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crispturquoisewater · 4 years

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Another day, another battle...

I constantly find myself astounded at the gaslighting that goes on from the doctors at my surgery. It’s absolutely shocking, and has recently brought to my mind the podcast ‘Dr Death’. When listening to this podcast, as a naive listener, you think ‘how could this guy possibly get away with this for so long?!’ But it’s simple really, doctors stick together and belittle patients. So, any complaint that is raised is dissolved or made to be the patient’s ‘mosunderstanding’ and is flung carelessly into the ether.

Yesterday, I called the surgery and spoke to one of the new doctors. I had to request repeat blood test (which were already requested on the letter from hospital for the surgery to carry out but of course that doesn’t happen without having to make an appointment). I mentioned that at the weekend, whilst bleeding profusely and in agonising pain in my kidneys, I didn’t know what to do. I received no answer or advice. I said that I’m waiting for a referral for nephrology, but that doctor X had refused to make the referral because he said that it wasn’t his job and that he wanted to make a point that the hospital could not “workload shift”. Immediately, this new doctor jumped in and “explained” (like I’m fucking incompetent) what doctor X meant by his comments, and that actually he was saying that it was quicker for the referral to be done in-house and that it would be easier for me if it was done this way (queue internal scream of utter fucking frustration!).

Firstly, do not patronise me. I am a grown women who, despite everything I am going through, is perfectly competent and reasonable - unlike like the doctors at my practice. Secondly, how unfathomable that a doctor that was not a part of the conversation thinks she has any right to tell me what was actually said(?! Arghhhh!!).

As much as I was infuriated by her blatant attempt to manipulate and dismiss what doctor X had so clearly said (I still find it astonishing that a doctor would try and tell someone else what happened in a conversation that they were not present in - she didn’t even say, ‘I think what he meant was’... just flat out gaslighted me. Nope, no denying it, he called the hospital lazy, was furious that they hadn’t done their job, and was perfectly happy to see his patient suffer in pain, rather than make the referral, in order to prove a point, because they “had to learn”. Narcissism at its finest), I still kept my cool and was polite and explained that he was clear in what he so emphatically and angrily stated. What I wanted to say was, how the hell do you think you know what was said or meant? But I didn’t. She then went on to try and patronise me further by explaining how the system works. I’m very clear on how the system works. For a period of time - not so long ago - I worked in an area of the NHS. I know perfectly well how the system works, but it incredibly concerning that they do not. However, brilliant to know that they are ignoring patients’ requests, and filling their responses with a load of infantile lies.

It may seem like nothing important, but this constant belittling is having a massive affect on my self-worth and self-belief. I try not to let their gaslighting affect me, but it does. Massively. As I am sure is the point. After all, if you continue to feel worthless or lacking in self-confidence, you will stop pushing for the treatment you deserve.

After we’d moved on from that, I asked to be referred to physiotherapy. I’ve got osteoarthritis, and due to severe bone pain and joint swelling, I can barely walk anymore - even around my apartment - and I desperately need someone to look at me, and help me. For a normal surgery, this should be simple. You have a physical problem including joint pain and muscle weakness, you get referred to physio. The fact that I cannot walk properly, and barely at all anymore due to the pain in my feet being so severe, is not normal. I have been reporting worsening bone pain and swollen joints for six months.

At the end of December I insisted on actually being seen in practice because the pain in my lower back and legs was so severe (they still weren’t seeing anyone due to covid). The doctor openly mocked me, asked me no questions about how long id had the pain (even though I’d reported it multiple times), told me that she “does yoga”, like I was lazy and not helping myself (I’d actually started physio of my own from watching videos to try and help myself), and told me that MRIs were SOLELY used if a patient was considering neurosurgery and not for any other reason (🥴 I’d asked for an MRI because the pain in my spine and hips were so bad and had been progressing for four months. I was at the point of not being able to sleep or stand for long properly). Actually (as well as arthritis), what that SEVERE pain turned out to be, was adrenal crisis. My cortisol levels was so low that it was (as the A&E doctor put it), barely existent. And all the symptoms I was reporting were clearly it.

I don’t mind a doctor not knowing something - they clearly are not trained in everything - but please do not mock me or make me out to be a hypochondriac without even looking into it or trying to find out. I came away from that appointment distraught at being belittled, again. Oddly, when I found out that I had adrenal insufficiency, I actually felt vindicated, because I think their attitude towards actually made had started to make me doubt myself.

I truly feel for people who present with traumatic symptoms of mental illness. My symptoms are physical. My bloods are showing issues. Im pissing blood. I’m unable to walk properly or without pain, and yet I am STILL being treated as though I am making the seriousness of this up. I can only imagine how harrowing it must be when there is nothing physical to show. And my heart goes out to you. I’ve spoken to friends who have been mocked or belittled by doctors over their mental health. Im so sorry they do this to you, and us. They are definitely in the wrong profession. The one they must switch to is the Narcissistic House of Disbelief.

Anyhoo, I digress.

So, what should have been a simple request for referral, turned into another battle. The doctor will not refer me until she gets my latest bloods back. And then she will decide if she deems it worthy of me to see a physio. I am in so much pain I can’t describe. How is it that our health is at the mercy of these people?

So, now, almost totally unable to walk because any pressure on my feet is so agonising, and my knees are ankles are so swollen (I’m vegan and eat a healthy diet, this is not excess salt or fats), I am left, yet again, in pain and without a referral.

It’s utterly exasperating. Totally and utterly exasperating, and draining, and mentally, emotionally and physically horrendous, which counteracts my ability to get better, because I end up facing a constant stress from the people that are supposed to help. And stress makes the symptoms worse.

Yesterday, after this agonising call with the doctor, after which I thanked her for her time (despite feeling despair inside - no need for me to be rude, even though the anxiety of each call with that surgery knaws like a ball inside my gut), I had to call the hospital to see if the referral had been made their end (it hasn’t - they simply sent the same letter back to surgery), had to call a different part of the hospital to see if the bloods had been put on the system and then call the blood department to make the booking. That was aside from five other phone calls chasing things. Being ill is a full-time job. And not made easier by doctors with inflated egos who believe they are untouchable.

If you haven’t listened to Dr Death, listen to it. It’s very easy in this situation to believe that this is only happening to you. But it isn’t. My surgery has a 2 star rating. That is testament to the fact that this is not just happening to me. But who will change it? No one, likely. Because complaints are buried. Patients are ignored. And you’re made out to be a complete crazy who somehow, and for reason, wants to be sick.

And why don’t I change? Because my illness is complex, and I don’t have the strength to start again. Also, I don’t believe that any other surgery will be any better. If it’s anything more than a cough and cold, they don’t want to know. Actual doctoring rarely goes on.

I want to finish this blog with a praise to doctors in A&E. because my surgery refuse to look at issues or pay attention to serious problems, it forces patients to go to A&E - because they’re not overstretched and exhausted enough already. Due to having a reaction to my new medication, I ended up there two weeks ago. And the doctors and team were fantastic. I was there seven hours, but I never, ever moan about the wait. These people are inundated with cases. And the reason it took so long is because I had to wait to see a specialist medical team once my bloods had come back. But, throughout, I was treated with respect and dignity, and left feeling assured that I was okay.

Respect and dignity should be a given, however, unfortunately, so often it is not. I do believe some doctors that have been practising for a long time believe themselves to be untouchable, and that is a dangerous precedent to set. But unfortunately, I believe it is one that rings true far often than anyone would like to admit.

Maybe if I was a man, and spoke to them with rage, I would receive a different result. It’s amazing how respect is expected one way, and not the other.

Is the NHS sexist? I think so...

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dlinnettetheauthor · 5 years

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Seeing The Signs Of Mental Health Crisis

MIBlog

I was reading a article on Facebook about a 17-year old boy who committed suicide by train just recently. Then I clicked on the recorded live feed from the young man’s mother. She was of course distraught over what happened to her son and she outlined the events leading up to her son’s untimely demise. She said that she and her kids were homeless and had just gotten a motel room. Let me back up. This young man was a well sought after college acceptance football star. He was scheduled to start college this month. He had graduated from high school early. Even though he was a promising rising football star, he was also encountering the stresses of his home life - of his siblings and mother being homeless, and he didn’t want to leave them in that predicament while he chased his dreams. He felt he was being selfish to do so. Him having a roof over his head and enjoying college while his family is back home suffering, his mother also noted that he had a dysfunctional relationship with his father whom he spoke to days before he took his life and the conversation did not end well. His mother recounted how his son came to her the last few days asking a lot of questions about life and religion. His mother said that he was stressing her out with all that talk while she was battling her own stresses trying to get a roof put over her family’s head. She said that she told her son to ‘toughen up’ and fight the battle within. She knew he was in pain and suffering, but she was not able to help because she was battling her own fight within.

Did this up and coming young man’s mother and siblings and family and friends see the signs? The mother said she did, but mentally was not able to help him because she couldn’t even help herself. The mother did say that she asked for help for months. Help with finding housing and finances? Help for her son and for herself? I don’t know, but she said she did ask for help. But, she also said that her son was a happy young man who was excited to start college and get his football career going.

Seeing the signs of mental illness and knowing when to seek help is still a big problem. It is a big problem because even though parent’s, spouse, friends, family member’s SEE that their loved one is going through some sort of pain, they are often told, “Get over it!”, “Everyone has issues!”, “Toughen Up”, “Fight it off!”, “You have so much to look forward to”, “I have my own problems”.

What we ought to say is, “Can I help you get some mental help?, it is nothing to be ashamed of, I want you to be happy and whole, so maybe you should talk to someone”, “I’ll help you”.

The mental health stigma has to end, otherwise young people like this young man will prematurely end their life before they can even get a glimpse of their blessed destiny. I thought to myself that the way the article explained this young man’s potential, that he may have went on to the NFL.

I, like the single parent mother dealt with a lot of stresses in my life too raising kids. Struggling to pay bills to keep a roof over my kids head. Eventually becoming homeless with my teenage son at the time, and us driving around in my car with no money not knowing what to do next until a former church member from a church I used to attend let us stay with her for two weeks. My son already diagnosed with mental illness had to endure my struggles. He didn’t know where we were going from that point. He was still a minor and I was responsible for him, even when he turned 18, I was still responsible for him because he had a disability. I thank God that we made it through. I was stressed out and diagnosed with my own mental illness as well. Anxiety, Depression, and later on Bipolar.

It is very difficult when both you and your loved one has a mental illness. It is even more difficult when you don’t have support from your family because they just don’t understand mental illness. You are left alone to deal with it; and you do not even have the mental capacity to give your suffering child your FULL attention. This mother did her best, she kept her children close and her son was an aspiring football player. She said she asked for help, and again I wonder was it for housing, financial, and mental help?? She said that although she had a job, the job wasn’t paying her on time.

The mother probably didn’t think her son needed mental help because he was scheduled to leave for college. But in the days before, she said that he said that he saw signs and symbols all over the place and was asking her questions non-stop. The stress of leaving his family and starting his life on his own could have pushed him over his tipping point. He did let his mother know he was “Seeing Things”, which is one of the main questions a mental health provider will ask you, “Are you or have you experienced ‘Seeing Things or Hearing Things’?”, “Are you or have you been suicidal?”, “Are you thinking about harming yourself or someone else?”.

I cannot fathom what they were going through, but I wished she would of taken him to the hospital and said that he was experiencing a mental health crisis and so was she. The hospital would have done a mental health evaluation. At the time her son as she thought was not in immediate danger therefore she did not dial 911 and ask for a CIT officer (Police Crisis Intervention Team who are trained and specializes in 911 mental health crises). You have to ask for a CIT officer!! If she wasn’t in immediate danger herself and she took her son to the hospital, I wish she could of said that she was very stressed out too and needed someone to talk to, and the hospital could have given her referrals or did a mental evaluation on her also.

As for her kids, she did mention that she had kids older than her 17-year old son that were homeless staying with her, and if she had kids younger than that maybe they could have watched them while she sought help.

