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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by mair on January 30, 2002, at 13:19:29
A friend of mine recently asked about how to choose a therapist. I realized that although I've been in therapy for quite awhile, I've never had to do this. My first therapist was also my psychiatrist. He's the only pdoc I had any knowledge about in my area, and it never occurred to me that I should explore more choices. Therapist #2 was referred by therapist #1 and again I never really looked around.
My friend lives in a much bigger pond (Atlanta) with many more choices. She doesn't know whether she needs a doc or therapist - my sense is that she should start with the therapist. I know people have written here before about the process one should go through to choose a therapist and about certain questions that you should ask. I'd love to here from those who have been more discriminating than I have.
Robin - if you see this I know that the Undoing Depression web site has some good stuff on this and I will refer my friend to that as well. I just wanted to hear some from those people with no contacts to the mental health community who've had to go through this selection process, more on their own.
Mair
Posted by kiddo on January 30, 2002, at 15:01:38
In reply to Choosing a Therapist or Pdoc, posted by mair on January 30, 2002, at 13:19:29
That would be me, I think:
I knew no one in the city I live in, and all I had was me, the yellow pages, my insurance book, and a lot of stress.
I didn't like the thought of browsing the yellow pages, so I called every therapist/psychiatrist in my provider directory. There were 63+ ppl I called, and only 1 called me back. He's also the only one that would agree to a 'test' session. (but I didn't use it, I was satisfied after the phone call)
I made sure to ask what was important to me. (This could be especially helpful since she lives in an area large enough for 'browsing'. I'd also suggest that she make several appointments with both a therapist and psychiatrist if possible, asking the same questions to each....that may help narrow things down a bit. (Mine was 583 questions-45 pages long-I can't believe he didn't ditch me over that alone :-)
Have her make a list of pros & cons between a therp/pdoc. One's more expensive, but if medication is needed, then she'd be seeing two....those kinds of pros and cons.
I have a bunch of information on my website and could go on forever, but I'm really tired right now. I'll be glad to write more if you're interested.
Kiddo
> A friend of mine recently asked about how to choose a therapist. I realized that although I've been in therapy for quite awhile, I've never had to do this. My first therapist was also my psychiatrist. He's the only pdoc I had any knowledge about in my area, and it never occurred to me that I should explore more choices. Therapist #2 was referred by therapist #1 and again I never really looked around.
>
> My friend lives in a much bigger pond (Atlanta) with many more choices. She doesn't know whether she needs a doc or therapist - my sense is that she should start with the therapist. I know people have written here before about the process one should go through to choose a therapist and about certain questions that you should ask. I'd love to here from those who have been more discriminating than I have.
>
> Robin - if you see this I know that the Undoing Depression web site has some good stuff on this and I will refer my friend to that as well. I just wanted to hear some from those people with no contacts to the mental health community who've had to go through this selection process, more on their own.
>
> Mair
Posted by Dinah on January 30, 2002, at 17:15:44
In reply to Re: Choosing a Therapist or Pdoc, posted by kiddo on January 30, 2002, at 15:01:38
My therapist gave a seminar on anxiety that I attended. I'm afraid my reason for choosing to go to him was that he was encouraging. That was sort of surprising because I was not too cooperative at the seminar. Cold calls from the yellow pages don't get a good reception around here, and I found that no one was very enthusiastic about setting up an appointment. They all wanted referrals.
I found a really good pdoc that way as well. He gave a public health seminar at our local hospital on women and depression and it was clear that he knew what he was talking about. It turned out he was a local big-wig in the mental health community. It didn't work out with him but that was solely my fault, not his.
My current pdoc came from a recommendation of a friend of my mother's. He's great, although I'm not sure how I felt about my mother telling everyone I was looking for a psychiatrist. She's not very tactful.
My poor yellow pages experience might have to do with the fact that this town is a barren wasteland for mental health services. It's not that there aren't any available. They just don't seem to be very up-to-date or even very responsive.
And that, she said, is all I know about choosing a therapist or pdoc.
Dinah
Posted by kiddo on January 30, 2002, at 17:28:38
In reply to Re: Choosing a Therapist or Pdoc, posted by Dinah on January 30, 2002, at 17:15:44
Sheesh!
I hope I didn't imply that.... that would be my absolute LAST resort, although what I did was close, but I had no choice in the matter. I was alone and didn't know anyone, so my insurance directory was the best shot I had....
Kiddo> My therapist gave a seminar on anxiety that I attended. I'm afraid my reason for choosing to go to him was that he was encouraging. That was sort of surprising because I was not too cooperative at the seminar. Cold calls from the yellow pages don't get a good reception around here, and I found that no one was very enthusiastic about setting up an appointment. They all wanted referrals.
> I found a really good pdoc that way as well. He gave a public health seminar at our local hospital on women and depression and it was clear that he knew what he was talking about. It turned out he was a local big-wig in the mental health community. It didn't work out with him but that was solely my fault, not his.
> My current pdoc came from a recommendation of a friend of my mother's. He's great, although I'm not sure how I felt about my mother telling everyone I was looking for a psychiatrist. She's not very tactful.
> My poor yellow pages experience might have to do with the fact that this town is a barren wasteland for mental health services. It's not that there aren't any available. They just don't seem to be very up-to-date or even very responsive.
