Navigating Trust Issues in Psychiatric Therapy: Key Questions Answered

excuse me?

Hello Dr.
Chang, I have been diagnosed with mild depression and have been having regular consultations with my physician.
However, I feel that I tend to become anxious or hostile when expressing emotions towards others, which makes it difficult for me to adapt during our discussions.
I can't distinguish whether the issue lies with me or the doctor.
Since I have a sense of distrust towards others, should I clearly communicate this concern to my physician? Additionally, how long should I have consultations before I can objectively assess whether this doctor is suitable for me? If I find it difficult to continue, will the doctor refer me to another physician? Lastly, what qualifications are required to become an attending physician, and is the head of psychiatry considered to be more skilled than an attending physician?

Zhizhi, 20~29 year old female. Ask Date: 2004/05/02

Dr. Zhang Xuncheng reply Psychiatry

Dear Zhizhi,
Dr.
Zhang Xun-Cheng from the Psychiatry Department of Tainan Hospital replies: There are various purposes and formats for consultations between psychiatrists and patients.
Typically, at the beginning of psychotherapy, treatment goals and duration are clearly discussed.
The initial sessions are a crucial period for establishing a trusting relationship between the doctor and the patient.
Trust between individuals is inherently difficult to build, yet it profoundly impacts treatment outcomes.
This is an important issue, and I suggest you have a thorough discussion about this with your therapist before proceeding with other treatments.
If the doctor assesses that they are not suitable to treat you, they will usually refer you to another physician.
Each hospital has its own evaluation standards.
However, to become a primary physician, one generally must pass the board certification exam from the psychiatric association.
Typically, department heads are senior and experienced attending physicians.
Whether they are considered more competent depends on the evaluations of the patients.
Wishing you a speedy recovery! Tainan Hospital wishes you good health and all the best.

Reply Date: 2004/05/02

More Info

Navigating trust issues in psychiatric therapy can be a complex and challenging experience, especially when dealing with conditions like mild depression. It's commendable that you are actively seeking help and engaging in therapy. Here are some insights and recommendations based on your concerns.

Trust Issues in Therapy
1. Understanding Your Feelings: It's not uncommon to feel apprehensive or even hostile towards others, especially in a therapeutic setting. These feelings can stem from past experiences, personal insecurities, or the nature of your mental health condition. Acknowledging these feelings is the first step toward addressing them.
2. Communicating with Your Therapist: It is crucial to communicate your feelings of distrust or discomfort with your therapist. A good therapist will appreciate your honesty and will work with you to create a safe space where you can express your concerns. This dialogue can help clarify whether your feelings are rooted in your own experiences or if there are aspects of the therapeutic relationship that need to be addressed.

3. Evaluating the Therapeutic Relationship: It typically takes several sessions to gauge whether a therapist is a good fit for you. Many professionals suggest a minimum of three to five sessions before making a decision. During this time, pay attention to how comfortable you feel sharing your thoughts and feelings. If you find that you are consistently feeling uneasy or misunderstood, it may be worth discussing this with your therapist or considering a referral to another professional.

4. Referral Process: If you decide that the therapeutic relationship is not working, most therapists will understand and can provide a referral to another professional. It's part of their job to ensure that you receive the best care possible, even if that means transitioning to another therapist.

Qualifications of Psychiatrists
1. Becoming a Psychiatrist: To become a psychiatrist, one must complete a medical degree followed by a residency in psychiatry, which typically lasts four years. After residency, some psychiatrists choose to pursue further specialization through fellowships in areas such as child psychiatry, geriatric psychiatry, or addiction psychiatry.

2. Differences Between Attending Physicians and Department Heads: A department head or director of psychiatry often has additional responsibilities, including administrative duties, leadership roles, and oversight of clinical practices within the department. While both positions require extensive training and expertise, department heads may have more experience and a broader scope of responsibilities, which can enhance their authority and influence within the hospital or clinic.

Moving Forward
- Self-Reflection: Take some time to reflect on your feelings and experiences in therapy. Journaling can be a helpful tool for processing your thoughts and emotions.

- Support Systems: Consider reaching out to trusted friends or family members who can provide support during this time. Sometimes, discussing your experiences with someone outside of therapy can offer new perspectives.

- Patience with the Process: Healing and building trust take time. Be patient with yourself and the process. It's okay to feel uncertain, and seeking help is a courageous step.

In conclusion, navigating trust issues in psychiatric therapy is a common challenge, but it is essential to address these feelings openly with your therapist. By fostering open communication, evaluating the therapeutic relationship, and understanding the qualifications of mental health professionals, you can take proactive steps toward finding the right support for your mental health journey. Remember that your feelings are valid, and seeking help is a sign of strength.

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