We must learn from her story and when somebody reaches out to social services, mental health organizations, non-profit organizations that help the homeless,and shelters, PLEASE HELP THEM!!!! Often times families in crisis are turned away and that is sad.

If that happens, keep a list and write complaints later. They have to live up to their company’s mission statement. If an organization say’s they are there to help then HELP!! It is however hard to go to a shelter when you have teenage and young adults--18-21 sons, and want to keep your family together because the shelter system is not set up that way. A single parent mother can have a minor son stay in the shelter with them up until the age of 13. Daughter’s up until the age of 18. So I can see why the mother may not have went that route.

I know there are a lot of crisis number’s out there, but there has to be an easier number to remember other than 911 unless it is an emergency. But, if you know you and your family needs crisis intervention, there has to be an easier number. The mother probably couldn’t think of a number to call other than 911.

That is why we have to advocate and fund raise more for mental health resources and homelessness resources.

This mother now has over $100,000 in gofundme funds. A little too late :(

Please do your proactive research and make a list of local mental health behavioral health organizations and non-profits. Write down the 1-800 suicide prevention numbers. Write down the local mobile crisis number. Go talk to one of them. If you don’t have insurance, most will refer you to a non-profit that helps with that. If you are turned away from one try another. A great place to start is NAMI.org. It is a national non-profit that works to advocate for mental illness. And some of their local numbers may ask you to leave a message, but will always say to call 911 in case of emergency which in that case you would ask for a CIT officer!! Leave a message. The NAMI in my local area sometimes got right back to me. They are volunteered staff and they will help you. If they do not respond within 24-hours, call again. Call the national number. All the information can be found on their website. If you have insurance or medicaid, a behavioral health number or agency name is listed. Look them up and call them.

If you see the signs, do something for your child, loved one, friend. If you know your depressed get yourself help too. Help is out there!!!! Don’t be afraid to seek help. Some great organizations helped me along the way and a few didn’t. But, I have the power of the pen, and their is always someone at the top of the chain that you can write to or call. That is a way to advocate.

This young man who was on his way to college probably didn’t want to tell anyone other than his mother what he was going through for fear he might get turned away from college or something. We as adults have to have these conversations with our children about how to reach out in case of crisis, the same way as we taught them about the birds and the bees. Mom’s we are mom’s and we have to turn into mental mamma bear sometimes when there is no one else. Prayers are up for the family!!!!!

#mentalhealthcrisis gethelp endthestigma helptheyouthreachoutinmentalhealthcrisisandlistentothem advocate

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meandmybumble · 8 years

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My head is a terrifyingly dangerous place at the minute. I am not even slightly ok.

Everything has snowballed and instead of everything in the world giving me anxiety and fear that I can kind of cope with and ignore by obliviously entering into a self destructive dissociative phase, I am so absolutely crippled by fear and “what ifs.”

I am so scared that I am “mental” and that every single bad thing that has happened to me (and let’s be frank my entire life has been a series of damaging, traumatising events) is a result of my mental-ness and that I deserve for those things to have happened. I’m terrified of that. I can’t explain how terrified I am. Not just because of how it will make me see myself but because then others will also think I am just a mental case who makes the bad things happen.

Obviously because I am definitely clearly crazy, obsessing over being crazy isn’t enough. I am plagued with worry and fear stressing that maybe I am not even mental at all and I am inventing all of this for attention and drama (two things I hate and strive to avoid more than anything) and I am paralysed with the fear of looking overdramatic and ridiculously humiliated when a Dr of some sort tells me I am absolutely fine and that I’m inventing all of this.

I am also terrified of being misunderstood and misdiagnosed by Drs because my head is so messy I can’t organise my thoughts enough to give accurate symptoms and examples of these plus also the fear of things not actually being true and that I’ve invented them. Which then leads me to be terrified that I’ll be given the wrong medication or the wrong course of treatment and that I will not only never get better but that I’ll get worse. This has lead me to overanalyse every single thing I do and say. Am I acting normal? Is this a symptom? Am I pushing people away? Fuck sake alesia stop rambling on incessantly because nobody cares…WHY ARE YOU STILL TALKING… YOURE MAKING A FOOL OF YOURSELF AND YOU WONDER WHY YOU ARE NOT WORTHY OF LOVE AND AFFECTION…JUST SHUT UP!

I am equally terrified of both being crazy and of not being crazy that I am abso-fucking-lutely making myself crazy/crazier than I have ever been.

I am terrified of being diagnosed with a mental illness most likely brought on by “childhood neglect and abuse” because even though I had a bad childhood, I was loved in the best way my parents could given everything that was going on (mostly my dad’s drug addiction and paranoid schizophrenia and the stillbirth of my baby brother that neither of my parents recovered from) but to ever have to tell my mum that or to have her Google whatever diagnosis I may or may not get and read that breaks my heart. I am scared of how my mum will react to my mental-ness because I don’t ever want her to feel like it is her fault that I am a terrible crazy person because it is my fault, my battle, my guilt and my shame to bear- nobody else’s. I’m also terrified of having to be completely dependent on medication because I am terrified my mum will think less of me as a person and because I will feel less of me as a person. Can you tell from my history of child neglect and abuse that all I have ever wanted is real love and approval from my mother???

I am scared that I am a terrible, toxic mental case and that I am poisonous to people around me. I am currently going through yet another phase of ignoring everyone that cares about me cos I don’t want to break them, bore them, annoy them. Also because I just cannot physically believe on any level that anybody actually genuinely cares about me purely because they just fucking care. My friends are telling me they’re struggling with things or need help/advice and I can’t even bear to be there for them because I am terrified to absolutely epic proportions that my thoughts/opinions/advice are mental and not healthy or helpful at all and I’m scared of hurting my friends or putting them into bad situations because they listened to my mental advice.

I’m scared that I will lose my job. I like this job and the people. But I am scared that either I will convince myself everyone hates me and quit feeling quite justified because everyone treat me like dirt or I will have some sort of a breakdown on shift in front of everyone and everyone will see how mental I am. I’m scared that if I get diagnosed with some condition or other that it will (rightly so) make my bosses see me differently if I tell them. Yet I am also worried that if I was to keep it a secret I’d be lying and deceiving them. I’m struggling with that right now- I feel like I’m deceiving them by not being honest (not in detail but ya know addressing the fact I’m clearly going through a dark, spiralling mental breakdown and damaging identity crisis)

As if worrying about everything isn’t bad enough. I am worrying about everything and also things I am imagining and then to really make sure I’m suffering as much as I deserve to suffer, I’m worrying about every single possible outcome/eventuality and even every single impossible outcome and eventuality.

I can’t make it stop. I’m so scared of feeling like this for the next X amount of months because the NHS massively massively fails people with mental health issues. I went to the Drs on Monday because I’m at such a LOW DESTRUCTIVE POINT that I’ve finally stopped ignoring and pretending that I don’t need help. I need help and I need it pronto. So the dr gave me absolutely no advice or information, no reassurance, no fucking drugs and told me he’d send an “urgent referral” I can only presume this is to a psychiatry team to assess my crazy properly. Only I have to wait up to 4 weeks and if I don’t receive anything my dr will send another URGENT referral and I am, again, to wait up to 4 more weeks in the highly probable case that this letter never shows up. And then it could be anywhere between weeks and months to the actual appointment date I’m terrified I’ll never actually receive. Last year I was referred for therapy and I’m still waiting for that letter.

I’m worried that I will feel like this, so full and heavy with worry and fear that I can barely get out of bed or leave my house, for the months it is probably going to take for me to be seen. I’m scared of feeling this way for so long because I literally cannot cope and it has only been 6 days. But then I’m scared that I won’t feel this way when the appt comes. What if I feel fine and happy and cannot even recall the bad things that happen/that I think that mean I can’t live any form of life? This just reinforces my fear of not actually being crazy at all. What if I convince myself I’m fine and normal and don’t even go to the appointment?

I’m scared. I’m terrified. I’m already picking apart every part of my “personality” because I do not know who I am but that certain aspects of my personality are actually just intense symptoms that I never knew were symptoms such as my crippling empathy for everyone and everything or the bouts of uncontrollable intense passion I have for things.

I’m scared that I’ve been like this forever so I rack my brain constantly all day every day trying to pinpoint a time I was normal. Trying to figure out if things “trigger” my episodes or if I just live continuously changing between episodes without any normality at all. Trying to work out if I’m normal right now or if this is some sort of episode. And yes, obviously this makes me terrified that I AM ABSOLUTELY 100% NORMAL STOP TRYING TO MAKE YOURSELF CRAZY YOU ARE A TERRIBLE ATTENTION SEEKING DRAMA QUEEN.

I just can’t stop being scared and worrying about every single little thing to the point I am inventing things to drain all my energy worrying about as if I don’t have enough genuine “normal” worries I should be focussing on and fixing.

And then on top of all of this- this post just being a mere few of the things flying round my head- I am absolutely paralysed with fear that I will get Annie taken away from me. I hate myself for ever going to the Drs or for actually telling people what I was going through last week because now I am accountable. Now I have to take steps to find out whether or not I’m absolutely bonkers and they are going to take my only piece of love and happiness away from me because I am bad for her. I am a bad mum and I am going to destroy her mind. Which then leads to me being absolutely certain that I am bad for her and that she would be better off with anyone other than me.

How do I make this stop? I can’t stop. All of this and more is spinning round literally every waking moment. Every day I wake up and think “this is it I’ve hit rock bottom” and then I break even more and find more things to worry about. I am scared of what rock bottom actually will mean for me.

#mental health #mental breakdown #broken #worry #fear #stress

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steven-heisler-law-firm · 4 years

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Ellen Platt: Why You Need a Geriatric Case Manager For Your Loved One

About Ellen: Ms. Platt is founder and owner of The Option Group, LLC. Her team conducts comprehensive evaluations, makes recommendations, implements a plan of care and coordinates resources to support it. They provide a thorough knowledge of the healthcare industry and can help families skillfully navigate the maze. Additionally, they provide advocacy services and can assist with care in the home or placement in a facility. Ongoing monitoring can also be set up so that the most appropriate plan of care can be implemented at all times and changes can be made to address changes in condition and avoid crises. The goal is to identify ways to enhance the quality of life for the clients she serves, in the safest, yet least restrictive environment possible, taking safety, independence, function, and comfort levels into consideration.

Ellen is both a Certified Rehabilitation Counselor, and a Certified Professional Geriatric/Aging LifeCare Manager, with a span of 30 years providing care management and case coordination services to those with catastrophic injury, chronic diseases and disabilities. Out of that experience, she created The Option Group to address similar needs and services specifically for seniors or those with special conditions and their family caregivers and guardians. Her primary practice focuses on working with caregivers and aging families and the large variety of issues and needs specific to that population.

In this episode, Steve and Ellen discuss:

1. Ellen, can you tell our listeners what a geriatric care manager does?

Care managers cover a wide variety of tasks. We help people navigate longevity, whatever that means for them, we go to the person where they are in that stage of life, and we help them navigate the system. It’s really a holistic, client centered approach of caring for people. We look out for people with a variety of health challenges. We’ll do an assessment. We’ll make recommendations for care and come up with an individualized care plan. Then we monitor it and tweak it to make sure that it’s meeting their needs and we also do some health, education, advocacy, family coaching, and crisis intervention. So we cover a wide scope of variety of tasks and a variety of people in situations.

2. Would it be correct to say that you are geriatric care managers, more focused on seniors and the elderly?

We do a lot of work with seniors in cognitive or physical decline but we also utilize our team to help younger people with M.S., mental health issues, traumatic brain injury, or catastrophic injury. People with these issues still need an advocate and someone to help them navigate the resources and their care.

3. What issues, would you say, are generally the most important to the senior and elderly community?

One of the biggest things is that people want to know what their options are, understand the options, given their situation, and they want to understand why they might pick one over the other. We’re able to educate them, give them ideas of what the options are, what the costs associated with those options are, and they know who is paying for it. Is it an insurance paid benefit, or is it something that they’re paying out of pocket? We’re helping them to pull together this holistic care plan and create a solution that’s going to help them remain safe, as independent as possible, functioning as well as they can, and maintaining their dignity in the process.

