Such a great topic and really useful advice. Something we don’t think about enough and is probably the most important aspect of treatment. I love the idea of aligning understanding of what’s wrong and goals/limitations with the patient as a starting place. Thank you!!!
I get happy whenever Dr. Fu brings up Lacan. Awesome episode. Have read in the past about Therapeutic Alliance improving adherence to treatment, but the concept has never been hashed out to me with the clarity, nuance, and expertise that you guys bring to the topic. You both sound like excellent mentors and am glad you found this Dr. West Coast, Dr. Fu, who's so gifted at being clear and succinct. This helps with my personal burnout and will be shared with everyone in my work circle. Please keep it up, thank you guys both!!
I really appreciate you covering patients inquiring about personal topics. As a former nurse working inpatient, this scenario came up quite often regarding political, religious, and questions about family/personal life. Sometimes I found that by opting out and saying "well, I think that's inappropriate to discuss. I can't share that information with you," would impact the alliance negatively. You gave some good examples of how to approach this, it's really difficult to toe the line between not agreeing or disagreeing, yet validating whatever that is seems important to them.
Thanks for the comment! Inpatient... involuntary... is alliance on impossible mode. In those situations it can feel like the goal is "minimizing damage" moreso than fostering a productive alliance.
My GP disclosed he and his wife both suffer from migraine. Given the total absurdity of migraine (I'll die on the hill that weather changes are triggers), it made me more enthusiastic and open in taking to him about treating mine. But I think I'd take a migraine over bringing up politics with any physician who's treating me ever.
Really appreciate the insight again. Definitely something I agree with and try to do. And some areas I can do a better job. Good conversation as always
Can you please discuss what you do in situations where a patient is better referred out to another therapeutic discipline (such as individual therapy, couples therapy, ECT, social work...) as you discussed, but there are financial barriers and progress is not made because they say they cannot afford it? Thank you for this excellent podcast, it helped me to clean my house while listening lol.
Yeah CSW here who has worked in inpatient psych units with psychiatrists, you guys suck a therapeutic alliance. A lot of psychiatrists think they can do therapy and they can't. It is not hard to build rapport with a client/patient, you guys just come off as cold an authoritative. I have therapeutic alliance with my clients first session.
Can i have your opinion on treatmnet of GAD and extreme. chest tightness from anxiety 24/7,extreme indecesiveness,im on pregabalin 150mg 2x daily and mirtazapine 30mg without any change
You probably won’t get any guidance on this because this is not a legal or ethical setting to discuss your treatment. Ask those same questions to your psychiatrists or find another if you are looking for a second opinion
@@PsychoFarm yeah tbh as a tw*tter user I see so much antipsych signaling that's obviously (sometimes explicitly) based in personal grievances there's probably something to the whole therapeutic alliance shtick. I don't think those cases are statistically significant, but when they go complain publicly, it might be counterproductive to the people who hear it.
Such a great topic and really useful advice. Something we don’t think about enough and is probably the most important aspect of treatment. I love the idea of aligning understanding of what’s wrong and goals/limitations with the patient as a starting place. Thank you!!!
Thanks!
I get happy whenever Dr. Fu brings up Lacan.
Awesome episode. Have read in the past about Therapeutic Alliance improving adherence to treatment, but the concept has never been hashed out to me with the clarity, nuance, and expertise that you guys bring to the topic.
You both sound like excellent mentors and am glad you found this Dr. West Coast, Dr. Fu, who's so gifted at being clear and succinct. This helps with my personal burnout and will be shared with everyone in my work circle.
Please keep it up, thank you guys both!!
I really appreciate you covering patients inquiring about personal topics. As a former nurse working inpatient, this scenario came up quite often regarding political, religious, and questions about family/personal life. Sometimes I found that by opting out and saying "well, I think that's inappropriate to discuss. I can't share that information with you," would impact the alliance negatively. You gave some good examples of how to approach this, it's really difficult to toe the line between not agreeing or disagreeing, yet validating whatever that is seems important to them.
Thanks for the comment! Inpatient... involuntary... is alliance on impossible mode. In those situations it can feel like the goal is "minimizing damage" moreso than fostering a productive alliance.
My GP disclosed he and his wife both suffer from migraine. Given the total absurdity of migraine (I'll die on the hill that weather changes are triggers), it made me more enthusiastic and open in taking to him about treating mine.
But I think I'd take a migraine over bringing up politics with any physician who's treating me ever.
Really appreciate the insight again. Definitely something I agree with and try to do. And some areas I can do a better job. Good conversation as always
i really love your content. the case studies/role plays are especially helpful. you put it all into words so succinctly . thanks!
Masterful advice on how to deftly refocus when put on the spot by a patient. Thank you both!
Thank you!
Thank you both! I'm in my first PMHNP clinical and all of your videos and pods have been so helpful! Keep up the great work!!!
Can you please discuss what you do in situations where a patient is better referred out to another therapeutic discipline (such as individual therapy, couples therapy, ECT, social work...) as you discussed, but there are financial barriers and progress is not made because they say they cannot afford it? Thank you for this excellent podcast, it helped me to clean my house while listening lol.
Very good job yall! Ty for what you do. Please do more of the role play stuff.
Thank you PsychMan! You sound like a psych super hero
10/10 bro-y - both of you.
Dr Malzberg is the kid of the duo, though.
Yeah CSW here who has worked in inpatient psych units with psychiatrists, you guys suck a therapeutic alliance. A lot of psychiatrists think they can do therapy and they can't. It is not hard to build rapport with a client/patient, you guys just come off as cold an authoritative. I have therapeutic alliance with my clients first session.
Can i have your opinion on treatmnet of GAD and extreme. chest tightness from anxiety 24/7,extreme indecesiveness,im on pregabalin 150mg 2x daily and mirtazapine 30mg without any change
You probably won’t get any guidance on this because this is not a legal or ethical setting to discuss your treatment. Ask those same questions to your psychiatrists or find another if you are looking for a second opinion
Not true. In psychotherapy, maybe. Most important topic in psychiatry is knowledge and critical thinking.
Well then this podcast is about knowledge and critical thinking about... the therapeutic alliance and frame! 😃
Good luck helping the patient with your knowledge and critical thinking when they're not on the same page as you...
@@PsychoFarm yeah tbh as a tw*tter user I see so much antipsych signaling that's obviously (sometimes explicitly) based in personal grievances there's probably something to the whole therapeutic alliance shtick.
I don't think those cases are statistically significant, but when they go complain publicly, it might be counterproductive to the people who hear it.