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Discussion in 'Psychiatry' started by CD101.9, Sep 19, 2014.

  1. CD101.9


    Aug 31, 2014
    Where do you keep your clock in your office? Do you have it displayed where everyone can see the time or just you? I have a clock near my window. It is in a good place where my patients and I are able to see the time. One patient pointed to the clock and told me: "That looks like it is the focus of our interaction!" Do you you think that this patient has a point?

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  3. slappy

    slappy Neuropsychiatrist Physician Faculty 2+ Year Member

    Apr 1, 2014
    I'm only a resident so take it for what it's worth, but I like having two clocks in the office. One that the patient can see and you can't, and one that's right next to the patient's face in your line of sight.

    More importantly of course, you would explore why the patient felt that way (whether it is just a superficial observation or whether he/she feels she deserves more attention from you), how long she had felt that way, and why she decided to mention it now.
  4. birchswing

    birchswing Patient/Interested in Psychiatry 5+ Year Member

    Nov 17, 2011
    I don't think my psychiatrist has a clock. She gets beeped when our fifteen minutes are up. I'm not even sure where the sound comes from. If we don't leave the room after a minute or so, her staff starts beeping more often.

    My therapist has a clock on a bookshelf, but I don't face it. He is somehow good at keeping track of the time without me noticing. He'll tell me when we're almost out of time so that it doesn't come as a surprise. I've never thought about it since I don't face the clock, but if I did, I would be the type to be distracted by it.

    I don't think it maters if your patient has a point in general or not. If it's an issue for him/her, then it's an issue. If it were me, I would just move it for that patient. But I'm not a psychiatrist.
  5. Shikima

    Shikima Physician 10+ Year Member

    Oct 15, 2006
    I have a clock under one of the end tables, which is hidden nicely.
  6. nitemagi

    nitemagi Senior Member Physician Faculty 10+ Year Member

    Oct 15, 2001
    Los Angeles, CA
    I have two clocks, in a similar setup to Slappy's. One for them, one for you.

    I will occasionally have someone overly conscious of the time, where it impedes their ability to engage in the session. In that case I turn it around :)
  7. MacDonaldTriad

    MacDonaldTriad 2+ Year Member

    I think everyone should have a clock behind the patient so that you can see the time without making an obvious head turn. This isn’t to have a particular advantage over our patients; you just need to manage a session. You don’t want to make a deep interpretation two seconds before the bell tolls. You may also need to help the patient recompose some before saying “next”.

    I have heard psychiatrist say they don’t like patients to see a clock because some of them will land bombs at the last minute in an effort to prolong sessions. I say they should have a clock, and if they lay bombs, that is just grist for the mill and you can bring that up in session.
    smalltownpsych likes this.
  8. Jalapeño King

    Jalapeño King

    Aug 16, 2014
    This wasn't my design, but at the clinic I'm working in there is a very large clock on the wall behind me. All I get to look at is the time display in the corner of my computer screen. The only problem I've had with the clock behind me is that when I want to do a clock-drawing test for patients with a potential cognitive disorder, some of them realize there is a large clock on the wall to copy from. My preference would be to have a clock on the wall behind the patient.
  9. MacDonaldTriad

    MacDonaldTriad 2+ Year Member

    That would be an interesting study. Find a bunch of patients with hemi-neglect and make them draw clocks with and without a big clock in view and see if it makes much difference. My guess is that it would take out a little of the sensitivity, but less than you would think. It would definitely help first graders, but then again, they would probably ask “what is an analogy clock?”
    Jalapeño King likes this.
  10. Ceke2002

    Ceke2002 Purveyor of Strange 7+ Year Member

    Sep 26, 2009
    I've only ever seen my Psychiatrist use a clock once. Because it was something I wasn't used to (actually seeing him place the clock on the table in front of him and set the timer) I will admit my initial reaction was to go 'Eek! I'm talking too much, quick stop talking', but once I realised he was using it to keep himself on track (hectic schedule on that particular day) I more or less forgot it was even there. Apart from that I do see him glancing at the computer screen during lulls in conversation, so I'm assuming he has some sort of timer/clock on there that I can't necessarily see from where I'm sitting, but there's not like a big clock that's visible on the wall anywhere in the room. I pretty much rely on him to keep session times, because I don't have a clue, which is fine by me I think I'd find a visible clock too distracting (there's something about being too aware of the passage of time that I find somewhat pressurising).
  11. Shikima

    Shikima Physician 10+ Year Member

    Oct 15, 2006
    The response would be? It's kind of like a digital clock?
  12. novopsych

    novopsych Banned Banned Account on Hold

    Dec 29, 2012
    A lot of dance therapists are going to tell you that you need a metronome for your arrhythmic clients to keep them in time. But clients without rhythm are going to clop trop, pony step all over the room anyway. The metronome is just one more frustration with them, much like the clock seems to be with your patient. It's important to remember that dance therapy does not make a person a dancer anymore than light therapy makes a person a light bulb. Do not expect perfection.

    What you can expect: vibrancy, grit, and vulnerability.
  13. Mad Jack

    Mad Jack Critically Caring Gold Donor Classifieds Approved 2+ Year Member

    Jul 27, 2013
    4th Dimension
    Just an idea for you guys: take notes on a clipboard with a clock if the wall clock is in a bad place in the room.
  14. CD101.9


    Aug 31, 2014
    In a way, I was thinking that displaying the clock is a way to let people know when we have to stop. Also, some patients ask me what time it is. But, I am thinking about moving it because it seems to distract a couple of patients.

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