4. What are some of the significant injuries that you deal with and see the most?

With an aging population, we see all different types of dementia, Parkinson’s, or stroke tend to happen more frequently with people who are advanced in age. We also deal with folks who have had traumatic brain injuries, concussions, a medical malpractice case, catastrophic injury that left them with significant residual disabilities, or they sustained a permanent injury of some type and now they need to reclaim their lives and have the best quality of life possible and function as well as they can give in their new circumstances. So they often need some help navigating that process.

5. At what point during the process does either a senior, an injured individual or their family contact a certified geriatric manager after a catastrophic injury?

People are often contacting us when there’s been a crisis and they don’t know how to navigate the various systems involved. We often are able to jump in pretty quickly to do that assessment and come up with recommendations and stabilize the situation. First thing we address is safety issues. Then we also look short term, then ideally, long term. So that’s where we come in with that full assessment, looking at the clinical picture, and figuring out what it is they need and care managers really have eight core areas of expertise that we work within. We navigate health care for people, look at the clinical picture of their health and disability, the financial picture, their housing situation, advocacy, and we look at their legal documents to make sure that they have their planning documents in place. We often do crisis intervention. Ideally, we’d like to be called before the crisis so that we can do some planning and they have some options in place.

6. What are some examples of crises that you see a lot?

Often we’ll see a husband and a wife living together and maybe one spouse has a lot of physical disability and there’s another spouse that has the cognitive disability. And together they make one person but if something happens to one of them, things start unraveling quickly prior to that they were compensating for each other’s difficulties and were able to maintain their living situation. But if something happens to that it topples pretty quickly. And families are looking to us to help. Right things.

7. If someone reached out to a geriatric care manager would they provide someone who would be able to step in and make sure that everything financially in a household is kept up to speed?

Yes, exactly. We would be able to link them with somebody who would be able to step in quickly and be able to keep them fiscally organized, make sure that they’re not receiving collections notices, or getting things ready for their accountant.

8. What’s the important part of consulting with a geriatric care manager before a loved one is placed in a nursing home?

Many times people say they want to stay at home. We’re able to help them bring in resources and services and put in that infrastructure that allows someone to stay at home longer. Sometimes there are situations where it’s going to either make more financial sense, or they have certain needs that need a special level of care on a consistent basis that you’re not able to establish in the home. We would then help them navigate to a facility. Working with a care manager, you have somebody who knows the systems, knows the local resources, and can look at the clinical picture and find a care facility that is going to support their particular needs. The care managers can help with all the paperwork and the legwork needed to be able to move into a facility. We also work to help set up the expectations with the care facility and how we expect the care to be provided to this individual.

9. What is the difference between what a geriatric care manager does as compared to a placement agency?

The primary difference between us and a placement agency is our payment source. We don’t get any payments whatsoever from our referral sources, whether we’re referring them to facilities or home care agencies, or other senior services. So there’s no temptation or no tendency to see things from a financial perspective of where that person is going to go for their care.

Care managers also work across the continuum of care. It could be somebody who’s independent, somebody who needs assisted living memory care, or skilled nursing so we can work in any level of care all the way through end of life. When you use a certified care manager, you’re getting someone that has a master’s level education and they’re held to a code of ethics. They have ongoing peer review meetings and ongoing continuing educational requirements so that they’re staying on top of the latest information. Care managers will work directly with the client and the family and are really their advocates. Our concern is the clients best interest.

10. Is a placement agency always going to place a patient in the best possible place for their needs?

You want somebody with a minimum standard and code of ethics that really understands the resources and the various systems out there to be placing an individual into the proper facility for them.

11. What is the most important thing for a geriatric care manager to do for a senior or elderly individual who has just sustained a catastrophic spinal injury?

In an incident like that, we would probably use a catastrophic case manager, a nurse case manager that we would have because they would be more in tune with the medical issues that are involved with a spinal cord injury.

That case manager would be getting the information from the physicians, the hospital, discharge records, and health history information to really understand the injury itself and how any underlying conditions may impact that injury.

12. Would a nurse case manager go with the individual to their medical appointments, review records, and keep an eye on what’s going on to make sure they’re getting the best possible care?

They do a lot of medical care coordination. They may even be doing things like scheduling appointments, requesting medical records, taking them to get imaging, coordinating surgery, and being there the day of surgery so we can do some really hands on stuff.

13. Do nurse case managers have a specialty like orthopedic injuries?

Yes, that’s possible.

14. Is it correct that another catastrophic injury that you might see a lot is traumatic brain injury?

Yeah, especially when in a sports world. We do work with some professional sports teams that have issues with head injury and concussion, and then older sports retired players who need assistance with coordinating their care as maybe they have dementia developing or other medical conditions and they need they have special circumstances that we need to help navigate.

15. Can you work with older individuals who have had sports injuries earlier in their lives?

Yes, and many of them need help navigating because they’re no longer able to do it for themselves. If you think about it, whether it’s football, rugby, soccer, ice hockey, boxing, there’s all different sports, where people are sustaining head injuries and over time, they may have some special circumstances arise.

16. When are you brought in to handle care for a patient with dementia?

In the instance of dementia, often people have symptoms or issues relating to dementia, possibly even 10 years before they actually get a diagnosis. It might be mild forgetfulness, it might be getting lost in a familiar area while they’re driving their car, it might be starting to forget names, more than just the typical stuff you see with aging, it becomes problematic and that’s when we get the call. It becomes problematic and difficult for somebody or the family to function given the person’s new ability or declining ability to function independently. That’s typically when we get the call and when services will be started because that’s when they’re really noticing it.

17. Are you brought in when you have individuals who might have gotten a clostridium difficile infection, pneumonia, or sepsis?

We do, but that is generally secondary to something else going on. Or while we’re managing their care, they get an infection. For instance, it may be because they have a catheter, they get a urinary tract infection, maybe pneumonia, maybe they have swallowing issues, and they have aspirated and it leads to pneumonia. So those are conditions that we’re always keeping our antenna up on. That’s not typically why we’re called but it definitely is something that needs to be watched.

18. What other professionals would you make part of your team in a situation where you had a senior or elder with catastrophic injury or dementia?

We could bring in a Certified Daily Money Manager to keep them fiscally organized on a day to day basis, a professional called a Senior Move Manager who can help coordinate and orchestrate a move from beginning to end, and a home care company to bring in all the hands on caregivers that are going to help with those activities of daily living. We also put into place systems for medication management, transportation, housekeeping, meal planning, and cooking.

“When you use a certified care manager, you’re getting someone that has a master’s level education and they’re held to a code of ethics.” — Ellen Platt

To find out more about the National Injured Senior Law Center or to set up a free consultation go to https://www.injuredseniorhotline.com/ or call 855-622-6530

Connect with Ellen Platt:

Website: Aging Lifecare Association LinkedIn: Ellen Platt Email: [email protected] Phone: 410-667-0266

CONNECT WITH STEVE H. HEISLER:

Website: http://www.injuredseniorhotline.com Facebook: https://www.facebook.com/attorneysteveheisler/ LinkedIn: https://www.linkedin.com/company/the-law-offices-of-steven-h.-heisler/about/ Email: [email protected]

Show notes by Podcastologist: Kristen Braun

Audio production by Turnkey Podcast Productions. You’re the expert. Your podcast will prove it.

The post Ellen Platt: Why You Need a Geriatric Case Manager For Your Loved One appeared first on The Maryland Injury Lawyer.

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brentrogers · 4 years

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Podcast: Police Response to Quarantined Mental Health Crisis

What happens when the police are called to handle a mental health emergency? And is the current coronavirus pandemic affecting their response? In today’s podcast, Gabe interviews Sergeant Matt Harris, a supervisor in the Mobile Crisis Response Unit at the Columbus, Ohio Police Department, to shed some light on an officer’s point of view during a mental health call. Sgt. Harris shares his crisis team’s typical protocol during one of these calls and describes what they do when things don’t go as planned.

How does the team handle psychosis? Is a mentally ill person ever taken to jail? Is the COVID-19 quarantine having an effect on the number of calls they receive? Join us to hear the answers to these questions and more.

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Guest information for ‘Matt Harris- CIT’ Podcast Episode

Matt Harris is a sergeant with the Columbus, Ohio, Division of Police and has been with the department for 22 years. He is currently assigned to the Mobile Crisis Response Unit where he supervises 5 police officers who co-respond to mental health crisis situations along with a social worker, licensed professional counselor, or other mental health clinician.

About The Psych Central Podcast Host

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from the author. To learn more about Gabe, please visit his website, gabehoward.com.

Computer Generated Transcript for ‘Matt Harris- CIT’ Episode

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to the Psych Central Podcast, where guest experts in the field of psychology and mental health share thought-provoking information using plain, everyday language. Here’s your host, Gabe Howard.

Gabe Howard: Hello, everyone, and welcome to this week’s episode of the Psych Central Podcast. Calling into the show today, we have Sergeant Matt Harris with the Columbus Police Department. Sergeant Harris is with the Mobile Crisis Response Unit, supervising five police officers who correspond to mental health crisis situations, along with a mental health clinician. Sergeant Harris, welcome to the show.

Sgt. Matt Harris: Thank you, Gabe. Good to be here.

Gabe Howard: Well, I’m very glad that you can take time out of your busy schedule. You know, right now we live in the age of the coronavirus quarantine. While stay and shelter orders are starting to lift and places are slowly reopening, that’s not the case everywhere in the country. And because here in Ohio, everything closed shelter in place in full effect. And obviously police officers are essential. So from your perspective, Sergeant Harris, everything has been shut down?

Sgt. Matt Harris: It has. The strangest thing that that I feel every day when I’m driving around the city is driving in the middle of downtown Columbus at broad and high on a weekday during business hours. And it feels like a Sunday. And it also feels like it’s third shift. And it also feels like it’s Christmas because there’s just nobody out. And I’ve never seen anything like it before.

Gabe Howard: It is a bit of an eerie feeling, you know, downtown for people that don’t know Columbus, Ohio, 14th largest city downtown on a business day is busy. It’s not New York City or Chicago busy, but it’s certainly not. Traveling is so easy right now.

Sgt. Matt Harris: That’s exactly right. I’ve never been able to get from point A to point B so efficiently. And it feels good.

Gabe Howard: But the positives, they’re not outweighing the negatives at this point, especially since you’re a C.I.T. officer now, C.I.T. is Crisis Intervention. You work with people who are in well, in the midst of a of a mental health, a mental illness crisis. I guess the question is, is how does that look in the age of the quarantine? Have you been pulled off of that duty or are you getting more calls? What’s your day to day life aside from being able to drive everywhere very efficiently?

Sgt. Matt Harris: Well, we haven’t been pulled off of the duties, the mental health calls are still coming in to 911 or they’re coming into the non-emergency number as well. We’re still getting referrals from other officers and community members. As far as the numbers go, I don’t really know. I’d have to look at CAD data to see. But anecdotally speaking, it seems like the mental health calls have been steady and not that much different.

Gabe Howard: I have not ever had to call your unit and I sincerely hope that I never do. But I have to tell you, I like the idea that it’s out there, because if I get sick, if I’m in crisis, unfortunately, the police are who I call it. It’s a little bit backwards, right? It would be like if somebody broke into my house and I called an ambulance. That’s sort of how it feels. Can you talk about that for a moment? Because I think many people are just confused about why somebody who’s having an illness, somebody who is sick, is calling the police in the first place.

Sgt. Matt Harris: Yeah, I think that that is a huge area of discussion, I’ve heard you talk about that on some of your other episodes and I get that it doesn’t necessarily make sense. The best thing I can come up with to try to provide clarity is if you are in a controlled environment, so say you have an illness and you’re in the hospital. Whether that be a physical illness or a mental illness, it is a controlled environment. You have doctors and nurses and techs and people who have every resource at their disposal and training and the ability to help you in whatever way that you need when you are in that controlled environment. It is pretty well assured that you are in an area where there is no access to weapons. And there is a whole complement of staff members that if something goes sideways to the point where a person becomes combative or dangerous in some way, it can be controlled. When you are in an uncontrolled environment such as your apartment or in the middle of the city, none of those things that I just described exist. Right?

