communication skills.
These can be developed through training, especially when realistic clinical situations, role-play exercises and analysis of interaction are used.
The training is adapted to the medical profile of the team rather than offered as a universal course independent of the clinical context.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For doctors, nurses and other professionals who communicate with patients and relatives.
Possible topics
- breaking bad news;
- discussing prognosis;
- working with anger and aggression;
- the “difficult” patient;
- refusal of treatment;
- communication with relatives;
- palliative conversations;
- end-of-life communication;
- professional boundaries;
- communication under medical uncertainty.
What does the work include?
A theoretical framework, analysis of clinical situations, practical exercises and discussion of real difficulties from participants’ practice.
How does the first meeting proceed?
When training a specific team, the clinical profile and the most common communication difficulties are clarified in advance.
Format and frequency
Format
Seminar, practical workshop, or a series of training sessions.
Duration and frequency
Depending on the topic and objectives.
Who conducts the training?
Specialists with competence in medical psychology, psycho-oncology, communication and the relevant clinical context.
Important
Communication models are a guide, not scripts to be followed mechanically. Every encounter with a patient requires clinical judgement and adaptation.
← All topics in the “For hospitals and healthcare facilities” section
Developing a model for psychosocial screening of patients
What is it?
Not all patients need intensive psychological help, but some experience significant distress that can easily go unnoticed in routine medical practice.
Psychosocial screening allows for more systematic identification of patients with increased anxiety, depressive experiences, social difficulties, care-related problems, family burden or other needs.
A well-built system does not consist merely of distributing questionnaires. It must be clear when the screening is carried out, who administers it, how the results are interpreted, and what follows once a need is identified.
Without a functioning algorithm for subsequent referral, the measurement itself has limited value.
Who is it suitable for?
For healthcare institutions seeking to systematically identify the psychological and social needs of patients.
When may it be helpful?
Particularly in oncology, chronic diseases, palliative care, transplantation, rehabilitation and other areas with a high psychosocial burden.
What does the work include?
- selection of suitable screening instruments;
- determining the points in the clinical pathway at which they should be applied;
- referral criteria;
- an algorithm for responding to high risk;
- integration with psychological and social support;
- staff training;
- monitoring of implementation.
How does the first meeting proceed?
The current patient flow, the available specialists and the current way in which psychosocial problems are identified are analysed.
Format and frequency
Format
A consultative project with the healthcare institution.
Duration and frequency
Depending on complexity and scope.
Who conducts the work?
Specialists in clinical psychology, psychosocial care and the relevant medical field.
Important
The screening instrument does not establish a diagnosis. It signals a possible need for further assessment.
← All topics in the “For hospitals and healthcare facilities” section
Consulting on building psychological and psychosocial care within a healthcare institution
What is it?
Establishing a psychological or psychosocial structure in a hospital requires more than appointing a psychologist.
It must be clear which patients can be referred, according to what criteria, how the specialist communicates with the medical team, how the work is documented, how confidentiality is maintained, and what the boundaries are between psychological, social, psychiatric and medical activity.
Questions of accessibility are also important – whether the patient can seek out a specialist independently, how referral takes place, and how urgent psychological or psychiatric risk is responded to.
The Institute can assist the healthcare institution in building a comprehensive model suited to its clinical profile.
Who is it suitable for?
For hospitals, clinics and medical centres that are creating a new or restructuring an existing psychological and psychosocial service.
When may it be helpful?
- when establishing a new psychological office or team;
- when integrating a clinical psychologist;
- when building clinical social work;
- when expanding psycho-oncological activity;
- when introducing psychosocial screening;
- when clear referral algorithms are needed.
What does the work include?
Needs analysis, definition of functions and roles, development of patient pathways, referral algorithms, documentation principles and interaction with the medical team.
How does the first meeting proceed?
The existing structure, clinical profile, patient flow and objectives of the healthcare institution are clarified.
Format and frequency
Format
Organisational and clinical consulting.
Duration and frequency
Depending on the project.
Who conducts the consulting?
Specialists with experience in clinical psychology, psycho-oncology, and psychosocial and organisational work in healthcare.
Important
The specific model must comply with the applicable regulatory framework and the professional competence of the specialists at the respective healthcare institution.
