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- Title
Institutional Transference in Serious Illness Care.
- Authors
Sholevar, Roxanne; Landerholm, Angela; Kher, Hema; Tung, Stephanie; Braun, Ilana; Peteet, John
- Abstract
Institutional transference is a phenomenon describing patients' attitudes toward the institutions where they receive mental health or medical care. While transference toward individual clinicians in palliative care has been described, attitudes of patients with serious illness toward the institutions where they receive specialized care have not been described. Here, we present three cases which demonstrate the phenomenon of institutional transference in patients with serious illness and the resulting clinical implications, which include countertransferential responses of clinicians caring for them. We consider three conditions: (1) the idealized reputation of the academic cancer center, often a tertiary referral center; (2) loss of an institutional connection during care transitions; and (3) countertransferential reactions to institutional transference. We highlight characteristics and personality styles of individuals with cancer that may complicate and intensify institutional transference and identify potential interventions to address common challenges associated with institutional transference.
- Subjects
ACADEMIC medical centers; PSYCHODYNAMIC psychotherapy; TERTIARY care; CATASTROPHIC illness; PATIENTS' attitudes; CRITICAL care medicine; HEALTH care teams; TRANSFERENCE (Psychology); COUNTERTRANSFERENCE (Psychology); PALLIATIVE treatment; MENTAL health services; PSYCHIATRIC treatment
- Publication
Journal of Palliative Medicine, 2024, Vol 27, Issue 1, p143
- ISSN
1096-6218
- Publication type
Article
- DOI
10.1089/jpm.2023.0312