Goals in Therapy

[Peanut]

I am going to lay it all on the line (no holding back) and see what happens.

Good, I'm glad to hear that! It sounds like in terms of her effectiveness that there's nothing to lose and everything to gain from doing that!

That's awesome that you could get a referral from Dr. Baxter!

keep hoping for a different outcome each time I bring this topic up but maybe it is time for me to make a change and give up on going to a psychiatrist

Hey, I don't think it's "giving up" to just change to somenoe else. That sounds more like trying to find something that will work better!

i make a list of thing to be done and if i can get thru it, ok, of not so what , the world won't end.

That is great was to look at it! I love it too!

 

[ThatLady]

Wishing you luck, Nancy. You're trying so darned hard! You deserve someone who's willing to work with you just as hard as you're working.

 

[Holly]

Hi Nancy,
I just wanted to wish you luck, as ThatLady says you are trying very hard! That hard work will have many rewards, Take care

 

[comfortzone]

Hello All!

I know I have said this in previous posts but I feel that this thread is a good place to repeat it. When I was doing my internship for my Bachelor's degree at a local psychiatric hospital I noticed how the patients were treated by some staff as not even being there. That was all it took for me to decide not to be like those staff. I greeted every patient upon my arrival or if I met them in the hallways or elsewhere. I did not treat them like they "belonged" there. Respect is important in both directions (to and from). I believe that many of the difficulties in life started when someone "forgot" to treat another person with respect. If this happens in childhood the person grows up not being able to respect themselves. I am a firm believer in showing compassion to others and giving the gift of a smile. The administration took notice of my treatment of the patients and told me that I was a breath of fresh air. So then I decided that I was going to be a breath of fresh air in life.

When my clients have to be admitted to the hospital I tell them my perspective of them being there...I tell them this is a step forward, not a step backward. I see each of my clients as having a difficulty, not as being mentally ill. I am not minimizing the depth of their situation but I don't want to add to it by using old concepts that only stigmatize them. Each of us defined by many things...the issues that we each deal with, our gender, our pursuits are all things that describe us but are NOT the totality of our definition. We are like roses with each pettle representing each wonderful aspect of ourselves. Although some of our pasts may have not provided a similar perception of us as being worthy. Like O'Henry said, "Everyone is worth knowing." Everyone! You are and will be in my thoughts and prayers. I hope that each of you reach your therapeutic goals. I hope that you can find that which you seek. Best wishes,

 

[foghlaim]

Comfortzone: thank you for your post.. can i ask you.. how do you get a patient\client to BELIEVE that being admitted to hospital is a step forward and not backward. ??? this might be for another thread tho.. not sure. I really felt as if i had gone backward and it hurt on top of all the other things i was feeling. the only thing i know for sure is that i had to be there at the time.

nsa

 

[comfortzone]

Hi NSA,

I think it fits within the topic of goals of therapy as it might happen at one time or another. I think it how I talk to them, the tone of voice I use, the compassion in my face and voice. It is an opportunity for addressing the issues that go on in their lives, getting their medications stablized, and I tell them it is like a "regrouping." I tell my clients to put my name on their permission list so that I can contact them while they are there. I believe what happens is that when one's perception of being the hospital is negative, then their experience is likely to negative. So if I have a positive outlook for them while being there, then I hope that they can experience their stay in a more positive note. Perceptions impact beliefs. If my perception of their stay is negative, then they will more likely to be stigmatized.

If something negative does occur during their stay, then I can help them explore their feelings and thoughts about it. Not everyone's experience of hospital are going to be similar. But I try to be the same to each and everyone of my clients. I am not saying it always so easy but I do try to maintain a positive reaction to it all. Does this make sense? I think I teach my clients by modeling behaviors and perceptions. Then when they are ever hospitalized they react to it in a similar fashion as what they have learned in our sessions.

 

[foghlaim]

It is an opportunity for addressing the issues that go on in their lives, getting their medications stablized, and I tell them it is like a "regrouping."

thank you for explaining how you interact with your clients and teaching them to see hospitalization as a step forward. At least for your clients you were there for them. Not so in my case, my stay in hospital was mainly about staying alive, resting and meds, no counselling. altho as i have said elsewhere the nurses were great, some of them would make excellent psychologists.

apart from helpingme stay alive, i still see being hospitalized as a negative whic i suppose could sound like a contradiction as it did help me to stay HERE.

thanks again Comfortzone for your response and may you continue for along time being the person yu are.

