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gandolfication

Therapists: Psychologist (PhD/PsyD) or Social Worker (LSW)?

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I moved back to OH, and I am starting to screen for a new therapist.

Below is a summary of the criterion I'd ideally like to try to get as close to as possible (I had a lot of this in VA - was very lucky).

I've worked with a few therapists now, and I guess my experience now is that I think I like the one or two LSW's better than the PhD's and PsYD's.  I normally venerate education and expertise, but the LSW's seem to be more...for lack of better terms...willing to get 'real,' and work practically, possibly be more empathetic or longsuffering, maybe more flexible.

Generalizations I'm sure, but what are others' experiences here as between the psychologists vs. LSWs / social workers?

Maybe it's more a matter of what clinic/office and obviously which particular person one works with?  That's why I'll phone screen - it'll also tell me if they're willing to really work with a patient, or just get 'em in and out the door.

I'm trying to copy in some friends here (how can I still be so bad at this site?)  Let's see if this works.  @depressionsucksass, I don't think  you and I have crossed paths, here but we need to since you've won today's prize for best depression avatar name.

 

Provider/Practice Name

 

Name

 

Qualifications

 

Location

 

Accepting new patients / clients?

 

Hours/Flexibility/availability - after normal work hrs, weekends?  virtual?

 

Anthem/BC/BS?

 

Cost

 

Areas of focus & modalities - DBT, CBT, ACT

 

Years experience

 

Work w/ Partners?

 

What like most about being therapist?

 

Empathetic

 

Integrated/Coaching/Goals approach

 

(workplace anxiety)

 

BiPolar clients

 

Okay to Get real, fast?

 

Referrals / knowledge of area support organizations

 
   
   

 

@Sophy

@uncertain1

@jd4010

@20yearsandcounting

@bohemian_artist

@riverlight

@stand_alone

@sober4life

@lonelyforeigner

@epictetus

@depressionsucksass

 

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Well thought out as always, wouldn't expect anything less from you @gandolfication😁

I've also had a very good experience with an LSW. Perhaps they're just more flexible in their thinking, as smart as PHDs are they can also be very stubborn, thinking they know it all which makes it difficult for them to truly empathize. Or it could be that LSWs are more likely people who have experienced major life challenges themselves and got into the field to help people. Some PHD types do it because their parents pushed them or because they like the prestige, doesn't mean they don't care but it would explain why some seem to have more difficulty relating. 

Screening clinics is a great idea. Some definitely specialize to some degree. A clinic mainly dealing with extreme cases (i.e. homeless, court ordered therapy etc.) may consist of people viewing your issues as trivial whereas a clinic mainly focused on helping frustrated housewives may be ill equipped to handle someone with serious mental health issues.

It's sad that it's so difficult to find a good match but looks like you're going about it the right way. 

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Well, because I'm a special little snowflake, I have all 3: a pdoc, a talk therapist and a social worker.

My pdoc obviously does meds, but also all the "Oy I'm a doctor so listen to what I say" stuff, if I need his help with things like disability claims, or whatever. As a pdoc, he has the clout that makes others shut up and listen, so I want/ need him on my team.

Then I have my talk therapist, who's kinda "theoretical". That's good and bad. It sucks for the more "practical/ pragmatic/ down-to-earth" stuff, but I still really need him for thinking things through on an intellectual level, to see where I'm getting stuck in my thinking or to analyse stuff.

And then there's my social worker who has a heart of gold and helps me with literally anything that I get my daft brain tied up in knots with. She even accompanies me to scary appointments, if I really need her to. She's got that wonderful down-to-earth "what help do you need?" thing. But, I also don't discuss the philosophical/ theoretical/ analytical stuff with her, the way I do with my T.

My insurance covers my pdoc and my T.

My social worker is from a community outreach kinda thing, which is funded through other sources and hence "free" for me to use.

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Posted (edited)
17 hours ago, lonelyforeigner said:

A clinic mainly dealing with extreme cases (i.e. homeless, court ordered therapy etc.) may consist of people viewing your issues as trivial

I agree that this could be the case, but wanted to share that my experience of this has been reeeeally different 🙂

My pdoc is the city's pdoc for: heroin addicts, meth addicts, homeless people, people with HIV and similar situations that other doctors find "too difficult".

He is AMAZING. He's literally one of the best people I've ever met in my life - and I mean him as a human being, not as a pdoc. He's incredibly dedicated and a total inspiration. And he's got an incredible sense of humour.

He actually LOVES having a few clients like me, that aren't homeless, addicted, in a DV situation, in jail, etc.

He really needs a few patients that aren't worst-case-scenario type patients, just to kinda help keep him sane/ optimistic.

