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Your Psychologist with you: Therapeutic accompaniment

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By Tommy Norheim, psychologist on the SINEWS clinical team. Tommy has extensive experience in the field of home care for patients with severe mental illness in his country of origin, Norway, and later during his internship in the Master in General Health Psychology at SINEWS.

In our present, in the age of information, the existing figures in the health area are well known to the entire population, figures such as professionals in medicine, nursing, physiotherapy, psychology, assistants of different types, etc. But even with the enormous amount of information we have about these experts, there are still some that are not as well known, and in this article I will try to shed light on one of them that, in my opinion, is still not completely known, specifically that of the therapeutic companion, the functions it performs and how it is done from the area of ​​psychology.

 

A therapeutic companion is a health professional who performs the task of assisting a person with health problems, whether physical or mental, in those areas where they cannot cope independently, usually in a field other than the clinical or hospital context such as the family home, school, work, etc. Very often, the cases where these tasks occur are with people suffering from severe mental disorders, developmental disorders, autism spectrum disorders, people disabled by reduced mobility or other problems that limit their ability to cope.

Unlike therapies in clinical or hospital contexts, the main job of a therapeutic companion is, whatever the redundancy, accompanying the person in the areas where they have specific problems, making sure to supervise the activities they can do on their own and helping, in the form of guidance rather than substitution, in activities that are difficult.

Having explained and understood what a therapeutic companion is (in general), it is worth asking what role a profesional in psychology who performs this function can play, what kind of problems can a psychologist solve by accompanying a person during their daily chores that are problematic.

Today there is still a lot of misinformation regarding the role of psychology in society, although in general the public begins to form an idea of ​​what psychological therapy would be, and in summary we could say that it consists of speech therapy, describing in words the different problems that a person has in their daily life (regarding habits, emotional state, thoughts, relationship with other people, etc.) so that the professional may help you find ways to change, improve, or accept the problem with which they come, but all this is done in consultation. In the vast majority of cases, the therapist does not have information with which to work beyond that provided by his client through what has been spoken, which, even though it is of incalculable value, it can sometimes make the task of helping difficult due to lost or omitted relevant information. Below I will roughly expose an example of how a treatment can be improved if the role of companion is performed from the area of ​​psychology, using for this a fairly typical example, depression: 

  • A person comes to the consultation with an acute depression problem that has been developing for several months. Let us say that the problematic behaviors that are present are the following: feeling of constant sadness, lack of appetite, lack of meetings and social communication, and a general lack of motivation to do things. When evaluating all the problems, talking to the person, we found that there seems to be no ‘reason’ behind all this, it just started to be like that little by little and they feel unable to change it. Let's focus on the social sphere for this example, let's consider that we ask the person what they feel and think when someone contacts them to go out with their friends or make some other type of social gathering and they tell us that they don't feel or think anything in particular, it just happens that they feel no motivation for it and decide not to, which is also influenced by their general state of sadness and lack of appetite. To help change this, the therapist would probably try to design and establish an action plan where the person would have to say yes to meeting up with someone even if the motivation is not present, and before they’d have to eat something to have energy for what awaits them, but this design would be based solely on the information given by the patient, which, although being incalculable as we have already said, could be omitting some important parts for some reason (among them, that they don’t know what information is important since they have no training in psychology).
  • Now, let's change the perspective and suppose that instead of doing the intervention from the clinical context, we go directly to the person's home as therapeutic companions. Suppose we arrive at the house first thing in the morning to be with the person, as soon as we arrive someone calls the person to go out for breakfast and they immediately say no, getting nervous. When asked what they thought about, they say that they cannot do it, they say they’re feeling ill and does not want people to see them like this, they wonder what other people will say about them or what they would think, having an anxiety response to this idea, but when asked how they feel they say good (they’re not aware of the response they have to the situation). Later, we propose the person to clean up the house (assuming that due to inactivity it is not cleaned) and we see that the person becomes paralyzed, begins to see everything that needs to be done and does not know where to start, they see a load of work that’s so big that it gets coupled with the lack of motivation and paralyzes them, when asked what they think they say that there are too many things to do, that they would exhaust themselves to the point that they could no longer do anything else (thought that could perhaps be omitted in the clinic due to not giving it importance or not remembering that they think about it). Our job here would be to guide and tell them that they can do the activity one by one, you don't have to do it all the same day.

As it may have been observed, in the role of the companion, an incalculable amount of information could be received that in another context could be omitted for various reasons, which shows the value of the role the therapeutic companion plays. As we’ve already mentioned, the role this professional plays is not well known today, both in the general population and by health professionals, which is why a good option for both populations to learn about it, in case this small introduction attracts attention, would be the book by Leonel Dozza de Mendoça entitled 'Therapeutic and clinical accompaniment of everyday life'. In this book, Leonel not only explains the different functions of the companion in a language understandable to all populations, but also describes and bases the reasons why the figure of the therapeutic companion is, and will be, a necessity in our society, the benefits it has and why betting on these professionals is a necessary investment in many current cases.

 

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