Sgt. Matt Harris: So anyone who we encounter, whether that person is suffering from a mental health situation or not, might have a gun in their waistband. They might have a pipe that they picked up. They might try to run out into traffic in front of a car that could hit them and could hit somebody that is trying to stop them from running out in the traffic. So it all has to do with the fact that when we’re responding in the community, you have to be prepared to deal with anything because it is a completely uncontrolled environment. Now, I don’t mean to say or imply that people always want to pick up a weapon. The problem is that it is a possibility. So if we sent folks into the community to respond to these crisis situations without the ability to deal with potentially combative scenarios, it could be it could go sideways real quick. That kind of provides some clarity. Do you think?

Gabe Howard: It really does. And it’s understandable. And this is sort of the this is the struggle of mental health advocacy. So. And I want everybody to love my guest because, you know, he’s a police officer and he’s helping people like me. But when you walk into my house, we’re on different sides. Right? It’s just the way that it is. And this is what scares my community. And I want to kind of give you an opportunity to address it from your point of view, because I think it gets missed. One of the things that I read all the time is that people with mental illness are much more likely to become victims of violent crime than to perpetrate violent crimes. That is 100 percent true. But we don’t need to talk about that because we’re talking specifically about when you walk in and somebody like me who is suffering from psychosis, who is not in their right mind. And when you walk in, I think you’re a blue dragon. I’m not attacking a police officer. I’m not even trying to hurt a police officer. But I am defending myself against a blue dragon. Now, of course, the problem is, is that anything that I do to the Blue Dragon affects you potentially gravely. Sergeant Harris. So that is sort of what sets up the issue. What happens more often than not is that we just get arrested. We don’t get de-escalated. And we’re not acknowledged that we have any sort of illness issue or anything like that. We’re just. Well, you assaulted a police officer and off to jail we go, but your unit is trying to do something about it. What do you do about the person who’s trying to attack you and hurt you? But you know that it’s not they’re not in their right mind. Like, how do you handle that? Because you can’t just let me slay the dragon.

Sgt. Matt Harris: Well, that’s exactly right. And I completely hear everything you’re saying. I just want to acknowledge that the officers and the clinicians that I work with every day. We completely understand the concept of the blue dragon or maybe maybe we’re the reptilians who are attempting to take over the world or maybe we’re the demons that came out of the drywall. We have been doing this long enough to where, you know, the concept of what you’re talking about has become very clear. So what we try to do is basically not make it worse. So when we get there, the person who called the cops will be directed outside and they will be speaking with the mental health clinician that we work with, that we co-respond with. And that clinician will be gathering information from them, trying to better understand what’s going on. We want to de-escalate the best way that we can, which is normally staying very calm, talking softly, talking slowly and respecting personal space, giving the person in crisis an opportunity to go from that vision of the blue dragon to maybe it clears up a little bit and maybe with some soothing conversation, we can come to the conclusion that it’s actually not the reptilians or not the blue dragons and somebody that’s there to help them. Now, sometimes that works and sometimes it doesn’t. But that is always the very first goal is to de-escalate, to where the blue dragon, being the police officer, does not need to be slayed. And

Gabe Howard: Right. Right.

Sgt. Matt Harris: Hopefully, hopefully we don’t get slayed and hopefully we can talk this individual into coming with us peacefully if that’s the route that we need to go.

Gabe Howard: My second question in this whole thing is you’re compassionate people, you don’t want anybody to have a bad outcome. But, you know, de-escalation doesn’t always work. This is not always an option. I mean, I know what this is like from my point of view, intimately. And I’m desperately trying to see it from your point of view where somebody is screaming at you, attacking you, yelling at you, they’re breaking the law. The reason that they break the law may be reasonable or understandable, but make no mistake, you were called for a reason and now you have to do something about it. I kind of want to ask you how you feel about taking mentally ill people to jail, but it seems like a mean-spirited question. Can you talk about that for a moment? Because it’s it is a reality.

Sgt. Matt Harris: Yeah, of course. I actually kind of like the slaying of the dragon scenario because it can help people to maybe understand if somebody is attacking or being violent or trying to slay that dragon. The cops are probably the best equipped to be able to handle that. Now in the hospital scenario, like I said, it’s a controlled environment. So, you know, there’s a whole group of people that can handle that. But in the outside world where it’s uncontrolled, this is why the cops are called as opposed to anybody else, because we’ve got training to restrain if need be. We have a whole tool belt. You know, I’ve got a walkie talkie. I can call for help. I’ve got pepper spray. I have a taser. I have a firearm that hopefully I never, ever have to use. But these are some of the reasons why the cops are involved in these scenarios as opposed to to somebody else who probably isn’t in a position where they can really defend themselves as well as what a police officer can. And they may not be able to call for help as efficiently as a police officer can. And I can get people who are driving with lights and sirens to get there fast to help me, whereas somebody else can’t. So I just kind of wanted to paint that picture a little bit.

Gabe Howard: I think it’s a fair point. Thank you.

Sgt. Matt Harris: As far as jail is concerned, I can tell you this. The Columbus police C.I.T officers and more specifically, the mobile crisis unit, my unit, we very rarely take somebody having a mental health crisis to jail. Occasionally, we may get word that somebody that is in crisis, maybe they’ve got warrants for their arrest. And then at that point, we’re obligated by the courts to bring the person in. So that could be one potential scenario where the trip might be to the jail instead of the hospital. However, it’s very rare — that doesn’t happen very often. The other times that this could happen would be, number one, unable to de-escalate a person. It just didn’t work that somebody is in full psychosis. There are often times where there’s no communicating. There’s simply no way to get through. And at that point, what we will do is we will try to restrain in a very humane way without using weapons, preferably. And if we can get that person under our control, probably involves putting cuffs on them and getting them into the back of a police car that has bars where they can’t break the window out. You know, while we’re on the way to the hospital and that’s the preferred course of action. However, if it gets so out of control where we’re unable to restrain a person or if somebody comes out of nowhere and sucker punches an officer, which I have seen happen before, because, again, they need to slay the dragon at that point.

Sgt. Matt Harris: Assaulting a police officer is a felony in Ohio. And generally, we will go with that. And the reason that we’re gonna go with that, Gabe, is because the court system has leverage. In other words, they can say to a person, we understand you have this illness. You’ve got to follow your doctor’s instructions. You’ve got to take these antipsychotics. You’ve got to take this medication. Otherwise, if you don’t, the court can order you into jail. That is leverage that oftentimes we need, because if we go to the hospital, the hospital will stabilize and sometimes they’ll do long term care and keep somebody for a while or they may get sent to one of the long term facilities. But if and when a person comes out of treatment, oftentimes people don’t want to take the medication and we can end up in a situation where we spin our wheels. Right? We end up right back there in that same situation where they’re slaying the dragon again. But there’s no real piece to prevent that from happening again with the hospital system only. So sometimes the courts can actually provide motivation to stay on course to prevent oneself from decompensating to the point of dangerousness, which is really favorable for everybody, because then it keeps the person out of trouble. It keeps other people, neighbors, the police officers that are responding. It’s better for everybody.

Gabe Howard: We’ll be right back after these messages.

Sponsor Message: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral.

Gabe Howard: We’re discussing policing in the age of the coronavirus quarantine with Sergeant Matt Harris. One of the things that keeps coming up over and over again in this debate is I’m not being negative to my loved one. I love them. Do you find that well-intentioned people who absolutely, unequivocally love the person whom they called the police on are also just doing all of the wrong things and creating issues? And then how do you handle that? Because I imagine that it’s really hard to look at somebody who, you know, is well-intentioned and saying what you’re doing is hurting the situation because they’re going to clap back immediately, but I’m only trying to help.

Sgt. Matt Harris: We usually run into one of two scenarios, Gabe. So the first scenario is we show up and the loved ones, the family members are not helping. They are making things worse. Sometimes when we leave after work, it’s all done. We say to ourselves. Oh, my goodness. You know, this person would be so much better off if they didn’t have these people in their lives. We see that a lot. And it’s not that the family members or whoever it is providing the adversity, I guess we would say it’s not that those people mean to do that. It’s not that they’re trying to be difficult. They just simply usually do not understand how to deal with the situation. They don’t necessarily understand the needs of their loved one. They are frustrated. They’ve been dealing with this for a long time. They tend to be pissed off because they feel failed by the system because nobody’s helping them or people show up to help, but then it starts up again and it spins its wheels. So that is a very common theme. So those are the folks that we need to get out of the room. Hey, come talk with us over here. They’re not helping the person in crisis in that moment.

Sgt. Matt Harris: Now, the other side of it is the folks who say go to NAMI meetings, the people who are educated on their loved ones’ condition and who really have taken time to understand what their friend or family member is going through. Maybe they’re self educated. Maybe they’ve gone to support groups. Maybe they have their own therapist that they work through these issues with. But that group of people, they tend to kind of get it and they will practice de-escalation on their own before we get there. And we can actually watch them doing really well with their loved one. And sometimes we need that person to actually help us get the person in crisis to do what you know, whatever the goal is, if we’re trying to get them into a cruiser so we can go to the hospital. And that’s oftentimes we’ll have the loved ones who are in the know can help us and they can kind of coax their family member into going along with whatever the best option is. So I don’t really see a whole lot in the middle, at least not based on my own personal experience. It’s usually kind of one or the other.

Gabe Howard: One of the things that we talked about when we use the slay the blue dragon analogy, is that the person with mental illness isn’t trying to be a problem. They’re a good person deserving of care and respect and love and resources. And that’s what makes this whole thing hard, because you can be all of those things and still be a danger to yourself or others and needing of police intervention. Along the same lines, as you said, there are people who they love their family, they love their children. They love the person that they’re trying to help, but they, too, are hurting them now. Are you allowed to intervene on behalf and get those people some place where they can become a better support system? Caregiver, friend, roommate, loved one?

Sgt. Matt Harris: Well, here’s well, here’s what I do. I always I advocate for people to get involved with NAMI because I just have to believe that. If you surround yourself with a group of people who have been there, who have been in a similar way or are in a similar situation with a loved one who suffers from mental illness, that can only be a good thing. You can learn from one another. You can go to meetings. You can go to workshops. You can educate yourself on how do I react in this scenario if my loved one is in the midst of a manic episode and they are posturing and acting out and becoming aggressive? If nobody ever taught that mother or that father or that sibling, what they’re supposed to do, how to better handle that situation, then things are not going to necessarily go well. So I tell people all the time or I encourage people all the time to seek out help in whatever way they want to, to try to better understand what their loved one is going through and how to better respond when they’re in crisis.

Gabe Howard: It does sound to me like you’re saying that education really helps all sides. And I just bring this up because there just is a lot of misunderstanding, really, in all of society. But even when we look at the people who are working through the mental health issues and are advocating for mental health issues and are living with mental health issues or have a loved one with mental health issues or are a police officer, there just seems to be a lot of in-fighting even among us. And I’d really like to see us all get on the same page so that we can move forward. I know this is a big question and please, you are not required to answer it. But do you have any advice for the mental health advocacy community who are often split about the best way to move forward?

Sgt. Matt Harris: The first thing that comes to mind is the global issue of how do we improve? How do we move forward is we have to have reasonable expectations because most people probably think, oh, this person is ill. They have some mental health issues, doctor or hospital, and get it fixed. Right? Well, as we all know, it’s not that simple. Nobody has a magic wand. The pharmaceutical companies have invented lots of different drugs over the years that can help with symptomology and it can help with mental health issues. But as has been explained to me by many mental health consumers, sometimes it takes a year to figure out the right combination of medications, and sometimes the medications stop working and have to be readjusted. And there’s all of these different factors. You can’t take a person to treatment and expect that overnight the treatment facility is going to fix everything and the problems are going to go away. So I’ve had to adjust my expectations because as you might imagine, many of the calls that my unit responds to, how can I say this? I don’t want to say repeat, customers. But a lot of the same folks that we get to know who are sort of in and out of the system.

