Abstract
The authors surveyed 38 psychiatry residents to determine the effect of end-of-residency transfer of care on psychopharmacology patients. Senior residents reported that 19% of patients worsened after notification about the upcoming transfer, 32% required medication changes, and up to 9% became noncompliant. Junior residents reported that, after transfer, 10% of patients worsened, 7% required medication changes, and up to 12% became non-compliant. Approximately 29% of patients considered the change of residents a major treatment disruption. The authors propose a system for minimizing deleterious effects and improving outcome in the transfer of psychopharmacology patients.
Similar content being viewed by others
References
Dewald PA: Reactions to the forced termination of therapy. Psychiatr Q 1965; 39: 102–126
Bostic JQ, Shadid LG, Blotcky MJ: Our time is up: forced terminations during psychotherapy training. Am J Psychother 1996; 50: 347–359
Mikkelsen EJ, Gutheil TG: Stages of forced termination: uses of the death metaphor. Psychiatr Q 1979; 51: 15–27
Parsons M: Imposed termination of psychotherapy and its relation to death and mourning. Br J Med Psychol 1982; 55: 35–40
Glenn ML: Separation anxiety: when the therapist leaves the patient. Am J Psychother 1971; 25: 437–446
Fielding B: Aspects affecting premature termination of psychotherapy at a training clinic. Am J Psychother 1972; 26: 268276
Schwarz IG: Forced termination of analysis revisited. International Review of Psychoanalysis 1974; 1: 283–290
Zahourek RP, Crawford CM: Forced termination of psychotherapy. Perspectives in Psychiatric Care 1978; 16: 193–199
Beatrice J: Premature termination: a therapist leaving. International Journal of Psychoanalytic Psychotherapy 1982–83; 9: 313–336
Smith S: Interrupted treatment and forced terminations. International Journal of Psychoanalytic Psychotherapy 198283; 9: 337–352
Martinez D: Pains and gains: a study of forced terminations. Journal of the American Psychoanalytic Association 1989; 37: 89–115
de Bosset F, Styrsky E: Termination in individual psychotherapy: a survey ofresidents’ experience. Can J Psychiatry (Rev Canadienne de Psychiatrie) 1986; 31: 636–642
Lenzer AS: Countertransference and the resident on leaving his patient. Journal of the Hillside Hospital 1955; 4: 148–150
Goldberg A: Narcissism and the readiness for psychotherapy termination. Arch Gen Psychiatry 1975; 32: 695–699
Weddington WW Jr, Cavenar JO Jr: Termination initiated by the therapist: a countertransference storm. Am J Psychiatry 1979; 136: 1302–1305
Otto MW: Statistical methods for clinical psychopharmacology trials, in Research Designs and Methods in Psychiatry. Edited by Fava M, Rosenbaum J. Amsterdam, The Netherlands, Elsevier Science, 1992, pp 247–266
Keith C: Multiple transfers of psychotherapy patients. Arch Gen Psychiatry 1966; 14: 185–189
Reider N: A type of transference to institutions. Bull Menninger Clin 1959; 17: 58–63
Pumpian-Mindlin E: Comments on techniques of termination and transfer in a clinic setting. Am J Psychother 1958; 12: 455–464
Becker TC: The difference between termination in psychotherapy and psychoanalysis. J Am Psychoanal Assoc 1993; 41: 765–773
Author information
Authors and Affiliations
Corresponding author
Additional information
The authors thank Michael Otto, Ph.D., for his assistance with statistical procedures.
Rights and permissions
About this article
Cite this article
Mischoulon, D., Rosenbaum, J.F. & Messner, E. Transfer to a New Psychopharmacologist. Acad Psychiatry 24, 156–163 (2000). https://doi.org/10.1176/appi.ap.24.3.156
Published:
Issue Date:
DOI: https://doi.org/10.1176/appi.ap.24.3.156