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Therapy question

Discussion in 'LGBT Later in Life' started by BMC77, Jul 12, 2016.

  1. BMC77

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    I'm in the process of looking for therapy once again, and one possible therapist--who apparently will work with my insurance--has made me wonder about a couple of things...

    First, based on some advice I saw someplace or other, I asked for some sort of short session to gauge whether he will work for me. He says he doesn't do that. It appears that he wants to start with a formal intake session (or sessions--apparently he often does 2-4 sessions before starting serious work. Or so I gathered). Is this unreasonable? I have mixed feelings--part of me doesn't care, but another part of me would like to at least have a chance to get a sense of whether he might work. Particularly since it sounds like the number of visits I have are limited by insurance.

    Secondly, he wants all the paperwork downloaded from his own site, and printed by the patient. This is more than a little irritating given the possible cost of printing. Indeed, I almost thought I might have to go to the library and print all 50+ pages at 10 cents/page. Fortunately, I found a printer that will work--at least for the moment. I am wondering if this downloading all the paperwork is at all standard. It seems like the forms should be pre-printed and in his office.

    Any comments about my questions are welcome--including if someone thinks something I say should be ringing alarm bells... I have another option or two, so it's not like this guy is the only option.
     
  2. Jjanon

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    I can't speak to your questions about 2-4 intake sessions, but it does seem reasonable to have a getting to know you session before you dive into the heavy stuff. Plus I'd think you'd know if something totally didn't click after one session.

    For the printing question, the therapist I'm seeing sent me the paperwork ahead of time, though it was described as an attempt to save me time on the day of having to get there earlier to fill it out.
     
  3. Lindsey23

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    Nothing you've said would be a deal breaker for me but I do agree with you on the paperwork. It would be nice if he gave clients the option of picking it up. As far as waiting a few sessions before getting into anything serious, I'm guessing he just wants to get to know you and build a relationship first. Also he may want to use that time to make sure you're a good fit for each other. Personally I would prefer this...but I'm not you. If your sessions are limited that kinda sucks, and he should be able to bend to his clients wishes right? I dunno... If you're already questioning it that's not a good sign. Maybe contact your other options and make a decision after talking to everyone?
     
  4. BMC77

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    Thanks for the answers so far!

    Another question: how much attention should one pay to on-line reviews (e.g., Google Reviews, Healthgrade.com, etc)? I ran this therapist's name just now, and healthgrades.com comes up with 2.5> rating with 3 reviews. Not exactly reassuring, although I'm also aware of the tendency for on-line reviews in general to often be negative (people who are happy don't bother, and people who are unhappy go out of their way to review!).

    ---------- Post added 12th Jul 2016 at 11:53 PM ----------

    I also keep thinking that if I'm questioning it's not a good sign. But then...I seem to also end up questioning everyone, at least to some degree.

    ---------- Post added 13th Jul 2016 at 12:10 AM ----------

    That is 2.5> stars out of 5 possible.
     
  5. RosePetals76

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    Having to print your own stuff with no option to pick it up, plus that paperwork being over 50 pages seems odd. And I would take this health grade into consideration. Things seem a little off. Maybe check around some more before you commit.
     
  6. Lindsey23

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    It's hard to say how much you should weigh the online reviews. I've seen doctors I've loved who I later saw had an average of 3.5 star reviews. It surprised me because I felt they deserved 5 stars. It's all so personal and subjective. With only three reviews I'd think it would be hard to gauge. It's more clear when you see someone with a dozen 1 star reviews or a dozen 5 star reviews.

    Did you talk to him on the phone? If so did you feel comfortable?
     
  7. BMC77

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    No, I haven't had any phone talk. All contact has been by e-mail. I don't think I specifically asked about a phone contact, although I did ask for a fast trial type appointment, which he said he didn't do. (It seems like if he'd be willing to do phone talk, he'd have offered at that point...although one never knows.)
     
  8. nerdbrain

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    The formal intake session and the paperwork requirement leads me to assume this guy is a psychiatrist (an MD) as opposed to a psychologist (PhD). This is an important distinction, as psychiatrists typically take a medication-first approach to things, and are more expensive. Not necessarily better or worse, but something to keep in mind.

