# Clinical Psychologist Appointment



## odd_one_out (Aug 22, 2006)

I asserted my needs today despite nerves _and_ was fully validated, but this is not just about a triumph over social anxiety. I'd been nervous about seeing the clinical psych because I didn't know why they'd given me the appointment and have had bad experiences with such people.

But I soon realised I hadn't encountered any mental health worker with such proficient listening and people skills. I was so anxious at first I made the skin on my hand raw but even while trembling was able to communicate and assert my needs, although through writing initially. She soon put me at ease and I had the sense I could tell her anything.

She was impressed with my depth of knowledge on support I required and kept a copy of my writing. She agreed with all my concerns and freely admitted the support didn't exist for anyone with Asperger's or my specific needs. We discussed my requirements in depth and brainstormed what we could try to get, both knowing there was nothing available. She agreed I needed CBT that was more specialised and long term than could be offered by her. The waiting list was 18 months anyway!

She and the psychiatrist I know will discuss the possibility of a neuropsych referral but funding looks unlikely. They keep going back and forth to one another because none of them know what to do. She was amazed how I'd been going round in circles the last 3 years but has seen similar cases. When I said we were in the same room in which I used to have therapy she was astonished at how I'd come full circle and we discussed how inappropriate the therapy and therapist had been. She works in the same team as the therapist so I didn't go into detail, but she was validating about what I did say. I'd encountered the therapist in the waiting room but had been hidden behind sunglasses.

The appointment went over time because she appeared to be enjoying it and told me similar. Although it's unlikely they can help she's going to write a letter about our meeting as an acknowledgement of the problems. I can use that when writing to the health managers or to Members of Parliament. As we were nearing the end she told me to not give up.


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## caflme (Jun 7, 2009)

:clap:boogie:banana:yay:high5:high5 - you were really overdue for something good.


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## odd_one_out (Aug 22, 2006)

The letter arrived. It contains many inaccuracies, which I will correct below in *bold*. Omissions for privacy are indicated by ----. I separated it into better paragraphs for readability. I should have just written everything for her. :roll

Dear --------,

Thank you for coming to meet with me on 29th July 2010 to discuss your current difficulties. As we agreed, I am writing to briefly summarise our meeting and discussion.

You told me a little about your previous experiences with psychological therapy. You first tried weekly CBT in ----. You indicated that the focus had been on behavioural change and setting tasks for changing behaviour which you had found very difficult and therefore you needed to end the therapy early. *This made my blood boil a bit because I was clear why I ended the therapy and how he was a behaviourist and didn't do CBT as I'd been told. He gave almost no input and would end the sessions as soon as I found it difficult to speak, once as early as 10 mins in. This was after travelling a long way.*

In ---- you were offered psychological therapy via your GP surgery for 12 sessions. It seemed that here there had been more emphasis on monitoring and challenging thoughts, which you found it easier to do and you thought this would be helpful for you. *Well, it was actual CBT this time!* You were referred on to secondary mental health services following this and commenced further therapy in ---- (either psychodynamic or psychoanalytic). This had not been helpful to you and you felt it had made you worse rather than better. *You omitted how they failed to spot my later diagnoses and behaved badly.*

You told me that currently, you were feeling frustrated at an apparent lack of progress since first talking to your doctor and different Social care professionals about the possibility of a diagnosis of Asperger's syndrome (an autistic spectrum disorder) ----. *Agh! You omit so much. You neglect to mention I got evaluated as having Autism by ------- in ---- and that I've been pursuing autism support with the support of doctors and my last counsellor, who emphasise my needs in this area. You neglected to mention any of the system failures.*

You felt that you were under pressure and had a limited network of support. Also, that without help to support your independence, your privacy and ability to make choices was restricted which contributed to a sense of helplessness. *This is one of the few things written accurately but I know this is only because I wrote this part down for her.*

You had previously received funding from ------ for [a few sessions with a disability advocate] and Social Services had been providing funding for support needs for 5 hours per week. *No they hadn't. Social Services approved funding but then didn't administer support. My friend's been chasing them up all week and has gotten nowhere.* You were concerned that your money would run out and financial difficulties were making your life much more stressful of late.

