How Person-Centered Therapy Can Help Transplant Recipients

Rear view of adult sitting on bed in pajamas looking outWhen a person is in need of an organ transplant, a process referred to in medical circles as a “transplant work-up” begins. This process is lengthy, as it is necessary to make sure the person is medically and psychologically fit for organ transplantation. Often, a social worker who works with transplant cases will conduct the psychological evaluation to identify any mental health issues the person may have that warrant consideration, as well as take stock of the emotional support network currently in place.

Typically, the emotional support network consists of family, friends, and the person’s transplant team. The transplant team includes doctors, nurses, and social workers. During the transplant work-up process, at the time of the transplant, and immediately after transplantation, the person has access to potentially dozens of people who can provide emotional support. The emotional support provided is almost ’round-the-clock if the person is hospitalized while waiting for transplantation. If the person is stable enough to remain at home while waiting for transplantation, they are in and out of doctor’s appointments so frequently that they, too, have consistent access to emotional supports as part of ongoing care.

What happens after organ transplantation? In the year following the procedure, the person continues frequent visits to doctors’ offices and the hospital for invasive check-ups to control for rejection and illness, as the person is immuno-suppressed. These frequent visits allow for continued access to professional emotional supports. However, as the person begins to improve physically, the appointments steadily decrease and may decline to as little as once per year. With this decline in physical check-ups, the person gradually loses ready access to professional forms of  emotional support. The transplant social worker is constantly working with new patients, and the cycle continues.

Organ transplant recipients may not have identifiable mental health issues pre-transplant, but lifestyle changes, medications, and immuno-suppression—necessary for the organ transplant to be successful—can take a toll mentally. Transplant patients can experience depression, anxiety, grief, survivor’s guilt, and other concerns. Sometimes, life becomes much more difficult after transplant due to unforeseen complications, job loss/change, loss of insurance, and a shift in caregiver roles. Sometimes, people are not able to do the work they once did. Transplant recipients may not be accustomed to a daily medication routine.

How do we balance the “gift of life” that organ donation represents with the emotional toll a transplant can have on an individual?

Post-transplant, people may become hypercritical of their own thoughts, feelings, and behaviors, especially if those thoughts, feelings, and behaviors do not align with the “gift of life” ideology commonly associated with transplantation. How do we balance the “gift of life” that organ donation represents with the emotional toll a transplant can have on an individual?

Person-centered therapy can help transplant recipients by giving them more control, with appropriate guidance. Transplant recipients have not had control over their illness or their treatment. Person-centered therapy can help by allowing the transplant recipient to process their experience and develop a more cohesive sense of self.

The genuineness, unconditional positive regard, and empathic relationship that is the nature of person-centered therapy can allow for deep healing among transplant recipients. Each transplant recipient has a unique experience to share. Some have been sick for years, some caught a fast-acting virus while on vacation abroad. Some are young, some are not. Person-centered therapy encourages the individual to choose the topics discussed in session, navigate and find solutions to their concerns, and decide how often to meet and when to stop therapy. For many, it’s the first step toward regaining a sense of agency in their lives.

© Copyright 2017 All rights reserved. Permission to publish granted by Charlotte Judd, NCC, LPC

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • catherine

    January 3rd, 2017 at 8:10 AM

    What a wonderful approach! I had never thought about how tough emotionally it could be for someone getting the transplant. I guess I have only viewed it from the point that they were getting a new chance at life, never thinking about the difficulties that they may have faced to get to this point or the pain that comes afterward. Thanks so much for shedding light on this for me as well as so many others.

  • Karen H.

    January 3rd, 2017 at 5:57 PM

    What a beautifully written article. Thank you for so much for sharing this perspective. I’m almost 2 years post transplant. I’m very grateful, yet I have experienced a lot of emotional difficulty. Thank you for putting it into words. Karen H.

  • Teena

    January 4th, 2017 at 9:15 AM

    My mom was an organ donor so when she died I know that she saved at least two lives. That makes the loss of her just a tiny bit easier to bear, to know that someone gained their life back as a result of that donation

  • vaughn

    January 5th, 2017 at 9:31 AM

    Do you think that it would help if insurance companies would require this of all patients?

  • Charlotte

    February 3rd, 2017 at 8:06 AM

    Great question. I think it would help if psychotherapy was part of the follow-up to transplant and covered by insurance. I think there should be more discussion and encouragement to seek therapy (post-transplant) during the transplant work-up process. I think recipients can experience guilt if they complain about their transplant for any reason and working with a therapist can help normalize this experience and help them work through their emotions. The medications are rough and dangerous and your body is significantly changed after surgery. So many issues to cover…..

  • Tess

    January 6th, 2017 at 12:41 PM

    Although I think that this would be a wonderful thing I am assuming that there would be some cases where time is far too valuable to g through a process like this, and you just have to move on it when the opportunity presents itself.

    I know that it must be difficult no matter which side of this you are on, but wow, to think that you have been given the chance to have a full life due to the selfless donation of another,,, that’s huge.

  • Marnita C.

    January 7th, 2017 at 8:43 PM

    LOLOLOL I had NO emotional support from my team, no social worker and my “mentor” refused to discuss my issues, since she didn’t ‘share’ them. My journey has been a nightmare. My favorite part is begging for help and still getting none.

  • Kelley

    January 9th, 2017 at 4:40 AM

    Marnita that is terrible!

  • Anna

    January 10th, 2017 at 11:21 AM

    It can be such a personal and really even a spiritual thing to receive a gift like this, one that no amount of appreciation and gratitude could even come close to matching the greatness of that donation. I suppose that this is where people tend to get sad, maybe feeling as if they have been given this second chance of having a life again and you wonder what you could have ever done to deserve this greatness that has been given to you.
    I can understand how many people could feel confused about those kinds of thoughts and feelings, and without having support to lean on, that could be a terribly isolating thing to have to go through alone.

  • Desiree H.

    January 16th, 2017 at 8:07 AM

    I am two years out from my transplant and find myself sad. I am very grateful for having a second and tell everyone that I am doing great because physically I am. I feel guilty if I said to them that I am not doing well mentally because they wouldn’t understand and I hope they never understand. I started reaching out to other recipients and find that it helps so much. I have a mentor who I have been speaking with since my surgery and if it wasn’t for her I couldn’t image what state I would be in. The National Kidney Foundation has a mentoring program which pairs up newly transplanted kidney recipients with someone who has been thru the process years prior. There are so many of us out there that no one who has had a transplant should suffer or be alone.

  • Kalyan

    January 6th, 2019 at 11:53 PM

    Person-Center theory why counselor’s attitude is most important than knowledge, theory and technique?

  • Sharon

    January 10th, 2022 at 4:31 PM

    I am waiting for a live liver donor. I still think it is helpful to have a therapist as we all are facing a huge operation that can change our lives. It took 3 months but I meet this week starting Thursday. I want to see if I can benefit from a professional. I can talk to family and friends which I appreciate but I simply want a pro. Hopefully this person is skilled! We shall see…

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