another therapist in the works

Discussion in 'General Parenting' started by klmno, Sep 26, 2008.

  1. klmno

    klmno Active Member

    Finally, I got a return call from a therapist (psychiatric PHD) recommended by the psychology refferal place. I gave him my spill about difficult child's diagnosis, the psychiatrists who have been involved, and difficult child had the adolescent-onset type of mood cycling that started with depression and that there were clear,obvious things that caused that depression. I asked if he had experience in treating kids with BiPolar (BP)- he said yes. I asked if he actually got involved in helping the kid and family with mood cycling issues and if he actually dealt with that portion of the problem and he said yes.

    I told him about difficult child's neuropsychologist test results, that when he's symptommatic, he is REALLY symptommatic, and told him about the MDE. He said he's worked with that psychiatrist for a couple of years and I said GREAT!! I told him that everything I'm reading says the therapy should address AAA, then BBB, then CCC. but, previous tdocs have kept telling me that medications should take care of all that and they can just give behavior modification or traditional family therapy.

    However, regular psychiatrist keeps telling me that it might take him 3 years to get a good balance on medications and that we need a therapist on board to help deal with identifying triggers, helping difficult child understand what's going on, and work on preventative strategies. Also, the MDE psychiatrist and I discussed it and I agree with her that given the things that caused difficult child to be depressed then start cycling to begin with, behavioral modification and traditional family therapy are bringing out the things that trigger him to cycle. So, where it might not make any difference in a lot of cases, in our case, after a 45-50 min appointment of that stuff, I'm sent home with a kid who is now symptommatic whereas he was stable before delving into that. So, I asked how he felt about that and if he could deal with these things from the angle that psychiatrists recommend?

    He said yes and that it sounded like a plan to him and we could meet individually before bringing difficult child in to discuss difficult child's specific symptoms and so forth. Then of course, he discussed insurance and payment. Great- so I made an appointment. Now I am wondering- do they all just say whatever it takes to get you in there? Am I really barking up the wrong tree because no matter what, tdocs are going to assume a purely behavioral cause for everything and treat it as such? Like, no matter what we discuss, instead of them really agreeing, they are looking at it like I'm just in denial and they need to work with me to get me to see that it's our dysfunctional family that needs fixed? Are they all sitting there thinking that the first thing they need to do is break my and difficult child's "mental incestous relationship"? (Quite frankly, I want my son and I to have as good of a relationship as we can and we need people to support it, not crticize it, and there is ABSOLUTELY NOTHING about our relationship that crosses that kind of line.) And although I know they want and need difficult child to talk to them about symtpoms, fears, anxieties, etc., right now he is comfortable telling me and psychiatrist those things. If they start therapy by ruining my and difficult child's relationship (not that it's perfect), he won't be telling ANYONE when he feels like harming himself or is tempted to do drugs, etc. and yes, that does scare me.

    Is there anything I should specificly cover to verify that he won't turn around and jump right back to "the medications take care of BiPolar (BP)- I take care of conduct issues" like the others have? How can I be sure? Can I have him sign something agreeing that he will not do a certain type of therapy without my prior consent?

    Don't get me wrong- it's not that I don't see that difficult child has to get a better grip on behavior, it's that that I agree with psychiatrists and what I've read, that when it's mood cycling and difficult child's initial issues, you reach that objective by taking "X" approach first instead of "Y" approach.
    Last edited: Sep 26, 2008
  2. BestICan

    BestICan This community rocks.

    I've been following your situation with some interest because it's been really awful for you to find someone you like. I'm in a different boat, but I, like most people here, have interviewed, tried, rejected, and loved various therapists, both for myself and my difficult child.

    It sounds to me that you laid out your cards, you were extremely honest and specific, and this guy knows your preferences now. Sadly, I have seen therapists say whatever it takes to get me to come back regularly (aka, exaggerate their experience in a particular area). And I've had poor fits and good fits with therapists. I've never had one who followed my exact requested protocol (although I've never asked, really) and I've certainly never had one who did everything perfectly.

    I think the best any of us can hope for is a good fit. If this person is willing to do things your way, and seems to be really trying, that's a good fit. He'll slip up as they all do, but if he's open to discussing the process with you (unlike the previous guy), that's a good fit. I have no doubt that he'll want to address the mood disorder, the family setting, and the relationship along with everything else, because clearly these things don't exist in a vacuum. If you're not terribly unhappy with the balance of the issues he's trying to address, I'd call that a good fit.

