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to gardengirl-- the perspective of a T

Posted by CareBear04 on February 3, 2005, at 14:09:34

hi gardengirl,
i've read a lot of your posts and have enjoyed hearing you talk from the perspective of a T in training. there are certain things i wouldn't feel comfortable asking my Ts, so i was wondering what your thoughts are.

1) when you stop seeing patients, especially because their insurance coverage runs out as opposed to termination or recovery, do you want to be updated as to their condition? i've read posts about Ts cutting all ties with former patients, and it seems irresponsible and scary to me. none of my pdocs (who have been my Ts) have done this. when i saw a pdoc at school, i ran out of sessions and was referred out to a private practice. then i took medical leave. with this person, i was in frequent email contact, and he seemed genuinely interested in my condition and would make suggestions and advocate for me on the school end. when i left my pdoc at home, whom i had seen for about four months, she referred me to a colleague near my school. she gave me a present when i left and would often call, especially in the beginning, to see how i was doing and because she was curious about what i was up to. when i left the new pdoc in late august, he also gave me a present and sent me back to the person at home. when i was doing very poorly in the fall, i called him, and we talked a few times. he suggested the hospital and helped me set priorities for which problems were the most urgent. i sent him a holiday card, and he wrote me back a really nice letter affirming that he believed in me and believed that i would find success wherever my heart leads me. with all these pdocs, i've never been emotionally attached. i never called the two men pdocs and only called the woman to leave messages if she asked me for an update, if i needed a script, or in mostly medical emergencies. is keeping in contact after termination dependent on how attached the patient is to the T? when you end with a patient, do you want to cut all ties, do you want to keep in contact but feel like you shouldn't, or do you make yourself available by email or phone? i'm just wondering what the typical protocol is and whether it differs between Ts of different generations and training. this is what i'm most curious about.

2) i have gotten the impression that you work at a university with college students. do you enjoy working with young patients more, or do you enjoy other age groups more, or are you impartial among age groups? are the problems of young adults much different from middle aged or older patients? my pdocs in private practice mostly fill their appointment books with middle aged professionals, mostly doctors and lawyers who come for analysis. the pdoc at school liked young people the best; i guess that's why he was at university counseling. in the hospital, though, it really bothered me that they preferred submissive and dependent elderly people whose quality and quantity of life was quickly detiorating. they didn't like me or want me on the unit because i'm young and ask too many questions and am very independent. it just seems to me that it is a worthwhile investment to meet a person where they're at instead of breaking them down first, and to try to help the young person back on her feet, to help her be able to live a long and fulfilling life. maybe this is a difference between inpatient and outpatient care? i've never had anything but damaging hospital stays, but i've had good outpatient Ts who have thrown the DSM out the door and have leveled with me and respected me. that's really important to me. i know that geriatrics and geriatric psychiatry are very important fields, especially as the population grows older. still, maybe because i've never been around grandparents or older people, i can't imagine people wanting to specialize in working with them. it seems to me like the problems are more dealing with helping the people resign themselves to retirement and less busyness and to come to terms with death. my impression is that geriatrics is more geared towards death, while child and adolescent or young adult care is about life. what is your impression and your preferences?

sorry for the long-windedness. if you've made it to the end of this post, i'm very impressed. i think you're so insightful and really appreciate your experience and thoughtfulness in your posts. if you can address these questions at all, i'd really appreciate it. and anyone else, feel free to jump in!!! thanks so much!!!




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poster:CareBear04 thread:452491