Psychiatrists' and social workers' disclosure practices with regards to the diagnosis of schizophrenia

• Main Author: Smyth, Mary A.
• Other Authors: Memorial University of Newfoundland. School of Social Work
• Format: Thesis
• Language: English
• Published: 1989
• Subjects: Psychiatric ethics > Newfoundland and Labrador; Psychiatric social work > Newfoundland and Labrador > Moral and ethical aspects; Informed consent (Medical law); Schizophrenics > Newfoundland and Labrador; Newfoundland; Canada; Newfoundland studies; University of Newfoundland
• Online Access: http://collections.mun.ca/cdm/ref/collection/theses2/id/223648

Thesis (M.S.W.)--Memorial University of Newfoundland, 1990. Social Work Bibliography: leaves 221-227. Psychiatrists' decisions regarding disclosure of the diagnosis of schizophrenia have implications for social work practice as well as for patient and family treatment. Ongoing controversy still exists on how disclosure of this diagnosis should be handled. -- This descriptive study examines Newfoundland psychiatrists and social workers who work in psychiatry as to what they report on their practices of disclosure, their opinions, and the various factors that influence them in this area. Sixty-three respondents representative of both populations were given personal interviews utilizing an open-ended semi-structured questionnaire. There was one hundred per cent participation. -- The study reveals that the practice of disclosure is not uniform among psychiatrists and social workers. Some psychiatrists generally disclose to all of their patients, some to a portion, and a few are refraining from revealing the diagnosis. Similarly, not all social workers disclose the diagnosis of schizophrenia to patients. Over half of the workers require participation in relation to disclosure from psychiatrists when working with uninformed schizophrenic patients. -- Some notable examples of the many factors which influence psychiatrists and social workers include: the certainty of the diagnosis, patients requests for the diagnoses, the degree of social stigma, the activity of the psychosis, the patients ability to understand, and individual patient characteristics. -- A diversity of issues were raised relating to disclosure; some of these include: the patient has a right to know his/her diagnosis, there is more than one illness lumped under the classification of schizophrenia, some patients prefer euphemisms to the term schizophrenia, knowledge of diagnosis allows patients and their families to increase their educational and therapeutic opportunities, social work's role is affected when patients do not know, it is important, when revealing, to consider "where one's client is at", revealing often reduces the blame for patients and their families, and revealing can at certain times be countertherapeutic. -- Overall, the psychiatrists and the majority of social workers believed that under most circumstances the psychiatrist should be the individual who reveals the diagnosis of schizophrenia but that this does not preclude other trusted individuals (including social workers) revealing or being present when disclosure occurs. -- This study concludes that disclosure is a complex phenomenon and is only a small part of educating patients about their schizophrenic illnesses. Ultimately, each case needs to be examined individually as to whether disclosure should occur, how it should be handled, and who is the most appropriate person to disclose the diagnosis and follow up the disclosure.