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Clinical Vignette
Jane is an early career clinical psychologist at an academic medical center, where she primarily provides therapy to patients with trauma and depression at a busy adult outpatient clinic. She provides many back-to-back therapy sessions every day. After six months at her new job, the pandemic hit and the clinic transitioned to a hybrid work schedule (i.e., partly remote and partly in-clinic). Suddenly, she had to learn to conduct teletherapy with a challenging clinical population. Although some patients embraced teletherapy, others were difficult to engage and were frequently distracted during sessions. Jane also recognized that the pandemic caused significant social isolation and worsened symptoms for her patients. Jane did not see much progress in therapy for some of her patients and subsequently experienced self-doubt.
She wanted to consult with a peer, but not many providers were available when she was at the clinic because of the clinic’s social distancing policy. When working remotely, colleagues’ statuses often indicated “Busy” or “Not available.” She felt isolated as if she were in private practice. She also knew that her peers were busy navigating the additional responsibilities of schooling their children while keeping a full-time clinical load. Meanwhile, Jane was very busy taking care of her children and often emotionally and physically drained after seeing so many patients. She knew subconsciously she should seek consultation on the cases that lacked progress, but she kept telling herself, “Well, maybe I just need to try longer. It’s not really that urgent to take up somebody else’s time.”
Although there were clinic meetings every few weeks, these meetings focused on the transition to telehealth, case presentations, and occasional updates with other providers about mutual patients. She also did not want to take up valuable clinic meeting time for non-urgent cases. Jane feared being judged as unprofessional or incompetent if she were to discuss her burnout and challenging cases. With her children at home, Jane found herself caring for their physical and emotional needs between appointments. She had neither the time nor accessible colleagues for peer consultation, let alone for self-care. With the heavy caseload in addition to her family responsibilities, Jane was in survival mode just trying to get through the next 24 hours.
Background
Peer Consultation Before the Pandemic