Psychiatric social worker and patient relationship

psychiatric social worker and patient relationship

The PSYCHIATRIC SOCIAL WORKER provides individual, family, and group social work other social work treatment interventions to psychiatric hospital patients and Skill in developing and maintaining a therapeutic relationship with . Department of Psychiatric Social Work, NIMHANS, Bangalore Mental health and legal services have a reciprocal relationship. In the legal aid services at the hospital, patients from the discipline of psychiatry, neurology. of social science psychiatric social work is. It was not until field, who impinge on the patient and his problems, the Relationship of P.S.W. and Medical Officer .

Social workers who are employed at psychiatric hospitals also do psychosocial assessments and provide therapy. They are in frequent contact with the family members of patients.

They meet with other members of the mental health team psychiatrists, nurse practitioners etc. If the patient is involved in any legal procedures, the social worker may have a role in information gathering.

Doctor-Patient Relationship in Psychiatry

Psychiatric social workers may also be employed in outpatient centers, working with juveniles and adults. They perform psychotherapy and assessments, educate the patient and his or her family, and make referrals as necessary. Mental health therapies include more than just talk. Social workers may, for example, employ Eye Movement Desensitization and Reprocessing with young trauma survivors.

Clients may include those with schizophrenia and those with complex sets of co-occurring conditions. Governmental agencies and residential care facilities are among the other employment options for psychiatric social workers.

Some eventually go into private practice as psychotherapists. Those interested in this career should enroll in social work programs accredited by the Council on Social Work Education. Ideally, they will select programs with a clinical focus and a clinical fieldwork experience — the state may or may not make clinical focus a formal requirement for the highest level of licensing.

Learn more about this program. Fordham University's top-ranked School of Social Work offers an online MSW program that prepares students for relevant, integrated practice with all populations. GRE scores not required.

psychiatric social worker and patient relationship

The MSW program helps prepare students to enter the general or clinical practice role in most states. In a case where you already have social intimacy with a patient, it is preferable to refer this patient to another psychiatrist. Certain reportable conditions Patient expressing suicidal or homicidal intentions: Consents Informed consent is both an ethical and legal issue.

It consists of the following components: The patient and relatives must be given reasonable information about the sickness and possible modes of treatment in the language they understand. Common side effects of any drugs need to be told.

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Consent for any procedure or treatment is necessary. Either implied consent, oral consent or written consent, as the case may be. In case of procedures like electroconvulsive therapy in psychiatry, there is the need to have details in the language understood by the patient and his relatives. This is the capacity to weigh, reason and make reasonable decisions based thereon.

If a patient is incompetent, appropriate health care proxy, e. For practical reasons, when a patient is not competent, relative's consent for the treatment should be considered sufficient.

However, when legal hassles are anticipated, e. Malpractice and liabilities Misdiagnosis: It is not expected that a psychiatrist should diagnose by the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases system.

But he must use his average skills in coming to conclusions. Legal issues arise when an organic condition in missed, and suicidal or homicidal risks are not properly evaluated. This includes under-treatment, over-treatment, wrong treatment, treatment without informed consent, involuntary treatment, side effects of treatment. When prolonged hospitalisation is necessary, the patient and relatives should be properly explained.

If necessary, a second opinion should be sought even in case of voluntary admissions. Definite guidelines exist in the case of involuntary admissions and must be followed. Improper relationship with the patient. Sexual relationship with a patient, exploiting a patient, social and economic deals with patient are not acceptable. As written earlier, even social intimacy with patient is not desirable.

Any sexual or physical intimacy is considered malpractice. There remain certain grey areas: Who bears responsibilities for mistakes done by subordinates? What is a psychiatrist's legal standing in a joint consultation? Liability prevention Liability prevention consists of the following: Needless to say, the greater the competence, the lesser the need for liability prevention.

Updating on knowledge and skills and judicious use of therapy is mandatory. Case histories and case records are a must. Even as case papers may be given to the patient, a record of the same in the office is a wise practice. Knowledge of legal and ethical issues: Adequate knowledge of legal and ethical issues to anticipate and abort potential liability action is necessary for a clinician, much as he cares for and is dedicated to patient welfare.

Also, remember the Bolam principle which states that management of a patient should be in accordance with a practice accepted at the time as proper by two different responsible groups of medical opinion of the same speciality.

Role of Social Worker in Psychiatry Setting

Consultation second opinion in difficult and complex cases: It is always wise to seek a second opinion or senior's opinion in difficult and complex cases. This does not undermine one's authority, rather it adds a necessary alternative opinion and outlook which may help patient welfare, and also protect the doctor against potential liability threats.

This had been discussed earlier. This is the refrain of this whole paper. Better the relationship, lesser the chance of liability hassles. In spite of doing the best of everything, Medical Indemnity insurance must be taken; for, sometimes, the best of intentions, procedures and therapies may not guarantee immunity from potential legal difficulties. Commercial aspects Professional fees: In private practice, a doctor has the right to charge his appropriate fees. He should reveal his fees to the patient at the first interview if asked about it.

If not, charging appropriate fees depends upon time, area of practice, seniority, etc. If the patient refuses, or is unable to pay, politely guide him regarding other avenues for treatment; or, if felt appropriate, give due consideration to his limitations by lowering the fees.

psychiatric social worker and patient relationship

Withholding prescription and advice because patient cannot pay is generally not done at the first interview. This helps them determine further involvement with therapy. Problems are faced by a doctor when a patient, even after due explanation, does not pay or underpays for professional services, hospitalisation, medicines and other expenses.

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Certain precautionary measures here are involving relatives, referring agencies, referring doctor and taking an adequate deposit. Sharing profits with referring agencies, money spent for public relations, direct or indirect advertisements, obliging referring agencies in cash or kind, are all issues in which there are straight and clear-cut ethical guidelines which prohibit them. However, in reality, there exists a lot of confusion about and connivance of these guidelines.

Conclusions [ Figure 1: Flowchart of the Paper].