[nottrustin]

First of all what I am about to type about has nothing to do with MY T. It is something I encountered yesterday and thought it was really strange.

I work on a psych unit and we will be discharging a patient (I'll call her Beth). Yesterday Beth called a friend (Kim)and arranged for transportation. Everything seemed fine. A couple of hours later Kim's therapist called my work. Kim was in an appointment with her T. Kim has been pretty much Beth's only support system for months and she has watched as her depression has gotten progressively worse with lots of crying and being very dependency on Kim Kim has felt overwhelmed lately and thought Beth probably hadn't been hospitalized long enough. Kim didn't want to be apart of discharge if the doctors didn't feel Beth was ready for discharge. She thought Beth might be pushing for discharge but wasn't ready. Of course because of hippa I couldn't give any information until I got a release to talk to Kim (I had consent to acknowledge to anybody she was there). I told the T that I would see about getting a release I would call Kim back.

According to the T this relationship is something she has been working with Kim on and Kim was uncomfortable with the situation. So here is my question, is it appropriate for T to have been calling me?? I can't imagine my T doing it.

I knew Kim was there in the room with her and I gave no information about Beth...I did get a release to talk to Kim a few minutes after the conversation.

[unaluna]

Its dr to dr, more or less. Kims dr is letting beths dr know that maybe beth is lying about her support system? Seems to me it has more weight than a call from kim. Is beth bullying kim? Is kim trying to end the relationship and beth becomes sui? I have been a gutless kim myself, where i allowed myself to be used. I would say kudos to kim for being honest and trying to do the right thing and getting help.

[winter4me]

I think it was OK for the therapist to call you (a little iffy---depends on your position at work---if you are Beth's t. for instance...could be fine...) and you responded appropriately. If you are not her t./pdoc; you may want to discuss this with a supervisor before moving forward.
My thought though would be that Kim's t. should be working with Kim on her telling Beth how she is feeling vs trying to find out if the discharge can be postponed ---
Kim needs to talk to Beth. That is my foremost thought. Beth needs to know what she has and does not have for a support network; and she needs to know the truth in order to be successful on discharge.

[stopdog]

Someone can always ask or give info - they just can't always get it. Therapists are no more less likely to ask for something even though they might not get it than anyone else. And I would guess this therapist has had success in doing so before. As an attorney who works with alleged incapacitated persons, I have found those who are in the mental health field (and I use that phrase loosely) often think rules are for everyone else.

[nottrustin]

I am a secretary so before answering I spoke to her Dr. and Social worker on the unit. I also got the release for to speak to Kim. I then called Kim and explained that yes the patient was ready for discharge. Discharge plans were initiated by the treatment team no the patient. Beth called after that. Kim said that absolutely she would pick the Beth if that is the case. She asked what she should do after that. I told her do what she feels best with. If she wants to be Beth's friend and support system then she should do so. However, she also needs to take care of herself and only do what she feels comfortable with.

I think what was going on is often we get patients demand discharge and while we don't think they are ready for discharge we also don't have grounds to commit them involuntary. So we may discharge them against medical advice. I think Kim was afraid this was the case and didn't want to make it easier for Beth to leave by providing her a ride.

With my T though, I imagine she would give me advice on how to handle the situation but leave it up to me...she make phone calls for me especially during a session.

[nottrustin]

Originally Posted by stopdog

Someone can always ask or give info - they just can't always get it. Therapists are no more less likely to ask for something even though they might not get it than anyone else. And I would guess this therapist has had success in doing so before. As an attorney who works with alleged incapacitated persons, I have found those who are in the mental health field (and I use that phrase loosely) often think rules are for everyone else.

I find that to be true in MANY fields...see it all the time with Medical doctors

[unaluna]

I will ask my t to call for me; his just saying he will do it is often enough to give me the courage to do it myself.

[Victoria'smom]

I have given my T permission to call people on my behalf.