Sgt. Matt Harris: And people are always asking us, you know, what can we do? How do we know this has been going on for years? And I’m just honest. And I tell everybody there is no magic answer here. We do the best we can. Meaning that the advocates, you know, people who are in your position, Gabe, you do the best you can. And my team, we do the best we can. We take people to the hospital. They do the best that they can. But we’re limited by resources, we’re limited by the law sometimes we’re limited by all of these different factors. So I always go back to moving forward. What do we do? And the best thing I can come up with is keep doing the best that we can. And hopefully there’s a natural state of progression, maybe in the pharmaceutical industry, maybe in the brain science realm, maybe with the way that we police involving mental health crisis. Everything progresses over time.

Gabe Howard: I really like what you said about, you know, patience and understanding and that we’re all doing the best that we can. I think that so often in this debate, one side believes that they’re doing the best that they can, but they believe that the other side is just intentionally making things worse or they have malicious intent or they’re uncaring when in actuality, what I’ve seen from working on all sides and frankly, from working all over the country is that you’re right, everybody is doing the best that they can in every area except communication. I don’t think that we’re communicating the best that we can because we’re often ignoring people when we don’t want to hear it. I speak to many, many people from family members to people living with mental illness like myself, and they say things like, well, I’m not going to talk to the police. They just want to arrest my son or I’m not going to talk to the police. They just want to arrest me. And I think that’s so sad and so cynical. But more importantly, it’s also not been my experience. I’m not saying that it never happens. I am certainly not saying that there’s not just so many tragic stories out there, but I don’t think they’re coming from a malicious place. I think they’re often coming from a place of misunderstanding. You know, we’re almost out of time. But all over the country, they don’t have crisis response units. There’s not a Sergeant Matt Harris in every single city and every single town and every single state. How did Columbus, Ohio, get one and how can every place get one?

Sgt. Matt Harris: It all comes down to resources and the right people being involved. So there was a group of individuals. I’d like to give Commander Chris Bowling and soon to be Commander Dennis Jeffrey accolades here, because those were two individuals that saw this as something that we needed. And not only did they know that we needed to do something like this, but they actually made it happen by partnering with our local mental health intake agency, crisis agency, Netcare. And put this idea on the table for both sides to talk about. And the police side and the Netcare side were able to come up with this partnership that we have actually not just conceptualize it, but put it into action. And next thing you know, we have social workers and counselors riding in the police car with officers responding to people in the community that need that service. So it’s the right people and it’s resources. So in Franklin County, we’re fortunate enough that there was funding on both sides to provide police officers and to provide mental health clinicians, paid positions as a full time job to do this this work. Many other areas within Ohio and across the United States, likely don’t have the funding or the resources to put this together. And that’s tragic. But that’s kind of the current state of affairs.

Gabe Howard: Sergeant Harris, what do you say to the people who say that, you know, in light of COVID-19 and the pandemic and the economic issues, that this is just something that we can’t afford right now and that it needs to be shut down so that we can use that money in, and I am making air quotes, in a better area? What do you say to those folks that are wondering about that right now?

Sgt. Matt Harris: I would say that whether they’re aware of it or not, there is a need to respond to our community, specifically to people in our community who are suffering from mental health issues, whether there is a pandemic that’s currently playing out or not. That need is always going to be there if we don’t have the correct resources. These situations don’t get better. They tend to decompensate further and get worse. And then you have an even bigger problem. So I advocate 100 percent that we need to to maintain our crisis unit and that we need to respond to mental health emergencies in the community, regardless of what the health crisis situation may or may not be. In fact, I would say that most would agree that the health pandemic has been quite anxiety inducing for many people. If you already have a high level of anxiety or if you suffer from an anxiety disorder, the crisis isn’t making it better. It’s going to make it worse, more likely than not. So these responses that we provide are much needed.

Gabe Howard: I could not agree more. Thank you, Sergeant Harris, for being here, we really appreciate it. And thank you everybody for listening in. If you like the show, please subscribe. Share us on social media. Use your words. Tell people why they should listen. We have a private Facebook group that you can join. It’s absolutely free. Just head over to PsychCentral.com/FBShow and it’ll take you right there. And remember, you can get one week of free, convenient, affordable, private online counseling anytime, anywhere, simply by visiting BetterHelp.com/PsychCentral. And we will see everyone next week.

Announcer: You’ve been listening to The Psych Central Podcast. Want your audience to be wowed at your next event? Feature an appearance and LIVE RECORDING of the Psych Central Podcast right from your stage! For more details, or to book an event, please email us at [email protected]. Previous episodes can be found at PsychCentral.com/Show or on your favorite podcast player. Psych Central is the internet’s oldest and largest independent mental health website run by mental health professionals. Overseen by Dr. John Grohol, Psych Central offers trusted resources and quizzes to help answer your questions about mental health, personality, psychotherapy, and more. Please visit us today at PsychCentral.com. To learn more about our host, Gabe Howard, please visit his website at gabehoward.com. Thank you for listening and please share with your friends, family, and followers.

Podcast: Police Response to Quarantined Mental Health Crisis syndicated from

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whorchataaa · 4 years

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Podcast: Police Response to Quarantined Mental Health Crisis

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Guest information for ‘Matt Harris- CIT’ Podcast Episode

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Sgt. Matt Harris: Thank you, Gabe. Good to be here.

Sgt. Matt Harris: That’s exactly right. I’ve never been able to get from point A to point B so efficiently. And it feels good.

Gabe Howard: Right. Right.

Sgt. Matt Harris: Hopefully, hopefully we don’t get slayed and hopefully we can talk this individual into coming with us peacefully if that’s the route that we need to go.

Gabe Howard: I think it’s a fair point. Thank you.

Gabe Howard: We’ll be right back after these messages.

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ashley-unicorn · 4 years

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Podcast: Police Response to Quarantined Mental Health Crisis

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Sgt. Matt Harris: Thank you, Gabe. Good to be here.

Sgt. Matt Harris: That’s exactly right. I’ve never been able to get from point A to point B so efficiently. And it feels good.

Gabe Howard: Right. Right.

Sgt. Matt Harris: Hopefully, hopefully we don’t get slayed and hopefully we can talk this individual into coming with us peacefully if that’s the route that we need to go.

Gabe Howard: I think it’s a fair point. Thank you.

Gabe Howard: We’ll be right back after these messages.

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erraticfairy · 5 years

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Podcast: Finding a Therapist- What to Look For

Are you thinking about making a therapy appointment but have no idea where to begin? What should you look for in a therapist? What’s the difference between an LPC, LCSW, Phd and PsyD? In today’s podcast, Jeff Guenther, LPC, founder of TherapyDen.com, takes us through the entire therapist-hunting process. He breaks it down into simple parts so it no longer feels daunting or confusing. He even gets us thinking about what kind of person we’d feel comfortable sharing our problems with — for example, would you prefer a male or female? A vegan? A parent? A religious person? Is it even OK to ask a potential therapist such personal questions?

Are you ready to learn how to find the right therapist for you? Join us for an in-depth discussion.

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Guest information for ‘Jeff Guenther- Find a Therapist’ Podcast Episode

Jeff Guenther, LPC is the host of the podcast Say More About That and runs an inclusive and progressive therapist directory at TherapyDen.com. TherapyDen is a small team of people who care about making access to mental healthcare easy and affordable, our Advisory Board is made up of local thought leaders and therapists working towards a brighter future for mental health. Jeff has a very strong background in family and couples work, and received his master’s degree in marriage and family therapy from the University of Southern California, and a bachelor’s degree in child and family development from San Diego State University. Prior to going into private practice, he worked in the public school system providing individual, group, and family therapy to high-risk students. He also taught parenting classes on a regular basis. Jeff’s therapeutic career started out at a crisis line in Portland, Oregon, where he mainly worked with people who were suffering from suicidal thoughts and severe anxiety. Jeff has lived in Portland since 2005 and the bulk of his work focuses on seeing couples and individuals in private practice.

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Gabe Howard: Hello, everyone, and welcome to this week’s episode of the Psych Central Podcast. Calling in to the show today we have Jeff Guenther, LPC. Jeff is the host of the podcast Say More About That and runs an inclusive and progressive therapist directory at TherapyDen.com. Jeff is here today to discuss how therapy works, how therapy doesn’t work and everything in between. Jeff, welcome to the show.

Jeff Guenther, LPC: Yeah. Thanks for having me here. I’m really excited to talk to you.

Gabe Howard: Well, I’m excited to talk as therapy is one of those things that everybody has heard of.

Jeff Guenther, LPC: Mm hmm.

Gabe Howard: Yet there is all this misconception about it.

Jeff Guenther, LPC: Yeah, totally. And it’s really tricky to figure out. Even if you want to go to therapy, how do you start it? Where do you find a therapist?

Gabe Howard: Jeff, let’s start small. What is therapy?

Jeff Guenther, LPC: Yeah, I feel like that’s a really good question and it’s a really difficult question to answer. So I run TherapyDen.com, which is this national therapist directory. So I get to find out what people are actually searching for when they’re trying to find a therapist. Most people go on and select their issue that they want to address in therapy. And over 40 percent of the time, it’s one of three issues that they’re selecting. So I think sometimes the public thinks that therapy is going to therapy for either anxiety, depression or relationship issues. Those are the most common issues that are selected when looking for a therapist. So maybe we can kind of start there and say that therapy is when you’re feeling like you’re struggling with something that you are having a hard time maybe resolving on your own. And you need some sort of outside third party to help you process and understand what’s going on so that you can move forward or grow.

Gabe Howard: I like that much better than the Webster’s dictionary version, which is the treatment of mental or psychological disorders by psychological means, and you can see why people maybe have this general misunderstanding of what therapy is, because in pop culture it’s laying on a couch. In real life, it’s sitting in a chair and therapy looks different for everybody.

Jeff Guenther, LPC: Totally.

Gabe Howard: You know, what therapy looks like for me is very different than what therapy looks like to somebody else. I think that therapy is this idea of taking an issue and discussing it with a trained professional to get a different viewpoint or perspective on that issue, to help you move forward in a meaningful way.

Jeff Guenther, LPC: Yeah, I think that’s a really good, succinct, concise definition that we can all get behind. I agree.

Gabe Howard: That’s it, we should e-mail Webster tomorrow.

Jeff Guenther, LPC: Can we please? Yes.

Gabe Howard: Yeah. Yeah.

Jeff Guenther, LPC: Yes.

Gabe Howard: Jeff and Gabe, changing the definition of therapy since…

Jeff Guenther, LPC: I support that.

Gabe Howard: Jeff, of all the things that you could have put your time and talent behind, why helping people get to therapy?

Jeff Guenther, LPC: So I’ve been a therapist since 2005 and in the beginning stages of starting my practice, like a lot of therapists, I was really focused on marketing my practice so that other people in the community in Portland, Oregon, where I am, can find me. And I was having a hard time trying to figure out how to attract clients. I was talking to a lot of therapists. Therapists were having a really hard time trying to figure out exactly how to market themselves and attract clients that would be a good ideal match. Then I was looking to the community, people that were looking for therapists and they were just totally lost. There’s got to be a better way. And so I just became obsessed with trying to figure out how to get people into therapy in the easiest way possible with the least amount of barriers and limits. And I eventually created a local therapists directory for Portland. And there’s hundreds and hundreds of therapists have signed up, and thousands and thousands of people every month that go to that website to look for a therapist. And I’ve been able to collect all the data. What is important for people when they’re looking for therapists? And then I was able to take all that data and create the national therapists’ directory TherapyDen.com. So part of it is I turned into like a data nerd of what is it that people are looking for and what makes a good match? And also just it’s really hard when people start to look for a therapist. It feels daunting. They don’t know where to go and then they don’t get treatment and they never are able to learn or grow or heal. My heart hurts for them. So for the last 10, 15 years, I’ve just been kind of going for it.

