Interventions with Parents to Support the Parental Holding Environment to Permit the Debriefing of Children

Ziegler, Robert; Weidner, Deborah

doi:10.1080/15289160309348461

Cited by 4 publications

(3 citation statements)

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“…In our sessions, participants noted the need to provide, as the clinician, this sort of holding environment for the patient and, at times, the parent. Ziegler and Weidner illustrate the need for interventions for parents of children who have experienced violence to help them debrief the violence and hold the child effectively [ 23 ]. The authors describe the particular need in times of crisis for a holding environment for children.…”

Section: Discussionmentioning

confidence: 99%

Family dyads, emotional labor, and holding environments in the simulated encounter: co-constructive patient simulation as a reflective tool in child and adolescent psychiatry training

Thomas,

Benoit,

Duvivier

et al. 2023

Child Adolesc Psychiatry Ment Health

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Background Patient simulation has been used in medical education to provide a safe and supportive learning environment for learners to practice clinical and interpersonal skills. However, simulation involving pediatric populations, particularly in child and adolescent psychiatry, is rare and generally does not reflect the child-caregiver dyad or the longitudinal aspects of this care, nor does it provide learners with an opportunity to engage with and reflect on these dynamics. Methods We organized as an educational opportunity a series of seven observed patient simulation sessions with a cohort of a dozen child and adolescent psychiatrists (eight fellows approaching graduation and four senior educators). In these sessions, we utilized the co-constructive patient simulation model to create the simulation cases. We included the use of at least two patient actors in most sessions, and two of the case narratives were longitudinally followed across multiple simulation sessions. We approached the data collected during the simulations and their respective debriefings by using thematic analysis informed by a symbolic interactionist approach. Results Based on data from the debriefing sessions and longitudinal narratives, we identified four overarching themes: (1) Reflecting on dyadic challenges: role reversal and individuation; (2) Centering the child, allying with the parent, and treating the family system; (3) Ambivalence in and about the parent-child dyad; and (4) Longitudinal narratives and ambivalence over time. Conclusion The emotional experience of the simulations, for interviewers and observers alike, provided an opportunity to reflect on personal and professional experiences and triggered meaningful insights and connections between participants. These simulated cases called for emotional labor, particularly in the form of creating holding environments; in this way, the simulated encounters and the debriefing sessions became dialogic experiences, in which the patient and provider, parent and child, and learner and instructor could co-construct meaning and foster professional development as reflective practitioners.

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Section: Discussionmentioning

confidence: 99%

Family dyads, emotional labor, and holding environments in the simulated encounter: co-constructive patient simulation as a reflective tool in child and adolescent psychiatry training

Thomas,

Benoit,

Duvivier

et al. 2023

Child Adolesc Psychiatry Ment Health

View full text Add to dashboard Cite

show abstract

“…In our sessions, participants noted the need to provide, as the clinician, this sort of holding environment for the patient and, at times, the parent. Ziegler and Weidner illustrate the need for interventions for parents of children who have experienced violence to help them debrief the violence and hold the child effectively (22). The authors describe the particular need in times of crisis for a holding environment for children.…”

Section: Clinical Encounters and Debrie Ngs As Holding Environmentsmentioning

confidence: 99%

Family dyads, emotional labor, and holding environments in the simulated encounter: Co-constructive patient simulation as a reflective tool in child and adolescent psychiatry training

Thomas,

Benoit,

Duvivier

et al. 2023

Preprint

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Background: Patient simulation has been used in medical education to provide a safe and supportive learning environment for learners to practice clinical and interpersonal skills. However, simulation involving pediatric populations, particularly in child and adolescent psychiatry, is rare and generally does not reflect the child-caregiver dyad or the longitudinal aspects of this care, nor does it provide learners with an opportunity to engage with and reflect on these dynamics. Methods: We organized as an educational opportunity a series of seven observed patient simulation sessions with a cohort of a dozen child and adolescent psychiatrists (eight fellows approaching graduation and four senior educators). In these sessions, we utilized the previously described co-constructive patient simulation model to create the simulation cases. We included the use of at least two patient actors in most sessions, and two of the case narratives were longitudinally followed across multiple simulation sessions. We approached the data collected during the simulations and their respective debriefings by using thematic analysis informed by a symbolic interactionist approach. Results: Based on data from the debriefing sessions and longitudinal narratives, we identified four overarching themes: 1) Reflecting on dyadic challenges: role reversal and individuation; 2) Centering the child, allying with the parent, and treating the family system; 3) Ambivalence in and about the parent-child dyad; and 4) Longitudinal narratives and ambivalence over time. Conclusion: The emotional experience of the simulations, for interviewers and observers alike, provided an opportunity to reflect on personal and professional experiences and triggered meaningful insights and connections between participants. These simulated cases called for emotional labor, particularly in the form of creating holding environments; in this way, the simulated encounters and the debriefing sessions became dialogic experiences, in which the patient and provider, parent and child, and learner and instructor could co-construct meaning and foster professional development as reflective practitioners.

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“…In The Theory of the Parent-Infant Relationship (1960), the notable pediatrician and psychoanalyst Donald Winnicott studied the early parent-infant relationship and developed the concept of the "holding environment." More contemporary researchers, however, focused on the positive holding environment that is necessary not just in early infancy but throughout the course of children's development, especially in times of crisis (Ziegler & Weidner, 2004). Ziegler and Weidner proposed essential components of the parental holding environment: safety and security, with care, warmth, and self-control; empathy, being receptive to the child's feelings, seeing the child as separate and different from themselves, appreciating the child's developmental level, emotional availability, and controlled attunement to the child; and facilitation, and the identification of resources to support and continue the child's growth, and commitment to provide these opportunities (Ziegler & Weidner, 2004, p. 188).…”

Section: Coping: Bolstering Resilience and Treating Ptsdmentioning

confidence: 99%

Resilience, Trauma, and Coping

Friedberg¹,

Malefakis

2018

Psychodynamic Psychiatry

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The study and use of resilience is of the utmost importance to psychodynamic psychiatry. It is deeply ingrained in ideas about well-being and the treatment and care of patients. However, its neurobiology is incompletely understood, its terminology and relation to trauma and coping not well defined, and its efficacy underutilized in clinical practice. This article reviews the scientific literature on resilience, especially as it relates to trauma and coping. It also attempts to point the way for its greater application in psychiatry and mental health by utilizing resilience in more informed and individualized approaches.

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Interventions with Parents to Support the Parental Holding Environment to Permit the Debriefing of Children

Cited by 4 publications

References 0 publications

Family dyads, emotional labor, and holding environments in the simulated encounter: co-constructive patient simulation as a reflective tool in child and adolescent psychiatry training

Family dyads, emotional labor, and holding environments in the simulated encounter: co-constructive patient simulation as a reflective tool in child and adolescent psychiatry training

Family dyads, emotional labor, and holding environments in the simulated encounter: Co-constructive patient simulation as a reflective tool in child and adolescent psychiatry training

Resilience, Trauma, and Coping

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