Management of Chronic Dependency in Out‐patient Clinics by a Comprehensive Medical‐psychiatry Service

Garner, H.H.; Simon, Abraham J.; Handelman, Milton S.

doi:10.1111/j.1532-5415.1958.tb00763.x

Cited by 6 publications

(3 citation statements)

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“…In managing both the discharged and not-yetadmitted elderly patients, the use of outpatient or ambulatory clinics has become recognized as an important element in the supportive maintenance of their mental health. Through these clinic services, older patients often may achieve such marked improvement that many can avoid protracted new hospitalization or rehospitalizations (72)(73)(74). Day hospital programs which provide mixed medical and psychiatric supervision also report maintenance of favorable results, especially when they are combined with home visits and family conferences with therapists and social workers (75).…”

Section: Trends In Management Of Aged Patientsmentioning

confidence: 99%

Opinions about Geriatric Patients in Public Mental Hospitals: Administrators of 269 Public Mental Hospitals and 53 Officials of State or Territorial Mental Hygiene Agencies Were Surveyed to Ascertain Their Opinions about the Potential for Rehabilitation of Older Patients

Hefferin¹,

Wilner²

1971

HSMHA Health Reports

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Section: Trends In Management Of Aged Patientsmentioning

confidence: 99%

Opinions about Geriatric Patients in Public Mental Hospitals: Administrators of 269 Public Mental Hospitals and 53 Officials of State or Territorial Mental Hygiene Agencies Were Surveyed to Ascertain Their Opinions about the Potential for Rehabilitation of Older Patients

Hefferin¹,

Wilner²

1971

HSMHA Health Reports

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“…Recurrent symptoms may be mistaken for an exacerbation of the original difficulty which brought the patient to the physician; actually they may be attempts to extract more sympathy and pity from the doctor and the family. Dependent feelings, the need for a protective supportive person, and an erotization of the feelings for the doctor create the atmosphere for a prolongation of treatment beyond what is necessary for “recovery.” In several studies dealing with chronicity of illness in medical clinics (54, 55) the author has emphasized the great influence of dependency needs in altering symptoms and complaints, and thus the diagnosis, treatment, and length of treatment. Countertransference, and attitudes of hostility created by equating the patient to disliked significant figures in the physician's past may lead to an undue abbreviation of the treatment relationship.…”

Section: Relation Of Symptoms To Treatmentmentioning

confidence: 99%

Treatment—review of a Medical Concept

Garner

1961

J American Geriatrics Society

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When Oliver Wendell Holmes (1) wrote, "It, is a physician's privilege to cure seldom, t,o relieve often, and to comfort, always," he was unaware of the t,remendous advances which were about to be made in medical treatment. Today we can aptly paraphrase his statement t,o read: It is t,he physician's privilege to cure often, to relieve almost always, and to comfort always. However, t'he inclination to focus our therapeutic sights on the goal of cure has tended to obscure the fact t,hat t,o give a helping hand and to comfort always are ideals of which tJhe practicing physician can well be proud. In this communication, we present a variety of concepts of treatment, rather than specific processes and procedures. The dynamic significance of certain treatment concepts is likewise explored. Holmes' words serve well as a background for this approach.Contemporary ideas of treatment are by no means completely separated from modes of thought that seem more appropriate for primit,ive or pre-literate societies. The early development of medicine even in civilized communities centered around a priest-doctor. The union in one person of the powers to communicate with the supernatural and to heal was somewhat disrupted by the developments in pathology, chemistry, bacteriology and ot,her scientific achievements. Thus as treatment concepts required more and more appreciation of the biologic and physical sciences, tJhere was a corresponding lessening in the significance of the priest, element in t,he priest-doct'or role. Many of the current development,s in medical philosophy or orientation, centering around such ideas as the comprehensive, ho1ist)ic or t,ot>al-person approach to therapy, are attempts to find a solution for vast numbers of medical problems that are difficult to relate to chemical, structural or physiologic dysfunction. This has led t,o various special branchirigs from t'he mainstream of medical practice, which is "organic" in its focus. Although pyschiatric disorders associated with struct>ural changes have been influenced in general by the concepts of treat,ment, characteristic of medical practice, the so-called functional psychoses and the neuroses have, in addition, been considered from viewpoints which involve varying degrees of philosophic, theologic and psycho-social frames of reference. The priestly content of the priest-doctor role is more in evidence in such treatment concepts as those developed by psychoanalysis, the various psychotherapeutic schools, or existentialism. The doctor who is almost completely devoid of priestly content is personified in the physician who deals with infect,ion and structural changes. In correcting the biochemical malfunctions of the organism he feels that t~he intricacies of the doctor-patient, relationship are not imporhnt for treat,ment aside from the cultivation of a "bedside manner." The physician who does not recognize the problems of the total person may limit treatment to such a narrow * Professor and Chairman, Department of Psychiatry and Neurology. 883 HARRY H. GARNER Vo...

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“…The majority of the reported counseling and therapy with the aged has come from a psychiatric or social casework background (Garner, Simon, & Hundelman, 1958;Goldfarb & Sheps, 1956;Kent, 1956;Krai, 1958;Lokshin, 1955;Wolff, 1957). A large number of these studies have been accomplished in hospital or institutional settings.…”

Section: Counseling the Aged Individualmentioning

confidence: 99%

The psychologist works with the aged individual.

Hunter¹

1960

Journal of Counseling Psychology

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Management of Chronic Dependency in Out‐patient Clinics by a Comprehensive Medical‐psychiatry Service

Cited by 6 publications

References 0 publications

Opinions about Geriatric Patients in Public Mental Hospitals: Administrators of 269 Public Mental Hospitals and 53 Officials of State or Territorial Mental Hygiene Agencies Were Surveyed to Ascertain Their Opinions about the Potential for Rehabilitation of Older Patients

Opinions about Geriatric Patients in Public Mental Hospitals: Administrators of 269 Public Mental Hospitals and 53 Officials of State or Territorial Mental Hygiene Agencies Were Surveyed to Ascertain Their Opinions about the Potential for Rehabilitation of Older Patients

Treatment—review of a Medical Concept

The psychologist works with the aged individual.

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