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Monday, January 14, 2013

Vignette 21: A Phone Call from a Friend


Dr. Goodfriend receives a call from Buddy, his very close high school friend. Dr. Goodfriend speaks with Buddy about once every six to nine months. During those calls, the conversations typically focus on careers, family members, and the whereabouts about other classmates.

Buddy phoned Dr. Goodfriend in an apparent emotional anguish by the tone of his voice.  Buddy states that he has been feeling "stressed" over the last month. He explains that he recently lost his job and has been worrying about the financial impact that this is having on his family. Buddy adds that he has had trouble sleeping, has stopped exercising, has little energy, and fleeting thoughts of hurting himself.  Buddy also shares that he has been short tempered with his wife and kids.

During the 90-minute call, Dr. Goodfriend tries to be a good listener, empathizes with Buddy's difficult situation, offers advice on ways that Buddy can better manage his stress, provides him with general encouragement, and suggests a book that outlines stress management and anxiety reduction strategies.

At the end of the call, Buddy tells Dr. Goodfriend that he is feeling much better. Just as he is about to hang up, Buddy says, "Thanks. My wife told me that I should see a therapist but I told her that I could talk with you and that it would be much cheaper."

Dr. Goodfriend is unclear whether Buddy is serious or joking.

If you were Dr. Goodfriend, how do you feel about the phone call?

Does Dr. Goodfriend need to phone his high school friend to clarify his last comment?

Does Dr. Goodfriend need to encourage Buddy to become involved in therapy if symptoms persist?

Should Dr. Goodfriend call Buddy and offer a few referrals?

What factors influence this decision?

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