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Patients' Reactions to Therapist Rotations
Neal DeChillo; Barbara Urquhart; Annette Leavy; Sarah Andrews; Allen Frances
Psychiatric Services 1988; doi:
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Payne Whitney Clinic of the New York Hospital-Cornell Univensity Medical Center

American Psychiatric Association

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Findings reveal that although most patients do not look forward to the resident rotations, the majority adjust with minimal complications. There is, however, a subgroup who experience distress. For these patients, the general agreement between their reports of adjustment difficulties and therapists' ratings of compbications indicates that patients do not exaggerate their difficulties in adjustment after the rotation.The increased rate of hospitalization during the three months after the notation for patients not participating in the study and the suicide of a nonparticipating patient suggest that a predictor of patient distress is an unwillingness to talk about the transfer, as evidenced by refusal to participate in the study. Although the study did not identify other predictors of patient distress, this back of communication should alert us to the potential problems in all patients. We should not expect patients at risk to be skillful in telling us they are experiencing difficulties as a result of the rotation. It is necessary for therapists to be especially careful during the period surrounding rotations even if patients exhibit no immediate warning signs.However, it is also necessary to avoid being overly pessimistic about the effect of changing therapists. Although patients may be apprehensive about therapist rotations, we can assure patients that most will have little difficulty with the change and, within a short period of time, will feel satisfied with their new therapy and therapist.

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