The Supervision team determined that Intern Jose should terminate with Kirk who is one of his assigned clients. Kirk was just released from the Psych Ward. He admitted himself into the Psych Ward after having a psychotic episode that he felt he could not control despite taking medication. While in the Psych Ward he was given a complete physical and received a new diagnosis for his mental health condition. Kirk told Jose that the Psychologist told him that his mental health condition is anxiety based and that his psychosis develops through the anxiety that he experiences. Kirk did not go into specifics about the type of anxiety that he experiences; he only generalized his psychotic delusion that racists and white supremacists are out to get him because of his decision to become a Jewish-Christian.
Also Kirk explained that some physical ailments were discovered. It was discovered that he has a high glucose index; however, he does not have diabetes. In addition to the high glucose he also has high blood pressure. During the stay in the Psych Ward the high blood pressure and glucose levels were brought under control, and his medication for his mental health condition was adjusted. Kirk is on a high dosage of medication and when he speaks his words it sounds as if they are slurring and sometimes he drools while speaking. Before Kirk admitted himself into the Psych ward the dosage of medication made his words slur but there was no drooling.
The supervision team felt that the outpatient organization cannot provide Kirk with the level of care that he needs. The Supervision team recommended that Jose terminate with the Kirk because the team is worried and does not know what will happen if Jose is in a session with Kirk on a day that he either did not take the medication or forgot to take the medication. The Supervision team said that they would help Jose find Kirk another organization that would be more suitable.
Jose delivered Kirk the news that he won’t be working with him anymore. Jose explained that the decision to terminate with him was made by the organization’s supervision team. Kirk was not happy with the decision. He stated that the organization’s assessment process was incompetent and he went on to say that that the organization isn’t equipped to handle someone like him (Supervision team already determined that) and that the determination should have been made after the intake was conducted and not during therapy. Kirk also expressed that he is going to sue the organization and that just because he has a mental health problem it doesn’t mean that he is stupid.
Before Kirk left the office he stated that everyone who he has developed a relationship with him end up rejecting him. He went on to say the names of some people in his life that he felt rejected him at some point in their relationship. Then he mentioned now he is being rejected again. At this point he expressed some sadness, and said that it will take time to find a new therapist; one that can afford to take what he can pay.
Jose felt sorry for Kirk because he caught himself up in self-pity, feeling that the world has rejected him. But these are the hidden scars for the mentally ill person; friends and family will opt not to deal with them because it is very stressful having a relationship with the mentally ill. They require constant supervision and support, and even if they have adequate supervision & support at times their mood and behavior is sometimes unpredictable and the decompensation factor and behavioral effects can take its toll on the primary caregiver if for some reason they are off their medication.
Jose also recognized that the termination dialogue could have been better. Yet, there is no perfect timing to say what needs to be said because there is a time limit in the therapy room.
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