    If your gut says this guy might be on the same page with you, I'd say follow that instinct. It stinks, but you probably won't know for sure if he's the right guy until several sessions down the road.
  3. witzend

    witzend Well-Known Member

    I would say that you are an intelligent and totally aware mom who knows when she is being hoodwinked. I think you are feeling some PTSD and rightfully so. Give it a couple of visits? Nothing ventured, nothing gained. Not when Mom is as savvy as you are.

    {{{{{{{{{{Big Hugs}}}}}}}}}}}
  4. klmno

    klmno Active Member

    Thank you, both so much! I don't feel that way right now, but I can't seem to throw in the towel when I think the tdocs haven't done what they should. And I really don't get the attitude from them that I'm trying to dictate things or tell them how to do their job- H**L, I didn't invent this stuff- it's what I have found through research, reading, listening to psychiatrists and other parents. Why am I getting nailed?
  5. I just want to say good luck. I hope this therapist really does want to help in the way you have asked. Keep us posted.

  6. TerryJ2

    TerryJ2 Well-Known Member

    I understand your hesitation and potential mistrust.

    However, you spelled it out so well that this individual knows exactly where you stand and that's got to be a good thing.

    I'd go for it and make sure that you keep the reins tight along the way.
  7. Marguerite

    Marguerite Active Member

    You spelled it out well. If you are still uncertain, copy and paste what you wrote in your first post on tis thread, into your diary. Then if at a later stage you have problems with tis guy, print it out and tell him, "Our first phone call, you agreed to the following..." then show him your notes. If he says that keeping notes like this is extremely anal, agree with him but tell him it is the result of being misled too many times, and needing to cut through the crud fast so as to not have more time wasted than absolutely necessary.

    If you were REALLY concerned you could hand him a copy of your notes at your first meeting and ask him to sign it as a contract between you; but that might be a bit too confronting.

    The other thing which I HAVE done under similar circumstances, is taken my notes and put them in a letter to the person.
    Dear ....,
    Thank you for talking to me on [list date]. As we discussed, my concerns are [list what you want addressed]. I was very pleased that you said you would [list what he agreed to do]. This really encourages me to be positive about the directions my son's therapy will take this year."

    Between the lines the letter says several things:

    1) I take good notes and have a memory like an elephant's.

    2) I'm meticulous about paying attention to small detail and following through.

    3) I'm watching you, but for now am very willing to work with you, providing you stick to what you agreed.

    If you are not already (and from your post, it seems you are) - get into the habit of taking detailed notes even for things which seem trivial. You can always wipe them later if they're not needed. For me it's now habit - when getting messages off my phone, I immediately begin to take notes even before I know who the call was. I start with the time (the phone tells me when the caller rang) and then the name. Then the issue, and the return phone number. I can have scraps of paper with a lot of irrelevant messages around (which I do throw away) but if it turns out to be someone I've been trying to talk to for months, who just happened to return my call while I was out - I still log that they called me back and left a message.
    If I try to call them and get their voicemail, same thing. I log that I tried to call AND left a message. They can't return a call if I didn't leave a message, and six months later you can't claim you left a message, if you can't remember for sure. Notes make it clear whether you did or you didn't. And whether you left a message or not can make a big difference in so many ways - some people are legally bound to make contact with you, after you leave a message.
    That's only an example - but keeping a log of calls plus what was said either way can make it much easier to detail exactly what has been happening, later on.

    It seems tedious (it IS tedious!) but it does pay off. Keeping a record on the computer also makes it easy for you to use "find" as a tool to quickly get to the bit of information you need in a hurry. So if you're on the phone to a particular therapist and he says, "I never told you that!" you can quickly use "find" on his name and maybe a key word and tell him the date he said it, plus exactly what he said it in reference to. Remind him of other things discussed at the same time to jog his memory.

    Scares the crud out of them!

  8. klmno

    klmno Active Member

    I like that Marg! I do that at work and did a lot of it through all the legal proceedings going on last year, but I haven't gone to that extent yet with tdocs. I guess I better though- I have been in a habit of a lot of things and could just organize and compile them as you suggest. I also like the idea of a follow-up letter- that could keep therapist "awake" and let the PO know exactly that I am trrying to pursue exactly what I testified to in court. Thank you!!