Paradoxes Faced by Residents Being Trained in the Psychosocial Treatment of People With Chronic Schizophrenia
Kenneth Minkoff M.D.1 and
Robert Stern M.D.2
1 Choate-Symmes Health Services, Inc., 21 Warren Avenue, Woburn, Massachusetts 01801 Harvard Medical School in Boston
2 The Eliot Community Mental Health Center in Concord, Massachusetts, Haryard Medical School
The authors describe seven paradoxes that confront psychiatric residents being trained in the psychosocial treatment of chronic schizopbrenic patients in community settings. The paradoxes arise because the psychosocial framework necessary for working with such patients challenges the residents' strongly held beliefs and values concerning the nature of psychotherapy and of schizophrenia. The paradoxes result in stress and resistance to learning new approaches and must be clarified and resolved for training to proceed successfully. The authors examine the origins of the paradoxes and the reactions of residents to each, and describe how the supervisory relationships of the training setting can be used to resolve them.