Gabe Howard: I love it, Jeff. Thank you so very much. I am one of these people that believes that everybody should probably be in therapy. And I also believe that many people who want to be in therapy don’t know how.

Jeff Guenther, LPC: Mm hmm.

Gabe Howard: And that’s what I’d kind of like to switch gears and talk about now. So you have decided that you want to find a therapist. Where should you start?

Jeff Guenther, LPC: I think a good place to start is ask yourself, do you have a health care provider in your life that you already trust? So that might be your primary care physician. And sometimes they’re connected to other therapists in the community and they know what you’re looking for. They know what other therapists out there are treating and they can be a really good first place to start. You’re sort of getting this really personalized referral. So I’d say start there and then maybe also start with your friends and your family. The tricky thing is lots of people don’t really want to talk about the fact that they’re seeing a counselor because there’s stigma attached to it. The next place that I think the majority of people probably go is to their computer. They go to the Internet and type something into Google and they try to find a therapist there. And when you’re on there, either look at therapy websites or you can go to therapist directories. Another thing in my like 15 years of being a therapist, I’m not sure any client has ever asked if I’m actually licensed to practice therapy.

Gabe Howard: So it’s fascinating that you bring that up because the next question I was going to ask you is how does one become a licensed therapist? Because I see LPC, I see MSW, I see PhD.

Jeff Guenther, LPC: Right.

Gabe Howard: And for a person not in the industry. What are all the differences? What is the license that we’re looking for so that we know we’re in good hands?

Jeff Guenther, LPC: First of all, look for a license, because in some states, even in my state, the state of Oregon, you can call yourself a professional counselor, but you don’t actually have like a master’s degree in the counseling field. So you can’t call yourself a licensed professional counselor, but you can call yourself a professional counselor. So make sure that there’s the word licensed in their titles that you know, that they’re legit. They’ve gotten like a graduate degree in counseling and you can be a licensed professional counselor. You can be a licensed clinical social worker. You can be a licensed marriage family therapist. And those are sort of master’s degree level. I’m a master’s degree level. And then there’s the PhD level. And they can call themselves psychologist. So they’ve been in school for five years. They’ve written a dissertation and they can call themselves a doctor as well as a PhD. And then there’s the PsyD, which is a little bit like a PhD, but they’ve focused more on clinical work instead of research at the university. They can also call themselves doctor. And then there’s a psychiatrist who prescribes medication and they have a medical degree.

Gabe Howard: In pop culture, it’s the psychiatrist that’s always providing therapy. But I know that out in the real world, a psychologist, licensed counselors, therapist, MSW’s, LSW’s, they’re providing the therapy and the psychiatrists are medical doctors who aren’t doing talk therapy. They’re doing medication management. Is that true? Is pop culture misleading us?

Jeff Guenther, LPC: It’s mostly true. There are some psychiatrists that will sit down with you for an hour. But many of them will be just like sitting down with you for 15 minutes every month or two or three to kind of talk to you about how you’re feeling about your medication. They typically all recommend they should go talk to a talk therapist, which is a therapist, counselor, social worker, psychologist. It’s good to make that point clear.

Gabe Howard: The Internet is vast.

Jeff Guenther, LPC: Oh, yeah.

Gabe Howard: So now you’re looking online. What are some things that clients should be looking for in order to keep them safe? Because, I mean, there’s just a lot on the Internet. And obviously we can drive people to like PsychCentral.com or TherapyDen.com. And we know that those are safe. But the Internet’s a really big place.

Jeff Guenther, LPC: The Internet is a really big place, and I think you bring up a good point, it’s important to find a safe Web site to know that you’re finding therapists that are credentialed and there are some therapists Web sites that you mentioned and also there’s GoodTherapy.org and Psychology Today that verify their therapists so you can feel safe knowing that you’re on these verified therapist directories that are already kind of vetted. You know, one thing that you can do, actually, is you can go to the local state board of licensed professional counselors and therapists. You can Google that in your state and you can find out if they’ve been suspended or reprimanded or if they’ve gotten in trouble. Usually like the Web site lists all those sorts of things. But when you’re looking for a therapist, there’s some common things that people usually start out with and two really popular things is the location of a therapist. Is it close to your work or your home? And then how are you going to pay? With insurance or out of pocket? Those are really important questions. But sometimes people just stop there. You know, they go location and payment, right? Let’s just do this. And I want them to be able to kind of expand their search and ask other questions or look for other data points that are important, like do they specialize in your issue? If you’re going in and you have a panic disorder, you should find a therapist that is obsessed with treating panic disorder. And do they get you? Can they empathize with you? Sometimes that’s hard to figure out on their website or on their therapist profile. But a lot more times these days, therapists are being better when they’re coming to kind of empathizing with their client through their marketing or website materials.

Gabe Howard: Now, what can a client look for to make sure they have a good fit? Now, I don’t mean licensed or unlicensed. I mean a good fit for you and a therapist.

Jeff Guenther, LPC: Every therapist is completely different and we all have so many different styles. What kind of person do you want to talk to? Some people want to talk to the older woman who feels has a caretaker energy or some people want to talk to like the professorial type who is quick witted and very smart. And some people want to talk to a therapist that does a lot of talking. Or they like giving a lot of homework or they’re like really super engaged and they want to kind of get that sort of dynamic? Some people are really interested in trying to find a therapist that has the same gender, their same sexuality, race, age or identity. What is this person’s culture? If you find a therapist that has a similar culture, it doesn’t automatically mean that that’s gonna be like the perfect fit and perfect therapist for you. But some clients feel like that’s important because they want the sort of lived experience that a therapist has gone through. And also there’s a lot of clients who are looking for therapists that have the same values. Do they have a value match? You know, some people really, like, value a specific type of politics. Does their therapist also value that? Some clients like don’t eat meat and they want to see a vegan therapist because they feel really like understood by that vegan therapist. You know what I mean?

Gabe Howard: I do, and I think that’s very reasonable if you’re not comfortable with your therapist. It doesn’t matter if that’s reasonable or unreasonable, right? You have to be comfortable in order to share some of these things. It would be great if we lived in a world where you just didn’t know. But, you know, sometimes we do things to tip our hands. You know, for example, we put that bumper sticker of the person that we voted for in the last election on our car. And then you see the therapist get out of the car and

Jeff Guenther, LPC: Right.

Gabe Howard: Maybe you just really dislike that person for whatever reason, right or wrong, we don’t have to get into that. But you’re like, I don’t trust your judgment anymore. Luckily, there’s more than one therapist in the world.

Jeff Guenther, LPC: There’s more than one therapist and they’ve all voted for different people.

Gabe Howard: And we’ll be right back after these messages.

Sponsor Message: Hey folks, Gabe here. I host another podcast for Psych Central. It’s called Not Crazy. He hosts Not Crazy with me, Jackie Zimmerman, and it is all about navigating our lives with mental illness and mental health concerns. Listen now at Psych Central.com/NotCrazy or on your favorite podcast player.

Sponsor Message: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral.and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral.

Gabe Howard: And we are back discussing therapy with Jeff Gunther. Now, here we are. We’ve done everything. We’ve looked online. We’ve made sure we’re safe. We chose our potential therapist. What happens now?

Jeff Guenther, LPC: Congratulations. I want you to actually choose three potential therapists.

Gabe Howard: Really?

Jeff Guenther, LPC: Yeah. I want people to, like, shop around a little bit and I want you to schedule a consult with three different therapists so that you can really get a good understanding of who these people are.

Gabe Howard: And when you say schedule a consult, that’s a phone call generally speaking, correct?

Jeff Guenther, LPC: Generally, it’s a phone call. I actually allow people to come in for a free 30 minute consult in person, which is also does a lot for me. So I can figure out how they are in person if I feel like I’d be a good match for them. But yeah, it’s typically a phone call. And if a therapist thinks that after the consult it’s not a good match. Then we have an ethical duty to refer you out to another therapist. That would be a good match for you. So we’re like, we’re already working for you. We’ve got your back. But even more importantly, it’s for the client to figure out if it’s a good fit for them. So you should feel free to ask all the questions that you feel are important in order to make sure that you just spill your guts to this person. So what’s important to you? It’s important for you to get in touch with that. You can ask about their training, their experience with your issue, their cultural competency, stuff like that.

Gabe Howard: So now you’re on the consult call. What are some good questions to cover?

Jeff Guenther, LPC: Yeah, so this is where I have a lot to say. So

Gabe Howard: Please, please.

Jeff Guenther, LPC: ,Just like a little disclaimer, it’s up to the therapist whether or not they feel like they want to answer questions that you’re asking them. Some therapists are really just sort of blank slate like you don’t get to know anything about them. It’s all about you. But other therapists on the other side of the spectrum are like, I’ll answer your questions if it’s important for you to feel comfortable and feel like you can kind of trust that I understand you. So some basic questions that clients should ask in a consult is where did you go to school? What did you study? What makes you qualified to treat my problem? Do you specialize in my problem? What makes you a specialist? Have you helped many people like me? What is the typical outcome of those cases? Am I a good fit? Why am I a good fit for you? What type of treatment styles will you use? Can you explain those treatment styles in detail with me? Will you talk about my family and relationship history? How important is it for you to know about my past? How will I know therapy is working? Will I feel worse before I feel better? Who talks more, you or me? Because sometimes therapists are really chatty and sometimes, they are just like you talk.

Jeff Guenther, LPC: And are you a confrontational therapist? Do you give homework? How often do I have to see you? So some other questions and maybe a little bit more personal, have you experienced my issue in your personal life? Or you can ask the therapist, are you married? Do you have kids? Have you always been a therapist? How long have you been in practice? Are you from my city? Do you see a therapist? Are you politically progressive or conservative? Are you religious? If so, how do you practice your religion? Do you believe in God? Who did you vote for? What are your views on social justice? Are you a vegan? Vegetarian? Meat eater? Are you pro-choice? What are your feelings about our current president? So obviously those questions are incredibly personal. And I’m not saying that you should ask these questions. I’m just saying like, hey, if these are important questions to you and it’s really important to find out if your therapist is pro-choice or pro-life, you can totally ask them that. So I’ll pause there for a second. Do you have any feelings about those questions?

Gabe Howard: On one hand, I feel that those questions are deeply personal and I would be uncomfortable answering them at my job. However, I asked one of those questions to one of my therapists

Jeff Guenther, LPC: Oh, yeah?

Gabe Howard: Because I had a problem with the therapist that I had fired over that issue and I wanted to make sure that it didn’t come up again. So I just straight out asked her. I said, what are your religious views? Because my previous therapist, who I did not have a console call with, tabled everything along the lines of religion. And it became uncomfortable to the point where I needed to move on. And I did not want any problems with my next therapist, I didn’t want to jump out of the frying pan into the fire. On one hand, I hear all of those questions like one after another, after another after another. And I think, wow, that is a lot of personal questions. But I am imagining that in practice, maybe only one or two of those is a deal breaker for the average person.

Jeff Guenther, LPC: Yeah, that’s what I found. And it’s so personal, like if I’m going to see a therapist, I want to talk about my kids and parenting. Then it makes total sense. If you ask the therapist, do you have kids? Are you a parent? The therapist can say no and still be a wonderful therapist for you. But it feels like you want to kind of know that information and in your example. Yeah, if the therapist is sort of frames things in spirituality or religion, but that doesn’t come up until the 20th session. It’s like, oh god, I wish I would have known this because now I’m like, not really vibing with what you’re like throwing out there, you know what I mean? So these questions, maybe just a handful of them that you might think are important are things that you might want to bring up.

Gabe Howard: And they obviously align with things that are very important to you. If you are not political, for example, then maybe you would frame the question of are you political? If the person says no, politics have nothing to do with my therapy, then whom they voted for is really irrelevant. What you’re trying to get at is are we going to have a political debate? Everybody has a different comfort level with some of these uncomfortable things, right?

