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From monologue towards therapeutic dialogue. Some remarks about systemic family consultations in a psychiatric in-patient ward
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Arch Psych Psych 2009;11(2):29-34
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ABSTRACT
Based on the example of one patient and her family, the paper discusses the concept of system family consultations as a way forward towards a therapeutic dialogue. The patient was hospitalized and diagnosed with schizophrenia, following which the psychiatrist attended the patient's family consultation, conducted by a psychologist. The consultation allowed for the development of a much more complex understanding of the situation. It gave the members of the patient's family the opportunity to present their own view of what was actually happening. The description of the situation from multiple perspectives exposed the ways in which the patient's symptoms functioned; this, in turn, raised doubts for the psychiatrist about his diagnosis, and made him consider to what extent the diagnosis of schizophrenia was actually justifiable. According to the authors, systemic consultations, which create grounds for feeling empathy for the patient's existential, psychological and family problems, lead to a dialogue with the patient's family and therefore play a significant role in the therapeutic and diagnostic process.