ABSTRACT
Patients seek psychotherapy for relief of symptoms and resolution of problems in living. Yet, they sometimes balk at the prospect of having to choose a topic without being prompted by therapist questions. This paper suggests that this apparently self-sabotaging behavior represents an acting out of a fundamental existential dilemma for many individuals, i.e., to be or not to be an adult. Adulthood comes with the heavy burden of responsibility for making life choices, and the possibility of making the wrong choices. The psychotherapeutic situation, with its demand that the patient choose a topic, is a microcosm of the adult-adult relationship. The author proposes that the proper treatment for these patients is Generative Caring Psychotherapy, which promotes emotional growth and facilitates patients' transition from childhood dependence to adult responsibility.
Subject(s)
Defense Mechanisms , Individuation , Personality Development , Psychotherapy , Adult , Choice Behavior , Female , Humans , Male , Motivation , Psychoanalytic TherapySubject(s)
Commitment of Mentally Ill , Mental Disorders/drug therapy , Mentally Ill Persons , Personal Autonomy , Treatment Refusal/psychology , Adaptation, Psychological , Antipsychotic Agents/therapeutic use , Empirical Research , Forensic Psychiatry/legislation & jurisprudence , Humans , Judicial Role , Mental Disorders/psychology , Patient Advocacy , Treatment Refusal/legislation & jurisprudence , VirginiaABSTRACT
In 1978, the authors, a psychiatrist and a lawyer, began a course in law and ethics for postgraduate year A psychiatry residents that continues today. The authors review the course in terms of its evolution, effect on residents and faculty during the course, evaluation by residents immediately after the course and since graduation, and future prospects of such a course being started at other institutions.
ABSTRACT
This article describes the process and results of the deliberations of the group of authors at the 1989 spring meeting of the Northeast Group for Educational Affairs. The participants worked under the premise that someone had given an unlimited amount of money to fund a new medical school. They had to select and define what the educational goals would be and produce a plan to help students reach these goals. There had to be an evaluation process that documented progress toward the stated goals. This paper describes the ethics and human values curriculum, which should be of interest to cancer educators. The knowledge, skills, values, and attitudes are defined and the four-year process of implementing the teaching is described. This curriculum-planning process is applicable to any aspect of cancer education--first defining the outcome, then the evaluation process, and finally, how to get to that outcome.
Subject(s)
Curriculum , Ethics, Medical , Program Development/methods , Schools, Medical/organization & administration , Education, Medical, Undergraduate/organization & administration , Humans , Interdisciplinary Communication , Organizational Objectives , Planning Techniques , Social ValuesSubject(s)
Carbamazepine/therapeutic use , Hallucinations/drug therapy , Adult , Female , Hallucinations/psychology , HumansABSTRACT
Decisions and interventions made in the course of psychiatric practice often have important ethical dimensions. Issues such as confidentiality, freedom of information, the duty to warn, double agentry, the patient's rights to treatment, and to refuse treatment are often identified in the context of inpatient psychiatry. In the practice of ambulatory psychiatry these issues are more easily ignored and therefore less frequently considered. The authors present six cases seen in an outpatient clinic of a community mental health program which illustrate ethical dilemmas in the six areas listed above. Questions raised by the cases and the clinic's interventions are discussed. Consequences for the patients and the clinic of the ethical decisions made in these are explored.
Subject(s)
Ethics, Medical , Psychiatry , Adult , Aged , Child , Confidentiality , Dangerous Behavior , Family Therapy , Female , Humans , Male , Medical Records , Mental Disorders/therapy , Middle AgedSubject(s)
Mentally Ill Persons , Patient Advocacy/legislation & jurisprudence , Patient Compliance , Adult , Electroconvulsive Therapy , Female , Government Regulation , Humans , Inpatients/psychology , Length of Stay , Male , Middle Aged , Patient Rights , Psychotropic Drugs/adverse effects , Risk Assessment , Supreme Court Decisions , United StatesABSTRACT
Individual supervision is a crucial element in the education of the psychiatric resident. Although the supervisory relationship is fully as complex as that between a patient and therapist, it is less frequently studied and far less well understood. After participating in a supervisory relationship for two years, the authors became aware of two important aspects of their relationship which were seriously interfering with the work of supervision. One was the fact of the dual role of the supervisor as teacher and evaluator. The second was the failure to deal openly with emotional issues between them. The authors' separate recollections of the experience are used to explicate the nature, opportunities and pitfalls of therapy supervision. Three levels of learning which occur in therapy supervision are examined. Particular attention is paid to the most neglected aspect of therapy supervision, namely ongoing examination of the emotional vicissitudes of the supervisory situation.