[SPS Conference June 2009 - Practical training in general health and mental health facilities] - Report 4 – The function of psychology in the hospital context as competence to think about relations. Two psychology units.

Abstract

In this paper we reflect on the role of psychology in the hospital, seen as an organisational competence based on clinical psychology models. We will suggest that between organisational competence based on clinical psychology and psychotherapeutic praxis there is a close connection, following this line of thought: from the setting identified with the psychologist’s room, who protects the psychotherapeutic praxis from the actions of the organization by closing the door, to the setting of the psychologist who operates in hospital divisions promoting emotionally competent organisational relations and therefore psychotherapeutic.
Clinical psychology tells us that all organisational practice is based on emotionally organised relations. These are relations marked by a symbolic meaning, which allow the organisation to achieve its aims. Every organization has its symbolic models for this purpose. Thinking of the hospital, two of these come to mind, both based on strongly individualistic premises, ignoring relations. This ignoring produces critical events, in which we think psychology can intervene. The first of these models, tendentially hegemonic, is the economic model which hypothesises a social relation involving rational individuals; it ignores the emotionality experienced in relating. The second relational model that comes to mind when thinking of the hospital is the medical model, which also tends to be hegemonic. In the medical model, the emotional symbolisation of the relation is envisaged in a precise rituality, described well by Fornari as the split into the sick part and the healthy part of the patient, with the consequent aggression by the sick part, seen as “other than self” and the enemy, while the healthy part forms an alliance with the doctor. This alliance sees a strong technical expert confronting a weak client, who accepts an acritical dependency because it is reversible and guaranteed by the medical competence. We hypothesise that in cases where in a hospital, these organisational models of the relation prove to be inadequate, failing to achieve their purpose, then they are offered to the psychology units.