A Different Kind of Holding Environment: A Case Study of Group Work with Pediatric Staff

ABSTRACT

This paper reports a nearly two-year intervention with staff at a major urban pediatric facility. The authors worked as trainers and consultants for two groups–the Emergency Department (ED) and Chronic Care units (CC). Following two days of training about grief and loss, highlighting skill building for work with traumatized and grieving children and parents, the consultants worked to develop teams which could provide a Winnicottian holding environment for staff. The efficacy of this staff training is analyzed and support needs of staff members are identified. Findings include varied willingness to make use of group support. Chronic care participants are more likely to express willingness to engage in on-going support for one another, while ED staff members seem to prefer structured, educational training and episodic support. The holding environment of the processing groups must be adapted to fit the needs of the medical sub-culture.

KEYWORDS:

• Pediatric staff support
• holding environment
• professional sub-cultures
• debriefing
• grief
• loss
• interdisciplinary practice