This week the MSPP group spent their mornings shadowing Costa Rican clinicians. Half of the students were at the Hospital Calderón Guardia and the other half were at the Clínica UNIBE. We were at the UNIBE Neuropsychological Clinic where we had the opportunity to observe both testing and psychotherapy being conducted in Spanish. We spent the first two days observing the intake and initial testing sessions of three children who are being tested for learning problems. Two were young children who are living in a shelter for foster children and one was a teenage boy who has been struggling in school. We were able to observe both the Bender Visual-Motor Gestalt Test II and the WISC-IV being administered and a few students participated in administering some of the subtests. For each of these sessions, three MSPP students sat in the room with the clinician while the rest observed from behind a two way mirror. Working with and observing these clients gave us the opportunity to begin learning how these assessments are run in Spanish, and also allowed us to learn about systemic issues in Costa Rica, such as the foster care system, Costa Rican adoptions, and how medication is prescribed for children.
On Thursday we had the opportunity to observe a clinician conducting two initial 90-minute therapy sessions. One of these clients was a woman who suffers from severe necrophobia and the other was a woman who has been suffering from insomnia for twelve years. We were able to learn about the intake process and even began learning about some possible interventions for these disorders. In our clinical supervision class, we discussed some of the cultural differences that are important to keep in mind when working with these clients. We discussed how here hugs between clients and clinicians are normal and informed consent is not given right away, as it would seem too formal and somewhat rude to start a session off in such a structured and direct manner. We also discussed some of the religious rituals and beliefs, such as the belief in espíritus, that are common in Costa Rican culture and may be important to understand in working with the necrophobic client. It has been extremely interesting and eye-opening to see some of the culture differences in how clinicians approach cases and interact with clients here as compared to the U.S.