> And that, she said, is all I know about choosing a therapist or pdoc.
> Dinah
Posted by Dinah on January 30, 2002, at 17:57:19
In reply to Re: Choosing a Therapist or Pdoc » Dinah, posted by kiddo on January 30, 2002, at 17:28:38
Sorry kiddo,
I wasn't referring to you. I'm afraid I just had a few minutes before picking up my son and I just read and responded to Mair's original question based on my own experience. I'll have to sit down after dinner and read your post to see what I inadvertantly sounded like I was responding to.
Sorry for any misunderstanding.
Dinah
Posted by Dinah on January 30, 2002, at 18:00:13
In reply to Re: Choosing a Therapist or Pdoc » kiddo, posted by Dinah on January 30, 2002, at 17:57:19
I didn't mean I didn't read your post, just that I only had time to skim over it and hadn't really taken it in. For that matter I didn't put all that much thought into my answer either. I shouldn't try to post in a hurry.
Sorry again.
Dinah
Posted by kiddo on January 30, 2002, at 19:27:30
In reply to Re: Choosing a Therapist or Pdoc - Kiddo, posted by Dinah on January 30, 2002, at 18:00:13
It's ok, on both-I read it and it kinda sounded that way to me...
:-)
> I didn't mean I didn't read your post, just that I only had time to skim over it and hadn't really taken it in. For that matter I didn't put all that much thought into my answer either. I shouldn't try to post in a hurry.
> Sorry again.
> Dinah
Posted by susan C on January 30, 2002, at 20:05:21
In reply to Re: Choosing a Therapist or Pdoc, posted by kiddo on January 30, 2002, at 15:01:38
Posted by KB on January 31, 2002, at 6:04:46
In reply to Re: Choosing a Therapist or Pdoc, posted by kiddo on January 30, 2002, at 15:01:38
I chose my first therapist because, in a desperate moment, I looked down at a copy of a gay/lesbian newsletter on my table and saw her ad.
Though this is probably not an ideal method - though she was great - it does suggest an idea: if you have attributes that are important to you, you can narrow the field with them (it was important to me at that time to have a lesbian therapist).My second therapist I got through a referral service - I met with their interviewer, who asked me LOTS of questions and she called me back a couple days later with a referral, who I'm still seeing. There are usually referral services with different themes - I used an art therapy one, but here in NYC there are gay/esbian ones, feminist ones, etc.
Finally, if you friend might want/need meds, she should find a therapist who's a)OK with meds and b) has a working relationship with a pdoc. I mention this b/c my first therapist was very into alternative medicine and had me taking herbs and stuff and never suggested meds to me, even though I was suicidal and cutting. When the second one
suggested seeing a pdoc, I was very scared, but it helped a lot that she knew him and could tell me about him - if I'd had to find a pdoc on my own, I wouldn't have been able to.Hope that helps.
Posted by medlib on January 31, 2002, at 6:27:03
In reply to Choosing a Therapist or Pdoc, posted by mair on January 30, 2002, at 13:19:29
Hi Mair--
You might consider treating your friend as you would a client. Then, like any professional service provider, what you advise will be the best "fit" for the client and the problem. In my area we call this inquiry the "reference interview." (Our general rule of thumb is that what an individual asks for is almost *never* what they really want.)
On topics (or with people) too sensitive for direct questions, alternatives may be offered; the client then chooses which option is the best fit for them. For example, "It's best to choose a pdoc first for severe mood fluctuations, for depressions which have lasted more than 6 months, for those which seem unrelated to external circumstances, for those which are severe enough to seriously impair basic living (holding a job, personal care, severe sleep changes, etc.), for serious depressions which have recurred, or for those accompanied by suicidal thoughts or self-harm. These situations may require medication before therapy can be successful. Selecting a therapist first may be more appropriate when specific phobias or anxieties are the main concern, when depressions are connected to life events, or when patterns of behavior are dysfunctional." [my opinions]
Choosing a pdoc: personal recommendations help, but I'm assuming that that's not an option here. If reimbursement is a major issue, start with the insurer's list. Then decide how involved you want to be with the specifics of your treatment, since a pdoc must be willing to be more collaborative than directive with more involved pt.s.) They should be board certified in psychiatry and have expertise in psychopharmacology. (Ask if their practice includes many treatment-resistant patients--since those are more likely to require current awareness of a wider range of meds.) Other quality Qs: How do they keep current w. new meds? Affiliation w. local med school? (ex- My pdoc's part of the STAR-D research trials.) How handle btw.-visit problems or emergencies?
Personally, I require a pdoc whose expertise I can respect who will give me what I ask for or offer convincing reasons why not. I found him thru a friend's rec., but kept him because he fit my needs.Choosing a therapist: Have had several in the past, but can't afford one at present. If I could, I'd want to know: What are Th's clinical interests? Does he specialize? If so, for how long? What type of pt.s make up his practice? Professional affiliations? What treatment methods does he use most? What would be his therapeutic approach to X type of problem? And most important, of course, gut feel re potential for rapport/ mutual respect.
Hope your friend lucks out; unfortunately, there seem to be very few good ones out there.
Well wishes---medlib
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