Question about mental health evaluations

Discussion in 'The Watercooler' started by klmno, Jul 26, 2010.

  1. klmno

    klmno Active Member

    I had an appointment with a therapist this morning. I was told it would be an intake appointment to get me into a VA therapist and get the referral into the VA work program and it would be a 1 hour appointment. When the first 2 questions were where was I born and tell her about my early childhood, it was obvious this was a real evaluation and I know that my hx is too full of issues to be able to get thru it in 1 hour. So I started blurting out the important stuff as quickly as possible. This lady is another who can't keep any of it straight. difficult child and I must just have more complicated lives than most because every therapist I've seen (whether for him or me) since he's been born has not been able to keep details about our hx straight.

    Examples this morning: I told her my bro went to live with grandparents. One minute later she says "so you lived with your grandparents". I was telling her about my bro trying to get difficult child condoms when he was 12yo and home on the ankle bracelet. She says "Oh my, your son is home on an ankle bracelet right now".

    It's not that they get confused that bothers me so much. It''s that if they can't keep this straight and this is what they go by to come up with a diagnosis and treatment plan and which therapist to send you to for that treatment plan, how much faith can I possibly have in their conclusions and therefore, their recommendations? If they can't pay attention to the details, do I trust them to diagnosis me?

    She said we didn't get finished so I have to go back in 3 1/2 weeks for her to finish. Of course by then she will have completely forgotten about me and anything I said and only have her notes to go by- and I don't have much confidence in them being correct. I've brought concerns up like this to the last two evaluators who evaluation'd difficult child and they both said they would let me look the evaluation over to correct things like hx prior to finalizing the report and giving it to anyone. But neither of them did. They gave me my copy at the same time other people got it and it was final and I had to send a letter outlining things and I feel sure the letter with corrections never gets read, if seen at all.

    So what should I do? The only thing I can think of is to tell her when I go back that since I threw so much out so fast, I am concerned that she might not have been able to write things down accurately that fast. Is that polite enough? Suggestions?

    She also seems to have a blind faith in the juvenile court system and that worries me a little about whether or not she'll think I'm just being paranoid but maybe not- I'll just have to wait and see on that one. People don't like to believe that courts people will tell their mental health evaluators (in detention) what to write in an evaluation and the evaluator will actually do it instead of coming up with their own prof opinion and writing that.
  2. JJJ

    JJJ Active Member

    You need to do a parent report on yourself.

    Type up a 2-3 page summary with all the highlights. Keep it simple and factual. When you go to the next appointment, tell her that you felt that things had been all jumbled last time and you want to make sure that you tell her everything so that she understands the timeline and the important events in your life.

    For example,

    June 2008
    difficult child (age 12) was still on ankle bracelet and probation. Brother bought difficult child condoms and encouraged him to make use of them. I told Brother to leave as he was encouraging law breaking and dangerous choices by difficult child. I explained to difficult child that he needed to follow his PO's instructions and that it was inappropriate to have sex at his age and reviewed age-appropriate sex education materials.

    Nice, simple, no emotions. She can get the emotions from you as you talk about each issue.
  3. klmno

    klmno Active Member

    Very good idea!! Thank you! I guess the three week wait then is an advantage because it gives me time between the other appts, job hunting, selling and trying to prepare to move.
  4. DDD

    DDD Well-Known Member

    If you don't mind my suggestion, prepare it in a synopsis format with identifying years. Your story is very complex and you have stated before that you tend to give too much information. Providing time frame info and highlights will make it more likely that she "gets it". Good luck. DDD
  5. klmno

    klmno Active Member

    I wonder if she'll read it though. Ideally, the therapist would get this and read it then have an appointment to ask questions and discuss it so she can ask how I feel about it or whatever. But being that they are slammed at VA in the mental health area, I somehow doubt she'd even read it before the appointment. and she's supposedly only doing the intake on me.

    Really, I don't think she's the right person to be doing a complete evaluation on me to begin with. When you are trying to distinguish childhood trauma issues, PTSD, and other forms of anxiety, given my past and current difficult child issues, is a Licensed Clinical Social Worker (LCSW) the best person to do this? Don't get me wrong, she's clearly a lot more knowledgable than typical Licensed Clinical Social Worker (LCSW)'s ITRW, but she's the one that's going to steer me to the right therapist, and she's already said she thinks I'm right on the money about the stuff going on the past few years has caused it's own stress issues but has also stirred up past childhood trauma issues. She said the issue with me would be to figure out if all this has reached the level of true PTSD yet. She agrees that family therapy with difficult child and me is seriously needed along with individual for me to sort all this out and deal with the stress, etc.

    To me, I would think that would be enough to do an intake and get me to the appropriate therapist, then let that therapist who has more specialized training in these areas do the more thorough evaluation to evaluate specific symptoms. However, they have a special PTSD clinic there and I was thinking that would only be for war related PTSD because they have group sessions and other things in addition to individual counseling and I'm not sure it woould be appropriate for me to be in those groups with my issues being so different, but if that clinic is for all types of trauma issues then I can see why the intake person needs to decipher if I'm have true PTSD or not. She told me that even having childhood trauma issues resurface and having some of these symptoms, which she says is clearly happening, didn't mean it had reached a point of being PTSD yet. I didn't know that, I would have considered it the same.

    I have to go to VA Thurs. morning but I won't be seeing her unless I just bump into her in the hallway. Maybe I can find someone who'll know and ask them if their PTSD clinic is used for all types of PTSD or only war related. That would clear up some confusion for me if I find that she needs to figure out if I should be referred to this clinic or just have an individual therapist.

    ETA: No, DDD, I didn't mind that suggestion at all! Thanks!

    As far as writing the issues/important information, the difficult part is for me to write it in a way where they can distinguish between childhood issues, difficult child's/our relationship issues, and my current issues that have resulted from dealing with all this the past few years. It's easy for me to compartmentalize most of this in my mind but I'm not sure how to write it where that is clear. I almost want to start with three pieces of paper and list things separately according to the way I have it categorized. Then, let them figure out how it all fits together or triggers issues in other categories.
    Last edited: Jul 27, 2010
  6. JJJ

    JJJ Active Member

    KISS it - Keep it Simple Sweetie

    The report should be very short and easy to read. You can go through it with her at the appointment that way she has it in front of her, it will keep YOU on track and she'll be able to ask any questions she needs to at that time.
  7. DammitJanet

    DammitJanet Well-Known Member Staff Member

    KLMNO...I have a "parent report" or what I actually call a medical report on myself and have taken it to almost all new doctors since I heard about the parent report!

    I started it off with a basic...I was born 1/17/1962 weighing xxx to a mother aged 35 by C section yada yada yada. No siblings. I list major health issues in my family. Then I give basic childhood health issues.

    I give an overall summation of what my childhood was like both emotionally and physically.

    I list all surgeries and hospitalizations, births of children, ages, known allergies, etc.