We talked a little about your particular support and treatment goals and the service offered here. I explained that [we] are currently commissioned to provide services to clients with complex mental health difficulties, with severe symptoms and current risk of harm to themselves or others and that psychological therapy would be limited. *Limited is an understatement considering you mentioned the waiting list was 18 months. And you emphasised and explored this option with me and said it would not meet my needs and how I needed help now. Why not mention this?*

You had previous experience of psychological treatment and had also researched certain possibilities in order to find the right match for your needs. *I am a fully informed patient be very afraid.* Based on this information, you wanted to be referred to a neuropsychologist for a specialist intervention. *Wrong! My doctor referred me to you incompetents because he needed a referral through you to a neuro; the neuro was his idea. The 3 of you behave as though I've pulled it out of the air, despite me emphasising in meetings my doctor only referred me to you so you could refer me on, that is, he knew you couldn't help me yourselves.* This would be for CBT that took account of developmental disabilities and co-morbid conditions. You indicated that the focus of the work should be around executive dysfunction difficulties, adaptive behaviour and independent living skills (also taking account of food issues and hypersensitivity). --------------.

You indicated that the timeframe would need to be longer than previous experiences ideally a year or more. *And you neglect to mention I took this directly from a professional recommendation as to what's required for my conditions.*

You also felt that having a case manager or service co-ordinator would be beneficial for you as it seemed that your main needs were in terms of assistance to support your daily living and helping you access financial support. *There is a failure to emphasise my mental health needs here. Of course my main needs are to ensure I have food and accommodation!*

You felt that you would enjoy improved wellbeing if you could regain your independence to a degree; resolve some financial problems; could meet with people with similar difficulties or enhance your social activities; and could enjoy an enhanced network of support.

I explained that [we] would not be able to provide particular support and treatment that you were requesting at this time. *My doctor referred me to you to have you refer me to those outside the region who could provide it!* Also that unfortunately, I am not aware of another local service that could currently offer help in this way and would therefore consider it to be a current gap in local service provision. *That's the understatement of the decade.*

We considered alternative possibilities and concluded that you would continue to make contact with local Social Services, with regard to case management and help with funding support for you as a vulnerable adult to enhance your independence. *That's redundant, and I mentioned I keep trying to get Social Services to carry out their plan with the funding they have agreed.*

Also, that you might browse the internet to see if there were helpful forums that may offer a source of support and contact with others with similar difficulties. *Pure gold. I'm so glad you admitted you advised this. :haha:rofl*

It was nice meeting with you and I'm sorry I could not be of further assistance. *In other words you're on your own with autism complicated by severe comorbids, inability to access Social Services and benefits, and zero income, so therefore you have to use internet forums because they can provide more support than the health service (which is negative help because now I have to take time to get your notes here amended in my records).*

Yours sincerely,
------------------


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## odd_one_out (Aug 22, 2006)

For context see blog entry: http://www.socialanxietysupport.com/forum/blogs/odd_one_out-9224/mentally-raped-1694/.


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## caflme (Jun 7, 2009)

I would be tempted to copy this and mail it to her to show her the omissions and inaccuracies she made...


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## odd_one_out (Aug 22, 2006)

caflme said:


> I would be tempted to copy this and mail it to her to show her the omissions and inaccuracies she made...


I just had a dream about this and was tempted to write to her. But I don't know whether it would be worth it and she'd not help. I know now people can present themselves well as one thing (as in the original post) and not be genuine.

She had a chance to make some difference just by explaining and acknowledging my situation. I can't believe she's inept enough that she failed by accident. It's more likely she's being weak, and her language use supports this. She doesn't get to the point, uses _you_ everywhere, never risking providing her own opinion, and lets the service failures off the hook with feeble, impotent language.

I will re-write my amendments and send them to my doctor to be added to my records. That will save the hassle of dealing with her ineptitude and possible hostility (I have to pick my battles). My friend's becoming flustered because social services still aren't returning calls, saying "It's getting beyond a joke".


