Commentaries

Patient- and Family-Centered Electroconvulsive Therapy

Fox, Herbert A. MD

From the Department of Psychiatry, Weill Cornell College of Medicine; Department of Psychiatry, New York Medical College; Department of Psychiatry, Northwell Lenox Hill Hospital; and Department of Psychiatry, Manhattan Eye, Ear and Throat Hospital, New York, NY.

Received for publication October 28, 2018; accepted February 17, 2019.

Reprints: Herbert A. Fox, MD, 347 5th Ave, Suite 1206, New York, NY 10016 (e-mail: [email protected]).

The author has no conflict of interest or financial disclosures to report.

The Journal of ECT 35(2):p 75-76, June 2019. | DOI: 10.1097/YCT.0000000000000596

Abstract

This article builds upon prior efforts to improve the quality of electroconvulsive therapy (ECT) practice and care by encouraging the participation of family members in the ECT process. This participation included the presence of a family member or significant other (SO) in the treatment room during the ECT procedure. Suggestions for limiting that presence to the induction process and for providing limited physical contact with the patient are proposed. The participation of the SO during the pretreatment assessment process is encouraged. Because of possible impairment of memory and judgment, accurate information about the patient's condition and intercurrent life events, as provided by the SO, is often crucial. Furthermore, the patient's report may be influenced by the common experience of fear of ECT. Under these circumstances, an alliance with the SO may at times be more crucial than the alliance with the patient. The importance of establishing a therapeutic alliance with both patient and SO is emphasized. An illustrative clinical vignette is provided.