Going Clinical for Spring Break

Posted on April 26,2013 by hmonkmspp

Felix Trede is a 1st year student in the Clinical PsyD program at MSPP. I have had the pleasure of having clinical seminar with Felix all year. Our seminar class has become sort of a mini-family, and we often share both academic and personal triumphs with one another. When we came back from break, Felix told our class about a really incredible experience he had doing mental health work in Mexico, and I asked him if he would share his experience with our blog readers. He graciously answered my interview questions, despite us being in the middle of finals.

From left: German (Red Cross staff), Lazaro (Red Cross jefe/boss), Bob, Katharina, Felix, Morgan, Orande, Dan. From left: German (Red Cross staff), Lazaro (Red Cross jefe/boss), Bob, Katharina, Felix, Morgan, Orande, Dan.

Q: What did you do this spring break?

A: Over spring break, I traveled to Mexico with my girlfriend, my mom, her boyfriend and two of their friends. We flew into Cancun on Saturday, 4/13 and spent a night in Puerto Morelos, right outside of Cancun. The following morning, we drove four hours inland to a small rural village, Javier Rojo Gomez, to volunteer at the Cruz Roja (Red Cross). My mother's boyfriend, Bob, is a surgeon at Maine Medical Center in Portland, Maine. My mother, Katharina, is a psychiatrist and is currently also working at Maine Medical Center. Their two friends, Dan and Orande, work at a different hospital in Maine. Dan is a surgical technician and Orande works in the billing department. My girlfriend, Morgan, manages a restaurant in Boston.

As soon as we arrived at the Red Cross, we began working. Katharina and Bob began seeing patients for surgical consults and developed a surgery schedule for the following three days. I took on the role of psychologist, a role that my mother had assumed during her previous trips to this Red Cross (twice a year for the past three years). I was immediately given a list of cases and began seeing clients. I met with five people that day, for approximately one hour each. We stayed in Javier Rojo Gomez until Wednesday night, spending the days and evenings at the Red Cross. I met with 5-7 clients each day, while the rest of the team attended to medical patients. Bob began performing surgeries on Monday and basically continued to perform one surgery after another until we left. Katharina helped out in the surgery room and saw new surgery consults throughout the day. Dan and Orande assisted Bob in the surgery room. Morgan called in patients, kept records and attended to patients who were preparing for surgery and who had just come out of surgery. When I had free time, I helped out with surgeries (mostly translating for patients, helping to hold incisions open and giving Bob tools that he needed).

What stood out to me throughout my clinical sessions was the eagerness to share and the gratefulness of the clients. I did a lot less talking than I normally do in my sessions with adolescents at my practicum; while this may have been partially due to my rustiness with the Spanish language, I believe it was largely because the clients had so much to say, and simply needed someone to listen and empathize with them. It was refreshing to work with people who had no resistance to therapy, something that I struggle with at times at my practicum. I worked with a large variety of people: families, adolescents, young adults and one elderly woman. Here are a few examples of sessions that I had (names changed for confidentiality):

Maria and Jose: I first met with Maria. She expressed a lot of anxiety and sadness about her 21-year-old son, Jose. She explained to me that Jose has been using drugs for several years and that she is concerned for his health and safety. I invited her to return with Jose and they came back the next day. I met with Jose individually and heard his perspective on his drug use and the dynamics of the family. We then met as a group, with both Jose and Maria present. I asked Maria and Jose to share the feelings that they had shared with me, which really helped both of them understand the other's point of view. We then developed a compromise through which Jose will plan to address his drug use by attending AA meetings and working. Both seemed very happy and relieved to have reached this compromise.

Sara: Sara was a woman who came in for a medical appointment and decided to schedule a psych appointment after discovering that this was available. I asked her what caused her to come in and she revealed that she has been highly suicidal for several years. She reported that she attempted suicide three times over the past month. She told me her life story, which included numerous highly traumatic events, including being raped and being separated from her children. My main focus during my time with Sara was to help her find supports in her community as well as reasons to continue living. Despite not seeing her children often, they still live close to her and she still cares deeply about them. I worked with her on thinking about how taking her own life would affect her children, as well as on what steps she could take to reestablish a connection with them. I then brought in Katharina, as I suspected that prescribing Sara medication may be important in treating her suicidally. Katharina met with Sara and we reviewed what she had revealed to me, after which Katharina prescribed Sara an antidepressant. While I was still highly concerned for Sara, she seemed to be in better spirits after leaving the clinic.

The Cruz Roja staff: The Red Cross staff asked me to conduct a group therapy for them, an offer that I gladly accepted. I asked them to tell me one by one what caused them to seek group therapy and each staff member (there were five of them, including the boss), explained that poor communication, bad attitudes and unresolved interpersonal issues have been affecting the morale of the group. I asked each member to address each other member, one at a time, and to identify something they appreciate about that person, as well as something they would like the person to change. I finished the session by having each person identify one change they would like to make in their own lives or approach to work. The exercise was intense at times, but really seemed to help the group open the lines of communication and communicate honestly and respectfully. I advised them to conduct this exercise weekly, to which they agreed.

Q: How did you get involved with this project?

A: Katharina, who met Bob on this same trip three years ago, became introduced to the project through a missionary group. This missionary group was present during our time in Javier Rojo Gomez and travels there every April and November. While Bob and Katharina are not part of this group, they work together and help coordinate patient care. Katharina invited me to join them on this trip and to assume the role of psychologist.

Q: How long has your mom been volunteering with this organization?

A: Three years.

Q: What was your role there?

A: Psychologist and occasional translator/surgical assistant.

Q: How do you feel that your training at MSPP prepared you for this experience?

A: I have learned a lot in my training at MSPP about building rapport, displaying empathy and asking the right questions. These three abilities were very useful during the experience. What I have learned about reflective listening also helped tremendously-by summarizing statements and feelings that were expressed, clients felt understood and appreciated. Reflective listening was also helpful in terms of having my Spanish corrected from time to time!

Q: What was your favorite part of the trip?

A: My favorite part of the trip was seeing people leave with a smile and thanking me. It was a great feeling to know that I was able to help somebody in need.

Q: What was the most difficult part of your experience?

A: Working with Sara, who was suicidal, was difficult. I have not had much experience working with suicidal clients, and worried that I would not be able to help her. It was emotionally trying to hear about the trauma that she has experienced. Her openness and honesty made it easier to work with her and to carry out some of the interventions that I used. It also helped a lot to have Katharina there to help, as she has a lot more experience than I do working with a suicidal client.

Q: Are there any ways for other people to get involved with this organization?

A: Get in touch with me! As I explained, Katharina and Bob volunteer independently, but got involved with the project through a missionary group (the name of which I don't remember, but can find out). Any additional help would definitely be welcomed and appreciated.

Q: What is your advice to future students that are interested in doing similar work?

A: If you ever feel unsure about a similar opportunity, just do it! It was incredible how much I learned in just four days of volunteering. I would also advise students to gain some knowledge of the culture and beliefs of the people they will be working with. Some of the clinical approaches that we may consider normative in work with our clients in the United States could potentially be viewed as offensive or inappropriate in another culture.