ABSTRACT
Frequently, in consultations, primary care clinicians find themselves sitting with more than one potential patient. We have already described how it is possible to do couple and family work by invoking the virtual presence of other family members by way of questioning and pondering with the family member who is present. There may be times when you welcome having someone else in the room, who, although apparently just coming ‘for support’, may help to ‘shift’ or change the consultation. You may just be fascinated to discover that two people you have seen independently are in fact related or you may find yourself intrigued that the person you have been consulting with for years actually has a partner! You ask yourself: ‘How did he fade out of the conversations I have had with her all this time?’ On the other hand, what do you do if a female patient insists on bringing her husband? What if an adult patient turns up with his mother? What if a couple decide, without any warning, to come together, so that you can deal with their marital problems? Or perhaps you decide that the only way forward is to invite both partners along? Then who is your patient? How do you start? How do you manage confidentiality issues? How do you set about working with a couple? It may feel that having more than one person in the room is the last thing you want.
