Quote:
Originally Posted by JaneTennison1
Poor writing and word choice aside, after 8 sessions the client was angry to the point of violence and overtly suicidal. There are T's that don't know what to do with this and will need to refer out rather than make a possibly fatal mistake. I see nothing wrong with referring if one is out of their depth. It's the refusal to discuss this that can end up causing pain.
I would rather any healthcare professional tell me they don't know than waste my time and money trying to figure it out. I don't like when a T claims to know what is best for someone, it's patronising and demeaning but I also think they can know that they are not what's best.
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I think referring out can (and probably will) cause pain despite a willingness to discuss the issue, but I agree that the willingness is essential. I remember very early on in my own therapy, when I was not super stable, my T talking about referring me out to a bona fide MD Psychiatrist and God knows who else. It was incredibly frightening, and, yes, I felt rejected and worthless. But the fact that this was a discussion--that it was open to debate, that my viewpoint was listened to and his gently and transparently explained--made a big difference.
As for whether a T (or anybody else, really) knows best...This is a sticky, ambivalent issue for me, too. Because, yes, it IS patronizing and paternalistic and all the rest. And I certainly don't think it's true that most (or even many) T's know what's best for most (or even many) clients....But, you know, is it so odious to say that maybe sometimes they do?
Humiliating as it is to admit, there have definitely been times in my life when other people DID know better than I did, and I am, retrospectively, enormously grateful that they stepped in to make decisions for me.