← All topics in the “For hospitals and healthcare facilities” section
Supervision of psychologists and social workers in healthcare institutions
What is it?
Psychologists and social workers in a hospital work at the intersection of the medical system and individual human suffering.
They may become involved in severe diagnoses, family conflicts, loss, social vulnerability, violence, financial problems, palliative situations, and cases in which different professionals have different priorities.
Supervision provides a space for examining clinical cases, the professional role, boundaries, and interaction with other members of the medical team.
It can be particularly important when the specialist is the only psychologist or social worker in the structure and has no immediate professional colleague with whom to discuss their practice.
Who is it suitable for?
For clinical psychologists, psychologists, psychotherapists and social workers in healthcare institutions.
When may it be helpful?
- in complex cases;
- in ethical dilemmas;
- in conflicts between the patient’s needs and the demands of the system;
- in difficulties with confidentiality;
- in cases of strong emotional reactions;
- when working with end-of-life issues;
- in cases of professional isolation;
- for the development of clinical practice.
What does the work include?
Regular discussion of cases, analysis of the professional position, boundaries, and relationships with the patient, relatives and the medical team.
Format and frequency
Format
Individual or group supervision.
Duration and frequency
Regular or on a case-by-case basis.
Who conducts the supervision?
Specialists with qualifications and experience in clinical supervision and the hospital context.
Important
Supervision must protect patient confidentiality and be conducted in accordance with the professional and regulatory requirements of the healthcare institution.
← All topics in the “For hospitals and healthcare facilities” section
Developing standards and algorithms for psychological care
What is it?
When psychological care depends solely on the individual initiative of a single specialist, patients’ access to it often remains uneven.
Standards and algorithms help clarify when a patient should be referred, how risk is assessed, what information is documented, when a psychiatrist, social worker or other specialist should be involved, and how the case is followed up.
The aim is not for psychological work to be turned into a mechanical procedure. On the contrary – a good algorithm provides a minimal safe framework within which individual clinical judgement can be applied consistently.
Algorithms are particularly important in cases of high psychological distress, suicide risk, cognitive impairment, violence, severe social problems and palliative care.
Who is it suitable for?
For healthcare institutions that wish to structure and standardise the psychosocial components of clinical care.
When can it be useful?
- when establishing a psychological service;
- when there are differing practices between departments;
- when introducing screening;
- when an algorithm for suicide risk is needed;
- in cases of patients' psychosocial problems;
- when integrating a psychologist, psychiatrist and social worker;
- when preparing internal rules and clinical procedures.
What does the work involve?
The following can be developed:
- criteria for psychological referral;
- an algorithm following a positive psychosocial screening;
- an algorithm for suicide risk;
- criteria for psychiatric consultation;
- a model for psycho-oncological assessment;
- an algorithm for working with relatives;
- procedures for crisis situations;
- standards for psychological documentation;
- principles for interaction within a multidisciplinary team;
- mechanisms for monitoring and quality assessment.
How does the first meeting proceed?
The specific clinical process, current practices, the specialists involved and the problems the standard is meant to address are identified.
Format and frequency
Format
Expert consultation and joint development with representatives of the healthcare institution.
Duration and frequency
According to the scope of the specific document or programme.
Who carries out the work?
Specialists with competence in clinical psychology, psychosocial care, medical practice and the relevant subject area.
Important
The algorithms developed must be adapted to the organisation and the regulatory framework of the specific healthcare institution and approved through the appropriate internal procedure.
← All topics in the “For hospitals and healthcare facilities” section
Our approach to healthcare institutions
Psychological care in the hospital makes sense when it is integrated into the actual clinical process, rather than existing in isolation from it.
This means that the patient can be recognised as a person with psychological and social needs already in the course of medical treatment; the doctor knows when and to whom to refer them; the psychologist and social worker have a clear professional role; and medical specialists have space for support and professional reflection.
The Institute does not offer a single ready-made model for every hospital. The work begins with the specific clinical context, the patients, the team and the resources, and from there an appropriate structure is built.
Quality medical care is determined not only by the treatment provided, but also by the way in which the person was supported through it.
Care for the patient and care for the medical team are parts of one and the same system.