The demand for severity, urgency, risk of death or its imminence, puts on the limit the capacity of emotional equilibrium in the human being. For the patient, ICU admission is a cut in the “existential continuity.” Nowadays, there is ample knowledge regarding the emotional problems linked to the critical illness, the treatments required, the associated experiences and the post-ICU difficulties in patients, families and professionals.
There is a large number of scientific evidence (both in bibliography or the practical experience in several countries) on the efficacy of psychological intervention in the ICU. Countries in Latin America, US, Canada, Europe and Australia are pioneers in this. In Spain, the presence of the psychologist in the ICU is anecdotal, being linked mainly to very punctual interventions of interconsultation from psychiatry, to rotations and practices of academic character, or thanks to interventions promoved by associations, foundations and NGO which perform functions not offered in the care service portfolios.
Based on this reality, Proyecto HU-CI has proposed to collaborate in the development, research and systematization of this type of assistance. To this end, we have created the International Group of psychologists in ICU from which we consider, as a first point, the definition and visibility of the figure of the Psychologist in Critical Care
The psychointensivist, through actions of evaluation, diagnosis, prevention, intervention and promotion of the health, aims as general objective to maintain the psychological balance of the patient, family and professionals, with the following specific objectives and areas of intervention:
Patient: In key moments such as the pre-surgical situation, the reception in ICU, the stay and post-ICU phase, is assessed at the same time that a containment is carried out, we act on the psychic situation and cognitive, emotional and behavioral needs of the patient. Early detection of dysfunctional feelings, affections and behaviors, periodic cognitive evaluation, orientation in time, person and space, work on identity cohesion, the stimulation of coping resources, the increase of the perception of control, and the accompaniment to the end of life.
Family: by helping in the initial process of emotional impact, acceptance and assimilation of relatives in relation to the clinical condition, prognosis and disease process of the patient; promoting interaction and effective communication with the ICU team; encouraging the participation in the care of his/her relative in the unit, the emotional regulation pre and post interaction with the patient; orientating on the emotional alterations manifested by the patient in ICU and after the discharge, detecting and early intervening in the possible emotional and dynamic problems of the family group; work on early griefs, emotionally accompanying the primary caregiver, and facilitating the preparation and accompaniment of the visit of children in ICU.
ICU professionals: by participating in interprofesional objectives as “common goals”; collaborating in the primary prevention of possible psychosocial risks (such as professional wear or burnout); to encourage the development of emotional skills and psychosocial tools for the clinical practice in the ICU and the management of the emotional demands; by offering a therapeutic context for emotional for emotional ventilation and psychic elaboration after situations and critical experiences and for the management of the emotional impact of the task, psychological intervention in crisis, early detection of possible emotional disturbances, and ultimately, promoting the integration of emotional health and occupational health.
The environmental ICU context: aspects such as the affective experience of the environment, the satisfaction with the same or the evaluation of the environmental impact, are subjects of the Environmental Psychology, discipline that, in an interdisciplinary way, can be applied in the design and possible modification of the structural contexts of the ICU and áreas for family and professionals, with the aim of creating friendly environments, avoiding (or at least diminishing) physical risks, and favoring contexts generators of well-being.
The professional profile of the Clinical Psychologist in Critical Care will require training in clinical and health psychology. In addition, other areas of psychological knowledge such as neuropsychology, occupational health, environmental psychology and emergency psychology, will facilitate the approach of the psychological and emotional complexity to be addressed in the ICU, which goes far beyond the Mental disorders. Sensitization and training in humanization will also be important, as well as the research capacity and psychoeducation in health.
In summary, some of the key psychosocial skills and competencies of this professional will be: the ability to work in interdisciplinary teams, interpersonal and communication skills, learning ability and updating, methodological neutrality (acceptance of individual, cultural diversity…), empathy, compassion, active listening and without judgement on the person, cozy posture in front of the process of death, capacity of accompaniment and performing in situations of high emotional demand, respecting to the confidentiality and protection of data, values and professional attitude according to ethical principles and Code of ethics, reflective practice, self-evaluation and self-care.
If you develop your professional work as a psychologist in the context of ICU and you are interested in collaborating with this working group, please fill this form. By the moment, this group is formed with professionals from Brazil, Costa Rica, Uruguay and Spain.
You are very welcome!!! There are many things to do in this #holymadness!!!
The International Group of Psychologists in ICU of Proyecto HU-CI