Thursday, September 17, 2009

Who Ordered Psychotherapy?


ClinkShrink and I are working on the psychotherapy chapter for our book-- so far, it's still called Off the Couch.

So Clink doesn't see patients for psychotherapy, her role has been to focus my rambling and to connect the thoughts--- I didn't know she had a talent for this, but she's good!

We started talking about how it is that one person can go to one psychiatrist and be told to come in weekly for therapy, while the same person can see another psychiatrist and be told to return in a couple of weeks for a med check without getting a recommendation for therapy. Clink asked: so where does the recommendation for therapy come from?

Does a patient want psychotherapy and look for a therapist who offers this?

Or does a patient go to a psychiatrist with a problem, get evaluated, and have psychotherapy prescribed to treat their problem just like one gets handed a prescription, as part of the package known as the treatment plan?

And what about those patients who come with preconceived ideas about what they need an unwillingness to entertain other options--so the patient who wants therapy but refuses even a trial of medications, or the patient who calls and says before they're even evaluated that they just want to be seen every three months for meds and aren't interested in talking?

I thought I'd invite you to join our conversation!