This case of supervision was reported by Mr. Wang. She reported a case of crisis intervention. Help-seekers have been diagnosed in major hospitals, and doctors have prescribed drugs, but parents feel that the side effects of drugs are too great, and drugs are only taken intermittently. Visitors have committed suicide several times. Teacher Wang's doubt is that this visitor was diagnosed with depression. Is she our scope of work?
In response to this question, Mr. Kuang first asked everyone how they felt about this case: How would you feel if you received such a helper? Everyone spoke in succession: nervousness, anxiety, fear, distress, weakness and so on.
After understanding everyone's feelings, Ms. Kuang told us about some patients she met in the clinic who needed medication and psychotherapy. She coined the word "border". There should be a line between a counselor and a psychiatrist.
Teacher Kuang gave a simple example: her advice to many patients includes two parts, one is taking medicine, and the other is psychotherapy. However, after a period of time, patients stopped taking medicine because their psychotherapist said that the side effects of taking medicine were too great and bad for their health.
This is a question of boundaries. As a psychiatrist, prescribing drugs to patients has its own specialty. As a patient, it is very important to follow the doctor's advice. The best proof of following the doctor's advice is to take medicine according to the doctor's advice, but many psychologists don't know medical knowledge, but they break through the boundaries and give advice to patients at will, which is really a very bad thing for patients.
This kind of thing is by no means a case. Many patients who consulted me stopped taking drugs without authorization. Therefore, it is very important to know the patient's medical experience first. Many patients have unilaterally expanded the influence of side effects after reading the drug instructions. I always patiently introduce them to the importance of following doctor's advice, and encourage them to discuss their illness with psychiatrists in time, and then cooperate with psychotherapy. Because I am well aware of my responsibilities, the professional knowledge of psychiatrists is by no means comparable to ours. Respecting their professional knowledge means being responsible for patients.
Therefore, Mr. Kuang pointed out that as a psychological counselor, it is best to have the knowledge of psychiatry and the support of psychiatrists, which is beneficial to both counselors and patients.
Some teachers mentioned that they were shocked when they learned about the visitors' experiences. Teacher Kuang also put forward the word "boundary": the consultant must understand whether the collapse of the consultation process comes from himself or from the visitors.
If the collapse comes from oneself, then the counselor's own growth also needs attention. If the counselor collapses in the process of listening, it is obvious that the counselor has no ability to stay awake and lead the helper out of the quagmire. In this case, early referral is a sign of responsibility to visitors; If the collapse comes from the visitor, and the counselor feels the collapse of the visitor and can get out of it in time, then it is only the good opinion of the counselor, and the counselor can go on.
This reminds me of an example told by teacher Li Ming of Beijing Forestry University. During an earthquake crisis intervention, many psychologists came to the affected area for psychological assistance. Some counselors collapsed after seeing the disaster caused by the earthquake. They are holding the recipients and their emotions are difficult to control. It is no exaggeration to describe them as "crying". Finally, it turns out that the victim in turn comforted the counselor.
Now I find it ridiculous. Behind it, the psychological counselor's tolerance for major events far exceeds his imagination. If the counselor can't tell whether this collapse comes from his own tolerance or his love for the other party at this time, how can he help others?
Hearing this, I suddenly thought of a patient I recently received. The patient was diagnosed with depression and anxiety in psychiatric department, but taking medicine became a problem because of pregnancy. In the process of communicating with patients, I found that her depressive symptoms were very serious, which often made me feel overwhelmed. If I don't take medicine, it's difficult to solve it simply by psychological counseling. So I asked Mr. Kuang, who said that psychological counseling is a high-risk industry. In this case, the counselor must be clear about his responsibilities. Without the support of psychiatrists, it is best not to take such cases.
My heart suddenly became much clearer, and the feeling that I had struggled for many days vanished. It turned out that I only vaguely felt that this patient needed a referral, but I always made up my mind. Therefore, for the sake of patients, I also have to make a referral. It was Mr. Kuang's urging that gave me strength.
The feeling of "listening to you is better than studying for ten years"
Teacher Kuang's supervision information is too large to be recorded in one article. A simple "boundary" is enough to make me think a lot. Mr. Wang also raised many questions at the supervision meeting, and Mr. Kuang answered them one by one. Don't worry, I'll sort it out slowly and enjoy it with you.