Psychotherapy and assessment in hospital settings: Ideological and professional conflicts.

Abstract

Hospital practice poses challenging professional issues for the psychologist. The hospital system and the medical setting present a variety of clinical and nonclinical task and role demands that necessarily influence the mental health practitioner's ability to function with patients. The strong potential in the hospital milieu for professional role conflicts requires examination. The paradigmatic clashes between existing medical and psychological approaches are seen as an intrinsic aspect of such professional conflicts and are, therefore, specifically addressed. The particular complicating effects of the hospital organization on psychotherapy and assessment are discussed, and suggestions for professional boundary definition and maintenance are made.

Psychologists in public inpatient psychiatric settings: Ethical dilemmas.

“…Continued supervision would be needed to support methods by which psychologists can function in multiple capacities in this multidisciplinary setting and remain true to and represent the roles usually associated with the profession. In addition, psychologists would learn to clarify the limits of thier roles and confidentiality in this setting in which the consumer may be the patient, the staff, the hospital, the general public, or some other third party (Elfant, 1985; Miller & Swartz, 1990).…”

Extending Clinical Practice to Medicine

“…The recognition of the knowledge competencies (i.e., Brain & Behavior, Social Interactions, Learning, Memory, Perception) fundamental to the training of doctoral level Clinical Psychologists expanded to the Veteran's Administration service and medical specialties of Neurology and Physical Medicine [4]. The integrated knowledge and skills of the Psychologist to design, implement and interpret research investigations of patients' behavior fortified the flourishing of Psychologists in general hospital settings [5,6]. Brown and Reed [7] noted a trend in the recent twenty-five years growth of utilizing Psychologists in healthcare as due to the increasing complexity of health care.…”

The history of rural hospital psychology.

“…These innovations dramatically increased the demand and use of psychological services in public general hospitals (McCarrick, Rosenstein, Milanzo-Sayre, & Manderscheid, 1988). The psychological and hospital literature began to point out the critical need for psychological approaches in the hospital (Elefant, 1985).…”