When 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.
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