Counseling services

[taylortotmom]

Counseling for various reasons (chronic illness, depression, and a combo of the two, etc.) has been discussed in many threads on this forum. I would like to add some information that might be beneficial. I am a former Master's level therapist and would appreciate the opportunity to explain how the "system" works and how counseling can be affordable for anyone. Okay, first Psychiatrists are MD"s and are the only mental health professionals that can prescribe medicine (legally). They are extremely expensive and almost always overbooked. Rarely do they do any substantial one on one counseling anymore. You will likely get a brief interview and a prescription if you have an appointment with a psychiatrist. A psychologist has a PHD and may do one on one counseling but USUALLY are the ones most likely to do "testing" and evaluations for severe mental disorders or learning disabilities. Again, expensive and often hard to get in as far as appointments go. Psychiatrists and psychologists are definintely crucial in the treatment of mental disorders but for us looking for long-term care for dealing with chronic illness let's move down the tiers. Now we are to the Master's level professionals. Master's level therapists and Master's level licensed Social Workers can be great resources for us. They often are supervised by either a psychologist or psychiatrist and can help you get the correct prescriptions you might need (just can't write them). The running rate is generally $50.00 for a 50 minute session. Insurance generally pays for these professionals AS LONG AS they are supervised by one of the above mentioned MD or PHD professionals. The amount of therapy required will vary from person to person and "crisis" to "crisis". You can generally expect to see your therapist at least bi-weekly and oftentimes more- at least in the beginning. Now, this is not the end of your options. Churches many times have "free" counseling for their members provided by memebers who have been trained to provide the counseling. The counselors are schooled on when it is appropriate to refer to a more skilled professional. If you live in a college town, you are in luck. Almost every university has counseling services open to the community. The fees for these are on a sliding scale and sometimes are even free- especially, if you agree to see a "student" counselor who is receiving supervised training. I would have to alert you to some things out there, however. Be cautious of church based counseling that is not "supervised" by a mental health professional or whose "counselors" have not received training on "when to refer". Non profit agencies can be good but look for the letters. In other words, make sure your "therapist" has a MINIMUM of a Master's and license (depending on your state) and is SUPERVISED by someone with more professional experience. I know this is a long thread but I think it is very relevant to dysautonomia and chronic illness. We get told we are crazy and its all in our heads all the time it is easy to dismiss the legitimate need for help when it does present. I hope this helps some of you understand what counseling is and what to be wary about. Thank you for reading.

Carmen

[briarrose]

Carmen

Thank you for the information it's very much appreciated.

Sorry, going off on a slight tangent.

I'm glad that you brought up the point that we're often told that it's in our heads or learn to deal with it because we have a chronic illness. My last primary told me that I'm like a diabetic, I have a chronic illness and need to learn to deal with it and not keep coming to him for symptoms. That was last summer when I was having problems with my vision and I finally took myself to a neurologist to get diagnosed with painless migraines with aura. Where is the medical doctors obligation to help us with new symptoms and as I told my last primary maybe it was him that needed the counselor.

I told my Endocrinologist about my primary and he said is that guy kidding? Diabetics are the ones that you have to pay close attention too because they can go bad on you fast.

I personally have seen a counselor a few times for other issues but the last time I saw him it was for a personnel issue and I brought up my illness. He told me that he thinks I should find a way to go back to school so I can have the career I want inspite of my illness. I told him how severe the fatigue and symptoms get when I'm overly tired and didn't know how I could work full time, raise my children and go back to school too. I like my counsleor very much but I also think that he has little experience with chronic illness patients.

I do think a counselor can be good for you if you agree that you need their help. I also think that it's a quick answer for a primary to pawn you off because they don't know what to do with you and lastly I think that it's the doctor's that should be counseled on a regular basis to keep them in mental check!

[taylortotmom]

Oh yeah, as a side note: part of the requirements in graduate school was to go through counseling yourself to see what it feells like on the other side of the couch. Wouldn't it be great if all med students had to have a "mystery illness" and be a "patient" while going through school. You know, the same way they make teenagers take home those fake babies to see what parenthood is like--- oh, but I digress...

Carmeni

[Poohbear]

Carmen,

Thanks for posting the info. I think we need to be really careful about this type of thing though. It all depends on a persons situation as to who is the best person to see. Psychiatrists are often not willing to sit and listen to their patients and often have huge ego's. Masters level can be a good option if you are dealing with certain issues. However, if one is needing documentation that their Psychological issues are secondary to physical illness then it's worth paying a little more for a psychologist because the insurance companies, social security and the courts brush off masters level therapists and rely most heavily on psychologists and psychiatrists.

I've also lived in many places over the past 10 years and I can tell you that NOWHERE I've lived was as cheap as $50 an hour for a masters level therapist unless it was a mental health service where they offer sliding scale fees.

I'm not discouraging anyone from getting help because there are lots of resources out there and counseling is available to all; but people do need to be careful about who they are picking, how they are supervised and what their qualificiations are.

I'm only trying to point out that sometimes people need to look at the bigger picture as well.

Yes, it would be great if Dr's could be forced to experience a mystery illness!!!!

It would also be great if they had to go a few months with no financial assistance of any kind and had to go through the process of filling out social security and insurance forms and be denied!!!!

[briarrose]

Carmen

Now were talking and what a great scenerio. Who do we need to talk to so it can be implemented into med school?

[taylortotmom]

Poohbear is right about depending on your personal situation it might be better to pay more for a PHD or MD for documentation purposes. What I am referring to is for those of us who need some long-term help dealing with the issues surrounding chronic illness. Once you get into serious mental illness, a different set of guidelines apply. One thing I left out was community mental health centers. Again, this is going to depend on where you live and your personal needs but they can be a good resource for some. There is no universal answer that is going to apply to anyone- ever. But, the other suggestions I gave are some things a lot of people might not have been aware of- I wasn't it until I worked in the field. As far as the cost, I stand by the $50.00 quote at least in the various parts of Alabama I've lived in. However, this is what a PUBLIC agency would charge- when you look at a PRIVATE agency, the cost goes up- big time. So, just some considerations. But, I still stand by my original point which is- don't let the fear of cost or inaccessibility keep you from getting help if you need it- but be careful about who you go to. Make sense?

Carmen

[Poohbear]

Makes perfect sense! And sometimes it really can be hard to find the resources in the community.

Sometimes a hospital social worker is a good person to contact too because they are often familiar with community resources but as you mention just because someone gives the referral doesn't mean it will be a good or right fit. Always look into the lic boards and try to get references.

In the past I've also picked a few I thought would be able to help me and I asked for 15-20 minutes by phone to interview before making an appt I would pay for; that way I could gain a little insight and ask questions that would pertain to me and ask about their practice, policy and procedures. My experience is they were either more than willing to talk to me a few minutes by phone first and answer some questions or they didn't call me back within a reasonable time and that told me a lot.

Definately though....sometimes depression, suicidal thoughts and other problems creep up on people and it is a matter of your life and everyone deserves treatment. You have to put yourself first in those cases and try not to worry about the finances etc. I know it's easier said then done.

[DawnA]

The high cost of liability insurance...I think has made the costs of masters level counseling go up. The going rate here in Milwaukee is $125.00 an hour. My insurance only covers 60%. My counselor is a christian counselor and she often makes deals regarding payment. She likes to see people finish therapy. Also, she has seen many people for free!! She has scratched many peoples bill out. She does this as a ministry. As you can guess she is pretty poor. Many people respect her and do a lot of things for her...but I worry about her not being able to keep her business going without much profit.

Dawn Anich