 

[ThatLady]

I think, after some time has passed, you'll see the whole thing differently, nsa. I was hospitalized, as well, and I see it as a positive turning point in my life. I don't imagine I looked at it that way at the time it was going on, but I certainly do now.

 

[Halo]

Thank you all for the encouragement that I need to do the hard stuff on Wednesday. Of course now that it is drawing closer I am getting cold feet about laying all on the line. I started to try and convince myself that I am fine with her and what I have done is good enough and don't really need or want to see someone else. I know that this is just the fear of change talking. I think to myself I don't want to see anyone knew, I don't want to have to pay to see someone, I don't want to keep messing around with new meds, I just don't want to change anything. Again...lots of fear of the unknown and of change. Then I start thinking to myself..have I really given this type of therapy a shot..(mental pause)..of course I have its been 10 years and nothing really has changed except for my meds over and over and over again.

I just hope that with everyones support I will be able to get the courage up to make some major changes.

Thanks all and I am sure that I might need more reassurance of what I am doing before Wednesday.

Nancy

 

[foghlaim]

Hi Nancy: i can understand you being nervous about wednesday.. but u said it yourself, 10yrs and nothing has really changed cept for meds, time and time again.

you know it's time things changed for you in therapy situation.. so like u said in another post, bring your list of goals, lay it out in the open and tell your therapist what you need from her.

You can do this, you need to do this for YOU!!.
go for it Nancy ok.

will be thinking of you

nsa

 

[Cat Dancer]

Nancy, I just wanted you to know that you have my support.

 

[Halo]

Thanks Janet and NSA. Like I said, I am extremely nervous about bringing all the list up with her. I am also scared that she is going to say then fine...we are through and I am going to be left with no one. What if there is a waiting list somewhere else and I don't have any therapy for a long time. Then I think I have it pretty good with not having to pay for therapy and I don't really have the resources to pay if need (well I do have the resources I am just trying to make excuses). I don't know....it is like the closer it gets to Wednesday I am trying to make excuses as to why I shouldn't say anything and just go on with what I know....not having to go to that unknown place. Although now that I think about it, free therapy is good but not if it isn't working. Paying might be better...are there a lot of people out there that have to pay for their therapy. I do have health insurance but it won't cover much. Also, I don't even know what kind of therapy I need or want I just know that what I have been doing isn't working.

Then I think to myself (and I guess to all of you) is that maybe I just need to stop therapy all together. Be done with it and if needed, go back later.

Too many things to think about.

paying someone
staying in therapy or not?
waiting lists for someone new
who/what kind of person?
what kind of therapy?
where do I get my meds from?

I don't know it all sounds so overwhelming right now that I am now just wanting to cancel my appointment and think some more about it. I just don't know.

Anyway, I just needed to vent all that.
Nancy

 

[David Baxter PhD]

Remember that even if you decide you need to move on you don't have to terminate with the current psychiatrist before you find someone else. That would at least solve the problem of medications.

 

[Halo]

Remember that even if you decide you need to move on you don't have to terminate with the current psychiatrist before you find someone else. That would at least solve the problem of medications.

I guess you are right but once I make up my mind about whether to go and find someone else, should I tell her first that I am going to do that or not until after I found someone. I am so scared at the thought of all this that I am getting very anxious and sick to my stomach. Should I ask her for a referral to someone (non-psychiatrist) or find someone on my own. I do have to be careful of who I can go to as I would not want to see someone who has had dealings with work company.

This almost sounds like too much.....but I know that it is what is best for me. I keep trying to hold onto that thought. Best for me, best for me.

Nancy

 

[David Baxter PhD]

First, what I am trying to say is that you can make up your mind about what you want to do after seeing her reaction to your questions. That doesn't obligate you to tell her that you're leaving her, if that's your decision, not does it obligate you to terminate with her before you have an appointment with someone else.

There are other options for medication, of course. Your family doctor may be willing and able to continue to prescribe the medications - perhaps you can talk to him/her first. Your family doctor would also be the best person usually to make a referral to a new psychiatrist, if that's your decision.

I'm sure you're aware that getting to see a psychiatrist is a long and difficult process in Ottawa. It's not unusual for that to take months. That's partly why I'm suggesting you not terminate with your current one before finding another one... That's simply the sad reality of the state of mental health services in this province.

 

[Halo]

Thanks Dr. B for your response.