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## caflme (Jun 7, 2009)

odd_one_out said:


> I just had a dream about this and was tempted to write to her. However, I don't know whether it would be worth it and she'd not help. I know now that people can present themselves well as one thing (as in the original post) and not be genuine.
> 
> She had a chance to make some difference just by explaining and acknowledging my situation. I can't believe she's so inept that she failed by accident. It's more likely she's just weak, and her language use supports this. She doesn't get to the point, uses _you_ everywhere, never risking providing her own opinion, and lets the service failures off the hook with her feeble, impotent language.
> 
> I will re-write my amendments and send them to my GP to be added to my records. That will save the hassle of dealing with her ineptitude and possible hostility (I have to pick my battles). My friend's becoming flustered because social services still aren't returning calls, saying "It's getting beyond a joke".


*I see your point about having to pick your battles... yes... your friend is right... this is all unimaginable to anyone outside of the issues involved. I'm not sure things would be much better here in the U.S. since you are an adult and not a child... all services here seem to be laid out of kids under 18 y/o. :roll what a mess.*


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## odd_one_out (Aug 22, 2006)

Maybe I should move somewhere like Liverpool one day to access their AS adult services. But I currently can't afford to move. My experiences have also resulted in me having no trust in any professionals so I don't know if I could ever face it again. I don't think anyone's caused as much harm to me as healthcare professionals.

ETA - No I can't do it anymore. I've had enough. They can stuff it.


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## caflme (Jun 7, 2009)

odd_one_out said:


> Maybe I should move somewhere like Liverpool one day to access their AS adult services. I currently can't afford to move, however. My experiences have also resulted in me having no trust in any professionals so I don't know if I could ever face it again. I don't think anyone's caused as much harm to me as healthcare professionals.


*I would hope if you had the money to move and access the services you would still try. But that's just me... I'm pretty sure your friend would feel the same. I do understand what you are saying though - truly.*


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## Lonely Hobbit (Aug 31, 2009)

odd_one_out said:


> The waiting list was 18 months anyway!


This makes me glad I live in the U.S.A. I can make my first appointment with a doctor no less than a week away. If I have to wait more than a week, I'll see someone else. Eighteen months is an awful long time to wait to see a clinical psychologist.


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## odd_one_out (Aug 22, 2006)

LaRibbon said:


> I don't think the psychologist has any reason to get hostile with you when the letter clearly has inaccuracies she made, and a letter of that sort is bound to need redrafting anyway. But obviously if you don't believe it will help your current situation then don't exhaust yourself over it. It's outrageous that you have to struggle so hard to get the support you need which you obviously need right now. I wonder what other people in your position do...


I've heard some stories and they follow the pattern of increasing isolation and mental health problems. There have been surveys and reports published that say similar.

I sometimes think it must be all in my imagination since they aren't helping me. But then I realise that's not the case when something abnormal happens. Like just now I was too ill to bathe myself and ended up lying on the kitchen floor to prevent myself fainting. I struggle to eat properly and sleep never seems enough. I want to wash and dress but have had to crawl back into bed.


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## Lonely Hobbit (Aug 31, 2009)

LaRibbon said:


> Are you referring to just a standard psychologist or psychiatrist or one that specialises / has experience with autism spectrum disorders?


I don't have an autism spectrum disorder, but even if I did I wouldn't have to wait a year and a half to see someone who specializes in that.


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## odd_one_out (Aug 22, 2006)

^ Although the waiting times can be that long, the 18 month wait the psychologist mentioned was not for that but for CBT for people with mental health issues that aren't too complicated. There's no autism support here so she was exploring other options. There's zilch.



LaRibbon said:


> Have you had a recent blood test done? Blood pressure checked? You may have anemia or something obvious contributing to the physical symptoms.


Blood pressure was fine and done a couple of months ago. It's always all right. So is everything else. I've been to the doctors for blood tests when experiencing symptom flare ups like this but results always come back normal. Maybe they're not doing detailed enough tests.


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