The answer is "No!"
The best kept secret about doing this work is that it takes
almost nothing more than just sitting and listening. If you
can listen attentively to "the family story," and
regard the parent as the essential teacher, the environment
is set up to help you acquire these psychosocial skills over
time.
While reading and going to lectures can be helpful, the
real teacher in psychosocial pediatrics is the parent. I have
been impressed, over and over again, how often listening to
and understanding the parent’s experience reviews for
me the basic lessons in becoming aware of a problem, understanding
what it is about, assessing its severity, and contemplating
resolution.
Our task is to set the stage and then, respecting who the
parents are, allow them to tell their story. The key is to
view parents as our teachers. If we create the right environment
and sit back and listen, parents can often help us understand
what the problem is, how it came to pass, why this particular
problem, and how we can help the child and the parent begin
to gain mastery of the situation.
Are there certain prerequisites that give us a running
start?
One prerequisite is our professional motivation. Do we want
to do this kind of work? Are we able to see the child as who
we, or our siblings, once were, wishing that someone had cared
about what we were going through, what we were worried about,
what we were feeling? Can we see the parent as who we were
as a parent, wishing that someone had reached out to us to
help us discover that we could learn to be competent, and
had offered to rescue us from our own anxieties about being
a good parent?
Or, consider our own parents. What would have happened if
someone had reached out to them when we were growing up --
not only for our own sake, but also for our siblings and,
especially, for our parents themselves?
When I listen to parents, I do so attentively. If I listen
closely, the problem unfolds and, repeatedly, family after
family seem to validate the lessons of how to listen and how
to intervene.
Another prerequisite is empathy. Those parents could be
us or our own parents. No longer is it just what we say or
recommend, but how we value the opportunity to be involved
in this discussion. Investing the parent with the respect
that one would reserve for a valued teacher, combined with
empathy, is empowering almost regardless of what we say. Perhaps
for the first time in their lives, at least as parents, someone
is saying to them, "I am interested in how you are feeling"
and "It would be a privilege to see if I could help you
understand how to solve this problem."
If we help parents feel so engaged, then they, in turn,
may be able to replicate that experience with other members
of their family, be it their spouse, their child, or perhaps
their own parents. In order to do so, their own batteries
can be charged up by the pediatrician-parent relationship.
An additional prerequisite is respect for ourselves in our
professional role. I call this "the pediatric advantage."
We bring to the table certain unique strengths just as the
parent and the child have unique strengths waiting to be discovered
in the context of the meeting.
Our motivation, empathy and self-respect can enable us to
practice pediatric medicine and family care in effective ways
with the highest standards for quality of care.
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