Therapeutic Presence in the Time of COVID: Podcast with Keri Brenner and Dani Chammas

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GeriPal - A Geriatrics and Palliative Medicine Podcast 52 min 4 speakers 8 chapters transcribed 6 hours ago
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What is therapeutic presence and why is it essential in palliative care?

Eric Widera 0:01
The Jerry Powell Podcast is brought to you by Archstone Foundation, preparing society and meeting the needs of an aging population. And now, here are your hosts. Welcome to the Jerry Pal podcast. This is Eric Radera. This is Alex Smith. And Alex, we have two people on the call with us today.
Alex Smith 0:20
We have two people joining us. Welcome to the Jerry Pal podcast, Carrie Brenner, who is a palliative care physician and a psychiatrist at Stanford. Stanford, welcome.
Keri Brenner 0:30
Hi, everyone. Thanks for having us.
Alex Smith 0:32
And then we have, welcome back to the podcast, Dani Shamas, who was with us in one of our earliest episodes. She's also a palliative care physician and psychiatrist at UCSF. Welcome back, Dani.
Dani Chammas 0:47
Hi, thanks for having me back.
Alex Smith 0:49
What was that first podcast you did? What was it about? It was
Dani Chammas 0:52
on therapeutic formulations.
Alex Smith 0:53
Formulations. That was a great podcast. I like how
Dani Chammas 0:58
you're just pretending that you forgot that.
Alex Smith 1:01
That's right, yeah.
Eric Widera 1:03
And today we're not going to be talking about therapeutic formulations. We're going to be talking about therapeutic presence. Is that right?
Dani Chammas 1:10
Yeah, that's right.
Eric Widera 1:12
And maintaining therapeutic presence in the midst of this COVID pandemic. Before we go into that, we always start off with a song request. Do you have a song request for Alex?
Dani Chammas 1:25
We do. But before I share our song, I just want to put out there the life lesson that it is a terrible idea to ask two psychiatrists to analyze together what the right song should be. But after like a lot of psychological back and forth,
Alex Smith 1:43
I'm
Dani Chammas 1:43
happy to report we landed on the brilliant choice of the theme song from the show
Eric Widera 1:48
Friends. Great. Good choice.
Unknown 1:55
So no one told you life was gonna be this way. Your job's a joke, you're broke, your love life's B.O.A. It's like you're always stuck in second gear when it hasn't been your turn.
Unknown 2:28
Now
Eric Widera 2:44
we just got to all finish by dancing in a fountain.
Unknown 2:47
Exactly.
Eric Widera 2:49
And have the biggest apartment in New York City. Crazy world where a barista can afford this monster apartment. Therapeutic presence. Before we talk about how to maintain it in a pandemic like the one that we're in right now, what the heck is it?
Keri Brenner 3:13
So therapeutic presence is about the relationships and the connection that we cultivate with patients and their families that we feel is one of the most fundamental aspects of what we do within palliative care. We know that we actually have a very robust skill set already in our field, a developed way of thinking about things like symptom management and communication techniques. But yet we also know that there's this third element of what we do that has a lot of benefit and value to it. And that's therapeutic presence. We feel that the more that we can identify these skills and employ these skills, we can be catalysts of calm, catalysts of clarity, catalysts of consolation in this time of distress and anxiety.
Alex Smith 4:00
Danny, anything you'd add to that?
Keri Brenner 4:02
No, I mean, I think she really nailed that one. It's interesting because we know within palliative care that there's a lot of research that shows that our presence leads to significant improvements in quality of life and mood. And we also have a lot of research that shows that our involvement helps promote better, more adaptive coping within our patients.
Alex Smith 4:25
And
Keri Brenner 4:25
therapeutic presence is something that we think is one of the key features that leads to these beneficial outcomes in our work.
Alex Smith 4:32
Now, when I hear the term therapeutic presence, it seems ineffable. Like, what is this? I know when I'm working with trainees, some of them have a therapeutic presence. Some of them put on a show like they are trying to have a therapeutic presence, but it comes off as insincere, not genuine, you know, and patients often can sense it. And other times there are other folks I've worked with who just do not have a therapeutic presence. and it's like uh i don't know you know it's just and sometimes it has to do with the particular relationship they have with the patient because every you know dyadic relationship is different um so for some patients they may come across as therapeutic and some not could you say a little bit more about like what what are kind of the key ingredients of a therapeutic presence

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