Jeff Guenther, LPC: Yes, exactly. And there’s also the like, if you’re a person of color, you can ask a white therapist, have you ever worked with a person of color before? What makes you qualified to work with a person of color? What have you done to learn about my specific culture? How are you continuing to learn about my culture? Why should I trust you? Do you operate from a racial justice framework? What are your thoughts on white privilege? How do you experience and handle your own white fragility? Or even if you’re somebody like in the LGBTQ community, go ahead. If you feel like you need to ask your therapist, what’s your gender identity? What’s your sexual identity? Have you ever treated a queer or trans person before? What’s your understanding of diverse sexualities and gender identities? Do you think being gay is a choice? Do you think homosexuality can be cured? How do you feel talking about gay sex? Are you trained in counseling people that want to go through gender reassignment surgery? I can continue to go on. But like what I’m trying to do is just encourage people, especially like disenfranchised communities that are talking to therapists. Therapists are just sort of predominantly white and sometimes come from like a pretty privileged background. Go ahead and be like, how are you competent to treat me, like, give me your credentials? And a therapist should kind of be excited to answer that question. And if they don’t have a good enough answer, politely move on to one of your other choices.

Gabe Howard: And it’s important to realize that how they answer the question is sometimes more important than what the answer to the question is. If you ask one of those questions and they say, listen, I’m not comfortable sharing that with you, but and they explain why or they explain how and they don’t dodge the question. That’s very telling vs. oh, that’s an inappropriate question. Well, yeah, they’re scolding you for the questions that you ask then, yeah. You kind of already know that this is not the therapist for you. So it’s important. Understand it for maybe that perspective as well.

Jeff Guenther, LPC: Yeah, I think that’s a really, really good point. If they don’t want to answer any of these questions again, that’s totally fine. But I’d really, I really hope that they give you a good, compassionate reason as to why they’re not going to answer these questions. And there’s really good reasons why some therapists won’t want to answer this question, because then like all of a sudden, it becomes about them and not about you. But they should have like a really good answer if they don’t want to answer it.

Gabe Howard: So now we’re on the consulting call. We’ve handled all of this. You’ve got your three, you’ve narrowed it down to one. You now have selected a winner. It’s like therapy, reality show, right? But now you’ve got it. You’re ready. You’ve made the appointment. You’ve picked the person. Now what?

Jeff Guenther, LPC: So it’s exciting because now you’re going to finally get into it. However, therapy can oftentimes move really slowly. So that’s something to keep in mind.

Gabe Howard: I know that a lot of people believe that therapy is quick because of the way insurance panels work. They approve you for three to five therapy sessions, which creates the idea that, oh, I just need three or five therapy sessions and I will be fixed. Can you talk about that for a moment?

Jeff Guenther, LPC: There are some issues that maybe could really be targeted in that amount of time. A lot of times if you’re coming in for a specific anxiety, I’m afraid of spiders or I have a hard time like crossing bridges or something. You can kind of like hone in on that and just focus on that and really have a solution focused short term interventions. But oftentimes we really need time to get into it. And this might sound like a really long time to be in therapy, but oftentimes I don’t see really big change until after the first year of therapy. Because then we can kind of like look back at where you were a year ago and see like how you’ve grown and how you’ve developed to, like, feel more healthy or act more healthy or think more healthy. But there’s a lot of secret subconscious defense mechanisms that are making it so that it’s really hard for you to change. So we have to kind of slowly dismantle all those defense mechanisms, with your permission, and then kind of replace them with something else that’s more positive or just get them to go away. And it takes a long time to positively influence you, even though you’re psyched to be there. There’s usually a lot of resistance.

Gabe Howard: Jeff, thank you so much. Are there any final thoughts, wrap ups, takeaways that our listeners should be aware of as they move from being wary of therapy to now understanding, embracing, and getting ready to go to therapy?

Jeff Guenther, LPC: One more thing I want to share that I feel like is super, super important. If you go through this whole process, everything we talked about today and you find your therapist and it’s kind of an exhausting process, I understand. But that therapist doesn’t work out and they’re not a good fit for you. It doesn’t mean that therapy in general is not a good fit for you. It doesn’t mean like, oh, therapy didn’t work for me. I’m never going to go back. If it doesn’t work out, go find another therapist. It doesn’t mean that therapy is not for you.

Gabe Howard: Jeff, thank you so much. How can folks find you on the Internet?

Jeff Guenther, LPC: They can find me at TherapyDen.com, they can find a therapist directory there, they can go to JeffGuntherLPC.com if they want to find my personal Web site. If you wanna shoot me an email about anything, any of these questions that you might have. Send me a message at [email protected] and you can find my podcast at Say More About That.

Gabe Howard: Wonderful, Jeff. Thank you so much for being here, we really appreciate it.

Jeff Guenther, LPC: Thanks for having me.

Gabe Howard: And thank you, everybody, for listening. Remember, wherever you downloaded the show, you can give us as many stars or hearts or bullet points as humanly possible and use your words. Tell people why you love the show. We have our own private Facebook group. You can go over to PsychCentral.com/FBShow and sign up for that. And finally, remember, you can get one week of free, convenient, affordable, private online counselling anytime, anywhere, simply by visiting BetterHelp.com/PsychCentral. We will see everybody next week.

from World of Psychology https://ift.tt/3bheyFm via theshiningmind.com

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gaiatheorist · 6 years

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What next?

Another epiphany-of-sorts, I was skimming through the news, as I do most mornings, and clicked on the ‘What does childbirth feel like?’ article in The Guardian, ready to snort indignantly, because I was that headstrong girl who gritted her teeth, and bore it, knowing that the pain was only going to get worse. There’s a line somewhere, about 3/4 through the article, detailing that cusp-moment, as the sac ruptures, and the waters break, a point-of-no-return of sorts. I didn’t experience ‘that’ then, 20 years ago, my experience of labour and childbirth was chaotic-traumatic. When my waters broke, I assumed I’d lost control of my bladder, and tried to help the inept ex strip the hospital bed I’d messed up.

My labour was excruciating, I imagine they all are, the family legend that the sister-in-law had said “Ooh, that smarts a bit.” was fake-news, she’d had a ‘mobile epidural’, my birth-plan, refusing chemical intervention wasn’t just me trying to one-up her. I’d researched the drugs they’d be most likely to give me. I didn’t want an epidural, because I wouldn’t be able to feel the contractions, I wouldn’t know when to ‘push’, in my mind, that increased the risk of the baby having to be cut or pulled out. I didn’t want pethidine for analgesia, because that passes through the bloodstream and placenta to the baby, the horror-stories about ‘sleepy’ babies that don’t cry, or breathe scared me more than the thought of my own pain. In the end, I was given 2 paracetamol, that I promptly vomited back up, and the entonox ‘gas and air’, which wasn’t any use at all, because the nozzle came off the pipe from the canister, and I was too busy pacing around the ‘observation room’ to try to fix it. It’s me, I’d decided how I wanted to do it, and mostly managed to stick to ‘Plan A.’

I’m recognising parallels in what I did then with what I’m doing now. Not so much the pain, that’s just ‘a thing’ now, a constant companion, at least childbirth has an end-point. It’s not the ‘No medical intervention unless essential, and any necessary intervention to be explained beforehand if possible.’ line that I’d hand-written in my ‘birth plan’. I’m actively seeking medical intervention now, I’m on prescription analgesics every day, and waiting for referrals to neurology and the mental health team. What I’m recognising in myself is that tedious trait of tenacity I have, that I just keep going, taking arms against a sea of troubles, and such.

My metaphorical waters have broken again, only this time, it’s a sheet of paper addressed to to the Secretary of State. (They don’t put a name on it, just a job-title, maybe that’s a reflection on the revolving-door, musical-chairs state of the government, maybe it’s just procedure.) The letter overturns DWP’s ‘decision’ that I’m zero-points, fully-fit, not-disabled-enough. 20 years ago, I brutally transitioned from ‘me’ to ‘Mum’ over the space of a few agonising hours, I’m smirking sarcastically at the ‘time in labour’ being recorded as ‘6 minutes’. The 6 minutes were my time in attended labour, after ‘doing it myself’ for something like six hours. ‘Then’, I didn’t want to cause a fuss, because I’d been told that the birth-process wouldn’t be properly underway until the following evening, as the contractions ripped through me, I paced around, and didn’t ask for help, because this was just the start, and it was only going to get worse. ‘Then’, I tried not to be a nuisance, but the night-staff were bothered by my pacing, by my being awake, so they sent me into the ‘observation room’, to be someone else’s problem, and phoned the ex, “She’s in a bit of discomfort, nothing to worry about, don’t rush here.” ‘Observation room’ is in quotes, because after the initial blood pressure and foetal heart-rate monitoring, I wasn’t ‘observed’ for another 4 hours, by which time my son’s head was visible, it’s a good thing babies are a bit ‘bendy’, and nothing but luck that I didn’t squirt him out onto the hard floor.

It’s the me-to-Mum transition all over again. ‘The kid’ is 20, now, in a less-complicated life, I might be re-claiming ‘me’ after all the years of ‘Mum’, ‘life begins at 40′ and all that. I don’t suppose that’s even a thing any more, with more people deciding to delay or decline starting a family in their 20s? I’d kicked out the ex, and tried to grab what was left of my job ‘with both hands’, I WAS going to make the most of my life after the brain injuries. Best laid plans, and all that. I acknowledge now that I was in denial about how impaired and impeded I was, coasting on the wave of euphoria from having survived another round of brain surgery, and separating from my toxic ex, I thought I could ‘get better’ if I just tried a little harder each day. I feinted and foiled, minimising how difficult and uncomfortable everything was, because working around obstacles is what I do. What I did, until I became the obstacle.

As self-aware as I am in many respects, I was ‘aware’ of my old self, that before-state, with an intact brain. I don’t have an intact brain any more, and trying to be as I was before is every bit as ridiculous as that ‘new mother’ realisation that you can’t just chuck a change of pants and a toothbrush in a bag, and bugger off for the weekend. At least I’m not contending with nappies and nipples this time.

There was a period of resistance, after the haemorrhage, that pure survivor-instinct in me, that I was going to ‘beat this’ and ‘get better’, it took me too long to realise that the fake-it-’til-you-make-it approach was genuinely dangerous. When I did fully realise that, it was too late to change the outcome, I’ve bounced and rebounded through the ‘stages of grief’ in my usual self-destructive pattern, I genuinely hope that the watershed of being ‘awarded’ disability-on-paper is going to lead to ‘acceptance’, and not another ludicrous phase of ‘bargaining.’

That’s the real risk with me, that this atrocious couple of years of having no control over anything could tip me into one of my near-manic ‘do something’ phases. I was going to type ‘doing something stupid’, but I’ve already had to explain to too many people that I’m not suicidal. (The social worker sent me the number for the mental health crisis team again on Tuesday, she could see from an email that I’m unstable again. I won’t need the number.) That’s the ‘What next?’ that’s troubling me this morning, and that’s what I need to ‘sit on’.

There are external elements of ‘What next?’ that I need to wait for. The PIP tribunal awarded me ‘enhanced’ rate for the ‘daily living’ component, but the DWP can challenge the decision. Even if they don’t challenge, the built-in bureaucracy in the systems means that I won’t see the ‘award’ in my bank account for at least two months. That’s complicating issues with my bills, the providers have all been mostly-reasonable so far, but some of them haven’t been paid for over six months, I’m building up debts because the unemployment benefit doesn’t cover my bills, my credit rating will be ruined for years. I have various applications in for assistance and trust funds and such, but they’re all ‘unknown’ outcomes as yet. Another ‘unknown’ is the Work Capability Assessment, after he’d turned the audio-recording off, the assessor said he felt there was weight for my case for limited capacity, but that might have been a trick, to avoid him being the last person I spoke to before throwing myself under a bus. (Standard disclaimer, I wouldn’t, but I know I really unsettled him at a couple of points during the assessment, I’m not at all stable at the moment.)