    Psychologists sometimes offer free consultations, but I've never met a psychiatrist who does. Is it annoying and baffling? Yes. But if you need meds you've got to deal with it.
     
  9. BMC77

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    Actually, he's neither. He's a licensed therapist.

    As I think of this some more... I had to see a psychologist to be screened in 2015 and it was amazing how much ground he was able to cover in about an hour. I have a copy of his report: "As loopy as they come!" :lol: Actually, it hits on everything from his impressions of issues of depression, and his impressions of my cognitive ability, judgment ability, and more. While I'm sure it's limited by the fact he was with me only an hour--there were some things I'd quibble about in the report--it's interesting that he was able to cover so much ground in an hour. This now has me wondering why a therapist needs 2-4 sessions for intake. Admittedly...he isn't doing a fast screening. But if a basic screening can be done in an hour, why can't a basic intake?

    The last time I tried therapy of any sort (2000) was with another MA level counselor, and I don't recall much of an intake. I set an appointment, and the first appointment ran longer than usual IIRC. He provided the paperwork, and that was pretty limited. It was then starting with talking.

    ---------- Post added 13th Jul 2016 at 10:00 PM ----------

    And psychiatrists are off my list of options just because they are so drug biased.

    It seems to me like less of an issue having a meeting with a psychiatrist. I guess if it came down to that, I'd want someone I felt comfortable with, and who'd at least make an effort to understand where I'm coming from. But because it's a drug-based approach, it becomes more like finding a doctor in general--as hard as that can be--and the match of doctor/patient doesn't seem as important as therapist/patient match.
     
    #9 BMC77, Jul 13, 2016
    Last edited: Jul 13, 2016
  10. Katchoo

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    I'm a therapist with kids. I can speak to my professional experience. Also, I currently have a therapist, and I have had a couple other therapists in the past.

    I work worth a group/agency, and our first session is usually 90 min to 2 hours of an intake/initial assessment, and we use the information gathered to develop a treatment plan and assign the most appropriate therapist or of the group. Our paperwork is somewhere around 20 pages just for the stuff we need signatures on, but we don't have our clients do their personal history on the forms, we ask about it in the interview. For us, we work with a lot of clients with poor reading skills or low iq, so we don't want to assume that new clients can read and wrote such important information without help.

    I have known some therapists who have clients print the packet in order to complete it in advance and not take up the session time that you are paying out the nose for. This also often has to do with most therapists not having a front desk worker to handle that kind of stuff.

    If printing the packet is a burden, you might ask if he could leave a blank packet in the waiting area, and you could get there early to fill it out.

    About assessment sessions.... Good assessment leads to good treatment. It helps to get a broad view of what's going on and also what is important to the client. It helps early on to ask the client about their goals and what they want to work on.

    Also, like when you go to a job interview, it's a good idea to ask about the therapist's style and how they would help with this sort of thing, or just ask about anything that is important to you. You do want to see if this person is a good fit. If you are nervous about something, say so. Therapists really like helping with your feelings, lol. It can be helpful to talk about your thoughts and feelings that are happening in that moment with the therapist.

    Personally, I think like 4 sessions of assessment is excessive unless there is something strange going on, like the client is being super evasive. But, I often have to accept that I don't have all the information after the initial assessment, and that I will have to keep gathering info as we move forward.

    ---------- Post added 14th Jul 2016 at 09:52 AM ----------

    Oh, and, another reason a dedicated assessment session is helpful.... it's a chance to back up and consider factors from all aspects of life, to see if other pieces are impacting you that you didn't think of. Like, medical issues, prenatal history, head trauma, emotional trauma, death of people who are important to you, job stuff, drug and alcohol use, financial stress, etc. So many times people tell me the teenager is a bad kid who is getting into all this trouble, and then we uncover something like that a close relative died around the time of the onset of the problem. Then, suddenly, rather than treating that kid by helping them consider the pros and cons of her risky choices and looking at risk reduction, we are able to work on bereavement stuff and really resolve the fundamental issue, which could not have happened without a thorough assessment.
     
