CAREER CHOICE (failure to get into med school) (male or female)
The caller is a 21 year old senior in college who planned to go on to medical school. After making many applications, he/she has received only rejections and it seems as if a career in medicine is no longer possible. Both parents are physicians, his/her older brother and sister are also M.D.S. In this family, any other career but medicine is unacceptable. Its a high pressure family in which intellectual endeavor is prized and feelings of any sort discouraged. The caller has not told his parents of his/her failure to get into school and knows that such news will not be greeted with sympathy but rather with condemnation. The caller has no alternative career plan and is markedly despondent. He/She feels there is no one to turn to, no options left, and is feeling like a failure in his/her own eyes and is sure that he/she will be seen in that light by the entire family. This caller is suicidal and wants to talk about it. Suicide is introduced into the conversation after the essential background details are provided. There have been no previous attempts, but the caller has managed to collect a lethal dose of barbiturates since medications are readily available in the home. The parents will be away this coming weekend and so the opportunity and the means to carry out the suicide plan is available. Although depressed, the caller is willing to talk about feeling a failure, trapped, discouraged, optionless. The caller will accept a referral to counseling if the liner encourages it. If the liner does not bring this up, the caller should make strong bids to get the liner to make such a referral.
SEXUAL DECISION MAKING (male or female)
The caller is a teenager (16-17) who is contemplated becoming sexually active. Concerned about sexually transmitted diseases and AIDS, this caller wants information about safe sex and birth control methods. The caller is bright and thoughtful, trying to make a reasoned decision about his/her sexual expression. The discussion should be about relationships, intimacy, and what means should she/he use to be sexually responsible.
DEPRESSION AND SEXUAL ORIENTATION (male)
The caller is depressed. He or she speaks minimally. There are long silences between sentences. Getting started talking should be very difficult. When the caller talks, his/her voice should be flat, almost a monotone. The concerns that the caller is dealing with have to do with homosexuality. He/She is wondering about being gay. How do you know? If you feel particularly close to a friend of the same sex, does that mean your gay? There is a friend of the same gender that the caller feels particularly close to, thinks about all the time, wants to spend all her/his time with. The caller also notices that she/he is very sensitive to the slightest sign of rejection from this friend and feels terrible when the friend neglects any aspect of the relationship. Thus, the call has two issues: (1) Could I be gay; and (2) what am I going to do about these feelings for my friend.
The caller is a young woman who finds herself pregnant. She is calling to discuss her options. Should she continue the pregnancy or should she have an abortion? While she had always felt she was in favor of abortion, she now finds she has questions and misgivings about abortion for herself. The option is no ruled out, but she doesn't feel sure about whether it is right for her. Since she is single, the option of carrying the pregnancy to term also has certain problems associated with it. She wants to talk about that too, and the possibility of placing the child for adoption if she completes the pregnancy. The caller is concerned, thoughtful, and open. An important aspect of this call is that the young woman is nearing her 12th week of pregnancy. This information, however, is not volunteered unless the liner probes for it. If the information is disclosed, however, information about 1st and 2nd trimester abortions should be sought by the caller. No definite conclusion should be reached, but the caller should ask about calling back and hopefully be encouraged to do so.
TERMINAL ILLNESS (male or female)
The caller is elderly and is terminally ill with liver cancer. In a very straightforward manner the caller discusses the possibility of suicide. The caller is well aware that as the illness progresses, there will be increased disability and increased pain before death occurs. The caller also knows that he/she will have to return to the hospital during the end phase and that the costs of that hospitalization will mount quickly. He/She does not want to leave his/her family with that kind of debt and so suicide seems a logical, legitimate, reasonable alternative since death is inevitable anyway. There is a quality of sadness to this caller, but he/she is not afraid of death. Rather, death is accepted as a part of life. There is a strong religious belief in life after death and death is simply seen as a transition. If the liner becomes to concerned or to busy advocating one side or the other of this dilemma, the caller should begin to take care of the liner because of the liner's problems facing death.
FIRST SEXUAL EXPERIENCE (male or female)
The caller is in his/her early 20s and has just had his/her first sexual experience. It was rather mediocre. There were no flashing lights or bells or fireworks. The caller is concerned that something might be wrong with him/her since the expectation was that sexual intercourse would be terrific. Lots of doubts are raised about having done it right, sexual inadequacy, even concerns about homosexuality. Maybe the caller is not "man enough" or "woman enough." Clearly, the caller's expectations about being a sexual gold medal winner are a bit out of line given the level of inexperience expressed. Hopefully, the liner will help the caller adjust his/her expectations.
INFIDELITY (male or female)
Caller has discovered that his/her significant other has been having an affair. The caller feels betrayed and angry, but is still very much in love with the other person. While the feelings of betrayal are very important, the predominant concern is that there must be something wrong with the caller and that is why the other person is looking elsewhere. Lots of questions about adequacy and self esteem enter the conversation. The caller is afraid to confront the other person about the affair for fear that it will confirm her/his worst fears that there is something irreparably wrong with the relationship and she/he will loose the other person. The anger, having no place to go, is turning into depression which the caller does not understand.
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