I will, eventually return to the workforce, I just don’t know when, or in what capacity, there are outstanding medical investigations and interventions required to maintain, or possibly even increase my functionality. The PIP-award effectively ‘buys’ me a year. It’s a three-year award, but the first year is the back-dated year+ since my application, and DWP apparently recall for re-assessment a year before the end of an award. What next? I wait for news on when the award is to be paid, or whether DWP want to drag me through more hoops and hurdles. I attend my Job Centre appointment next week, and see if there’s any change to my ‘claimant commitment’ as a result of the Work Capability Assessment, or whether I’m expected to apply for any/all jobs, despite the PIP-notice. ‘What next?’ is bigger than those ‘minor’ administrative and logistical issues, it’s knowing that I’m physically as ‘healed’ as I’m going to be, and that I’m going to need emotional support to heal holistically. I need to evaluate what I ‘can’ do next, and that’s what’s difficult. I know what I ‘could’ do before, and I’m fairly certain I can still do some of that safely, but the ‘gap’ in my CV is going to take some explaining. “The UK government deliberately obfuscates and delays in the hope that we’ll just die” is probably a bit blunt.

What next? I genuinely don’t know. I know which bits of ‘me’ I don’t want to give up, and I will fight tooth and claw to keep them, like the animal I am.

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pedrorsmith · 7 years

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Finding a Treatment that “Fits”

The addiction treatment field, and specifically inpatient programs (or rehabs), have been in the press a lot lately. In the last decade programs have opened, closed, merged into large conglomerates and many have been noted for unethical practices that take advantage of people who use substances and their families. The opioid crisis in this country has brought many things to light, such as the failure of many programs to provide effective, life-saving medication assisted treatments, and we hope that positive changes in the treatment field will be the outcome. Until those changes consistently take hold however, if you are someone who is looking for treatment or looking for a loved one, it can be helpful to have a few things in mind as you search for the best program that fits your needs.

Finding treatment is a bit like shopping for jeans; just because something is listed as your size, it doesn’t guarantee that it will fit well. Sometimes it’s too snug, or the cut isn’t quite right. Or the fabric feels scratchy against your skin You often have to try on a few brands and styles to find the pair that is a good fit. If you or someone you love needs treatment for a substance use problem, it’s important to take the same approach. Take the time to interview several treatment providers and arm yourself with a list of questions so that you can compare and contrast them before you make your final decision.

Additionally, while it may be tempting to rush to the computer and do a search for “best rehabs” we recommend against taking this strategy. The internet is full of 1800 call services that appear to be linking you to someone who can help you find the best options. The thing they don’t tell you is that they are more than likely paid by specific programs for referrals to them and their suggestion of the best place for you will not be based on anything other than the amount of out of pocket expense you can afford or your insurance benefits.

Instead we recommend that you try and arrange a face-to-face professional assessment since substance use problems run the gamut from experimental and non-problematic to severe and life threatening. People turn to substances for a variety of reasons and a good assessment can help you identify the best course of action (meeting with a psychiatrist, behavioral treatments or maybe no treatment at all and just increasing community connection like attending self-help meetings). Be sure to ask about the qualifications and approach of the person doing the assessment (see additional comments below) since they have a huge impact on the recommendations that they will make. Once you get feedback, you can move onto exploring the following questions. And if you can’t get a good assessment, then just proceed to ask these questions of any program you are considering.

Here is a short primer for what to look for in a treatment program. Like jeans, we know that everyone has a unique fit and that there isn’t one specific treatment program or treatment philosophy that will work for everyone. The questions we are suggesting are good ones for everyone to ask and will help you find support that matches your specific needs.

What is your Treatment Philosophy?

Different treatment programs have different philosophies about how to help someone with their substance use problems. Some places adhere closely to the traditional 12-step approach, while others are open to taking a more harm reduction approach. And if you review program websites you will quickly think that every program does everything! They say they are experts in treating co-occurring issues, trauma, professionals, and effectively use every modality under the sun (e.g., CBT, MI, DBT, EMDR and all sorts of other acronyms). The reality is that many providers have realized that consumers are wanting access to a variety of services and market themselves as such.. It can be very difficult to ascertain what will be helpful to you or your loved one and a program that outlines all of these options as a way to sell the program does not guarantee they do any of the treatments effectively. So it is important to dig a little deeper.

A website may be a good way to start the process of finding a treatment program, but calling is much more informative. It’s good to ask specifically how they determine which treatment modality will be the best fit for you and how is it provided (i.e., individual sessions, group sessions or lectures). How many individual sessions do you get a week and what is the focus of those sessions. If there are groups, how many a day and how many people are in each group. And if they say something that you don’t understand or are vague in their explanations, ask them to clarify! If they can’t do it or don’t do it well enough for you, that might be a sign about how happy you will be with the treatment program overall.

Who provides the actual treatment? What are their credentials? And how are they supervised and trained?

Treatment programs differ widely in who on staff has actual day-to-day therapeutic contact with clients. As you interview programs, ask who will be running the groups and providing the individual therapy, because it’s not always who you think it is! Many programs are staffed largely by counselor level providers and some states require only a high school degree in order to be eligible for the certification. Many people with this level of training are talented and have other degrees or specialties that are helpful. Others however are ill-equipped to treat the range of issues that are often part of the clinical picture. Most programs say they treat co-occurring mental health issues and yet they have few on staff with doctoral or medical degrees. We recommend that you look for programs where there are a mix of credentials and where you will have regular (at least weekly) contact with a masters level clinician or above. What are your feelings about medications and how often is there access to a psychiatrist?

Just as programs have different treatment philosophies, they can have different philosophies about medication. Many programs continue to be “abstinence only” which means they hold the older, more-traditional belief that the job of a treatment program is to get the client off of all substances, which includes prescribed medications that are sometimes associated with misuse (e.g., stimulants etc). Unfortunately, these programs have also been against the use of very effective medication assisted therapies such as opioid replacement medications (e.g., methadone and Suboxone) and Naltrexone. While many are having to change their position due to public pressure associated with the rate of overdose from opioids, their ambivalence about these medications often causes them to be less supportive than they should be of many clients needing to be on long term maintenance.

Ask the treatment program about their stance on medications and, if you’re not sure why they hold their stance, ask them to explain. Specifically inquire about whether or not they are willing to maintain clients on opioid replacement medications or whether they discharge clients on Vivitrol (for opiates or alcohol) or Antabuse (for alcohol). .Again, if the explanation isn’t satisfying to you, or seems to go against what you’re reading here or elsewhere, that’s an important sign that this program might not be right for you. Also ask how often the psychiatrist will see you or your loved one as frequency is the only way medications can be well monitored and the treatment individually tailored to your needs.

If this program isn’t right for me/my loved one, what is your refund policy?

Unfortunately, even when you have done all your homework and planned everything out as much as possible, sometimes the “fit” just isn’t right and you won’t know that until you participate in the program. Many programs require payment up front and it is important to know how they will handle it if you decide the program isn’t a good match for you. Many places do not offer partial refunds, but some do and will work with you if you decide to end the treatment relationship. It’s important for you to know those details up front, as it can lead to an extended battle for your money (and adding another battle is not really consistent with self-care!!).

How do they help you develop an aftercare plan if inpatient or ongoing plan if outpatient and how do they work with treatment providers you already may have in place?

As you try to identify an inpatient program it might seem strange to be asking about aftercare before you’ve even started! What you’re looking for is two-fold: a very clear and supportive aftercare program that is developed in collaboration with you and some follow up for a period of time to make sure you are connecting to the supports in your community. You also want to know how they are going to collaborate with any provider you have already been working with. Will your inpatient therapist talk directly to your outpatient therapist or psychiatrist? Or is it just the admissions team. If it is the later, be advised that information can get lost in translation and advocate that your team talk directly to each other, and frequently! You would be surprised how many treatment providers never pick up the phone to speak to another professional.

This primer is just the tip of the iceberg about what to look for in a treatment program. For more information about what to look for, look to Anne Fletcher’s book Inside Rehab to learn more about what happens in rehabs and different programs, when rehab is the best choice (and when it’s actually not the ideal treatment setting) as well as more questions to ask as you make your decision.

The post Finding a Treatment that “Fits” appeared first on The Center for Motivation & Change.

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carinaconnor5 · 7 years

Text

Finding a Treatment that “Fits”

What is your Treatment Philosophy?

Who provides the actual treatment? What are their credentials? And how are they supervised and trained?

If this program isn’t right for me/my loved one, what is your refund policy?

How do they help you develop an aftercare plan if inpatient or ongoing plan if outpatient and how do they work with treatment providers you already may have in place?

The post Finding a Treatment that “Fits” appeared first on The Center for Motivation & Change.

from https://motivationandchange.com/finding-treatment-fits/

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brentrogers · 5 years

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Podcast: Finding a Therapist- What to Look For

Are you ready to learn how to find the right therapist for you? Join us for an in-depth discussion.

SUBSCRIBE & REVIEW

Guest information for ‘Jeff Guenther- Find a Therapist’ Podcast Episode

About The Psych Central Podcast Host

Computer Generated Transcript for ‘Jeff Guenther- Find a Therapist’ Episode

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Jeff Guenther, LPC: Yeah. Thanks for having me here. I’m really excited to talk to you.

Gabe Howard: Well, I’m excited to talk as therapy is one of those things that everybody has heard of.

Jeff Guenther, LPC: Mm hmm.

Gabe Howard: Yet there is all this misconception about it.

Jeff Guenther, LPC: Yeah, totally. And it’s really tricky to figure out. Even if you want to go to therapy, how do you start it? Where do you find a therapist?

Gabe Howard: Jeff, let’s start small. What is therapy?

Jeff Guenther, LPC: Totally.

Jeff Guenther, LPC: Yeah, I think that’s a really good, succinct, concise definition that we can all get behind. I agree.

Gabe Howard: That’s it, we should e-mail Webster tomorrow.

Jeff Guenther, LPC: Can we please? Yes.

Gabe Howard: Yeah. Yeah.

Jeff Guenther, LPC: Yes.

Gabe Howard: Jeff and Gabe, changing the definition of therapy since…

Jeff Guenther, LPC: I support that.

Gabe Howard: Jeff, of all the things that you could have put your time and talent behind, why helping people get to therapy?

Jeff Guenther, LPC: Mm hmm.

Gabe Howard: And that’s what I’d kind of like to switch gears and talk about now. So you have decided that you want to find a therapist. Where should you start?

Gabe Howard: So it’s fascinating that you bring that up because the next question I was going to ask you is how does one become a licensed therapist? Because I see LPC, I see MSW, I see PhD.

Jeff Guenther, LPC: Right.

Gabe Howard: And for a person not in the industry. What are all the differences? What is the license that we’re looking for so that we know we’re in good hands?

Gabe Howard: The Internet is vast.

Jeff Guenther, LPC: Oh, yeah.

Gabe Howard: Now, what can a client look for to make sure they have a good fit? Now, I don’t mean licensed or unlicensed. I mean a good fit for you and a therapist.

Jeff Guenther, LPC: Right.

Jeff Guenther, LPC: There’s more than one therapist and they’ve all voted for different people.

Gabe Howard: And we’ll be right back after these messages.

Sponsor Message: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral.and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral.

Jeff Guenther, LPC: Congratulations. I want you to actually choose three potential therapists.

Gabe Howard: Really?

Gabe Howard: And when you say schedule a consult, that’s a phone call generally speaking, correct?

Gabe Howard: So now you’re on the consult call. What are some good questions to cover?

Jeff Guenther, LPC: Yeah, so this is where I have a lot to say. So

Gabe Howard: Please, please.

Gabe Howard: On one hand, I feel that those questions are deeply personal and I would be uncomfortable answering them at my job. However, I asked one of those questions to one of my therapists

Jeff Guenther, LPC: Oh, yeah?

Jeff Guenther, LPC: So it’s exciting because now you’re going to finally get into it. However, therapy can oftentimes move really slowly. So that’s something to keep in mind.

Gabe Howard: Jeff, thank you so much. How can folks find you on the Internet?

Gabe Howard: Wonderful, Jeff. Thank you so much for being here, we really appreciate it.

Jeff Guenther, LPC: Thanks for having me.

Podcast: Finding a Therapist- What to Look For syndicated from

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