    #10 Katchoo, Jul 14, 2016
    Last edited: Jul 14, 2016
  11. Tomás1

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    Your comments about the possible therapist sound negative - which to me is not a good indicator of success with this therapist. The printing of the forms, and a desire for 2-4 sessions, to me, is not a good sign... more a sign that this therapist is bureaucratic, and more interested in having you comply with his structure... than in being in dialog with you.

    There is a somewhat well known study, showing the value/effectiveness of therapy sessions, input from many people. The first session ranks high, and the rest have declining value, like going down a staircase... until it plateaus out after 10-15 sessions, where even tho you may see a therapist once a week for 5 years, you don't get much value after the initial sessions.
     
    #11 Tomás1, Jul 14, 2016
    Last edited: Jul 14, 2016
  12. BMC77

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    I have already seen the value in having the paperwork done before the first session.
    I already asked if he had copies pre-printed. Answer was no. He said I could go to the library--where printing costs are 10 cents/page. While not perhaps the end of the world, I am seriously low income, and that $5 or so could be better used for necessities like dish detergent and toilet paper.

    And I can't help but feel sorry for those who wipe out a $20 ink jet cartridge at home as they print all this.

    It seems to me that forms should be his problem since he's the one who wants all that paperwork. Plus it can be argued it can be seen as a cost of him doing business--just like renting his office or paying his electric bill. If I go to him, will I be expected to pay a dime if I use the toilet to help cover the water bill?
     
  13. Katchoo

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    Well, I hope therapy is helpful for you. Im glad I am going to my therapist. Every time I have started therapy for myself, I start out finding random things I dislike about the therapist (or yesterday, my new psychiatrist). Eventually I settle in and like them, and I realize I was fault finding because I was nervous about therapy, and I was putting it on them. That's why I think it takes a couple sessions before i know if they are a good fit or not. If you get nervous like me, it takes a minute to tell if you really have a problem with the therapist or if it's therapy itself making you uncomfortable.
     
  14. Chip

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    Any therapist that genuinely cares about a good match should be willing to have at least a short conversation (10-15 minutes) by phone where you can get a feel for the conversational style, approach, and other factors. If this person isn't willing to do that, I'd keep looking.

    A 50 page intake packet?! Seems pretty ridiculous to me. And if you're going to have an intake packet that big, he should provide it. Since you've said he's unwilling to, that would also raise a flag for me: he's more interested in his own convenience than in convenience for his clients, and that would be a pretty big "no" for me.

    I'd say if you have other options, explore them first.
     
  15. Landgirl

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    I have certainly found this to be true in instances where I had great hopes of the therapist, which were gradually dashed because although I liked them they were not very good. It has also been true at times when I have needed therapy but the closer I started to relate to the therapist, the more anxious I got about the truth coming out, so I started to pull away, and blame her for it not working.

    However, now I have a therapist who is a really good fit, and very skilled at her job, plus things had got to a point that my life was in such turmoil, letting everything out couldn't possibly make the situation worse.

    As a result, after two years, I am finding my understanding growing deeper all the time, and I am able to observe my own changing and be proud of it, but it didn't happen instantly, as it took me a long time to build up the trust necessary for this to be allowed to happen.
     
  16. BMC77

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    I was idly looking at the forms, and discovered I must have miscounted. The package is only in the low 30 page range--at least for the ones I apparently would need. Still...that's a lot, and I still sort of think that the therapist should provide the paperwork.

    The other day, he indicated this about the forms: "If I print them there is a fee.($10). The website forms library is for your convenience."

    It seems like the real convenience is for him, not me.

    I haven't ruled him out. But between the forms and other issues (e.g., healthgrades.com reviews), I am actively considering other choices.

    One possibility that I'm giving more consideration to are community mental health centers. I had ruled them out for a multitude of reasons. But one place isn't that hard to get to. The other is hard for me to get to, but a neighbor has been going there, and says she's been very, very happy.