I guess that I could probably go to my family doctor for my meds but I guess that would mean that I would have to catch him up on my status. I have not discussed my mental health with him in a number of years. I am actually fearful of going to him for a number of reasons (of which I will not discuss here).

As for seeing another psychiatrist...I really don't think that that is the route that I am seeking. If and when I decide to leave my current psychiatrist, I will look for an alternate avenue as I have been through a number of them here in Ottawa and they all tend to work the same, I talk and talk and talk and they prescribe, prescribe, prescribe. I want to do something that instead of focusing on the meds we can focus the issues that I have and what I can do to overcome and move past them. To change my way of thinking and lead a healthier life without having to escape that is my ultimate goal. When I say that I escape I don't just want to be pushed with more meds. Meds isn't the only thing that is going to make me stop.

I think that I really know what I want to do but the hard part is going to be verbalizing what I want and need to her.

Dr. B. in your professional opinion would a psychologist, counsellor or social worker be better for this type of therapy? If you can't answer that than I completely understand. I am just nervous about my history and current status being too overwhelming for someone who is not experienced.

Anyway, thanks for your help.
Nancy

 

[Halo]

If anyone else has any input.....it would be appreciated.

Thanks all.

Nancy

 

[David Baxter PhD]

Quite honestly, Nancy, I don't think all the best therapists are necessarily psychologists but I do think that's probably your best bet.

That said, there is another factor here. You're right - medication isn't the only answer for you. But I'm assuming you do need to continue the meds you're taking currently, at least for the time being. You will need some sort of physician to do that - if you have a psychiatrist who you see periodically who monitors and prescribes those medications, then maybe an option is to see someone else for psychotherapy and simply continue your visits with your psychiatrist to deal with the medication issues. That's not an unusual arrangement at all, perhaps especially in Ottawa where many psychiatrists don't seem to do psychotherpay per se. If you don't see that as an option, you will need to either make an arrangement with your family doctor or try to find another family doctor - that of course is another nightmare with the current state of medical resources in Ontario.

 

[Peanut]

If anyone else has any input.....it would be appreciated.

Hi Nancy! I'm not supposed to be on here right now but I thought (since you asked) I would give you my input! I can tell you are really agonizing over this and I really feel for you! If I were you I think I would keep the current psychiatrist for medication, find a psychologist that you like (and I would take Dr. Baxter up on his referral offer) and start working with the psychologist. If it starts going well then the psychologist could probably help you figure out what to do from there (I.e. change to getting the meds from your regular doctor or find a new doctor or whatever). You don't have to navigate through this whole process by yourself right at this moment (I mean clearly you are not alone here but I mean in terms of planning this all out). From your posts it does not really seem like you feel very good about your therapeutic relationship with your current doctor and that is a big barrier to accomplishing what you are hoping to in therapy.

FYI before I found my current psychologist I mistakenly went to a psychiatrist, all he wanted to talk about was medication even though I didn't want any. Then I went to a social worker (one time) and that was bizarre to say the least (not that they all are but this one was). At that time Dr. Baxter suggested to me also that a psychologist would likely be a better fit and he was right.

I think like Dr. B said, it's not like one group is all really good and the other is not but I agree that likely the best choice for what you want is a psychologist.

Well there's my totally uninformed opinion! Sorry you asked?!

 

[Halo]

Toeless

I am not sorry at all that I asked. I am always hoping for more and more opinions on this. Although Dr. B. has given some great advice and insight into the situation. I just know that I am getting closer to Wednesday when I think that I need to verbalize what my thoughts and feelings are and what I need to do for myself. As you can probably tell I am not good at saying things that I think are going to hurt peoples feelings. Although I have been reassured that stating what I need (even if it is not therapy with the current person) is quite common. I too think that a psychologist is probably the best route for me and I will definitely take Dr. B. up on his offer.

Of course I know that if I went to my family doctor he would most definitely give me renews on my meds but he is not that experienced with the mental health field and really doesn't know what kind of meds I have and have not tried. But I do like the option of keeping my current psychiatrist if only for med issues.

Thank you both for responding and trying to alleviate my fears. I owe you both a lot. Of course this doesn't mean that tomorrow or even Wednesday morning are going to be any less anxious for me and I will probably drive you guys up the wall but I know myself and if I try to ignore the feelings and anxious feeling that I have then I will end up not saying anything when I go to see her on Wednesday.

Thanks again.
Nancy