Same goes for my social worker. She works mainly with people who have acute psychosis and who need major daily "care" to get through life.

She too is sooooo grateful to have a few clients that she can talk to about things in a normal, adult way and who are "only" struggling with relatively minor crap. At the moment she's helping me sort out some disability claim stuff and helping me organise the paperwork so I can enrol in uni again.

Sometimes I feel like maybe I shouldn't be using up her time/ the resources of this outreach place, but usually I only see her a few times per year, so I'm taking up hardly any time/ resources. For 2019 we've agreed to do monthly appointments, to really get a lot of my paperwork sorted out, once and for all.

For her too, having clients who struggle with "less awful stuff" is a godsend and gives her a breather and helps her stay dedicated and motivated with her more difficult clients.

So that's *their* perspective.

And mine is: I love these 2 people. They work with such intensely challenging clients, and they both have a heart of gold. They're both so dedicated and inspirational.

Also, because I know they've both "seen it all" I feel much more comfortable sharing my crap with them and don't feel so stupid for struggling with basic life stuff, that I feel I shouldn't be struggling with.

If I struggle with stuff they go "Hey Sophy, you're not homeless and you're not an addict - YOU ARE DOING SO GOOD!!!"

It's kinda a good change in perspective, that yeah... I'm not homeless, I'm not an addict... You know what? Things aren't as shit as they sometimes feel/ seem...

((hug))

Edited by Sophy

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Most wonderful therapist I had left a successful tech career to get his LPC. But as you know the most meaningful criterion is how you and the therapist connect. Google "Psychology Today find a therapist" - I found it helpful. I bookmarked a couple of possibilities in case I go back into therapy (my guy retired). I suspect that you are not interested  at looking into free support groups right now. Supposedly these groups are a reasonable way to get recommendations for therapists.

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6 hours ago, Sophy said:

Well, because I'm a special little snowflake, I have all 3: a pdoc, a talk therapist and a social worker.

My pdoc obviously does meds, but also all the "Oy I'm a doctor so listen to what I say" stuff, if I need his help with things like disability claims, or whatever. As a pdoc, he has the clout that makes others shut up and listen, so I want/ need him on my team.

Then I have my talk therapist, who's kinda "theoretical". That's good and bad. It sucks for the more "practical/ pragmatic/ down-to-earth" stuff, but I still really need him for thinking things through on an intellectual level, to see where I'm getting stuck in my thinking or to analyse stuff.

And then there's my social worker who has a heart of gold and helps me with literally anything that I get my daft brain tied up in knots with. She even accompanies me to scary appointments, if I really need her to. She's got that wonderful down-to-earth "what help do you need?" thing. But, I also don't discuss the philosophical/ theoretical/ analytical stuff with her, the way I do with my T.

My insurance covers my pdoc and my T.

My social worker is from a community outreach kinda thing, which is funded through other sources and hence "free" for me to use.

Yah, good description, and this is what I had in VA.  I did some significant research and calling here, and have at this point narrowed to a small handful of community integrated behavioral health care places...so far the main 3 don't seem to be overly service oriented with respect to new/prospective clients.  I strongly prefer a center where each of these 2-3 people work mainly at the same place so that it actually is integrated.  

I think the profession otherwise is fatally flawed in that these supposed experts literally do not talk to each other, or at any rate, not adequately.  The difference is everything to me.

Anyhow, I'll keep trying.

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My 3 peeps are all in totally separate places but they all know and like and respect each other. I don't think they really swap notes/ info about me or anything tho, other than maybe diagnosis?

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2 minutes ago, Sophy said:

My 3 peeps are all in totally separate places but they all know and like and respect each other. I don't think they really swap notes/ info about me or anything tho, other than maybe diagnosis?

I can understand that, and am glad that works for people...I suppose and can imagine it might if I had really good people, but now that I've had the experience of an integrated place, it seems obvious.  Hard to tell how much of that is in my head, but I know a number of times, it really added both synergy and convenience, which helped me.

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23 hours ago, lonelyforeigner said:

Well thought out as always, wouldn't expect anything less from you @gandolfication😁

I've also had a very good experience with an LSW. Perhaps they're just more flexible in their thinking, as smart as PHDs are they can also be very stubborn, thinking they know it all which makes it difficult for them to truly empathize. Or it could be that LSWs are more likely people who have experienced major life challenges themselves and got into the field to help people. Some PHD types do it because their parents pushed them or because they like the prestige, doesn't mean they don't care but it would explain why some seem to have more difficulty relating. 

Screening clinics is a great idea. Some definitely specialize to some degree. A clinic mainly dealing with extreme cases (i.e. homeless, court ordered therapy etc.) may consist of people viewing your issues as trivial whereas a clinic mainly focused on helping frustrated housewives may be ill equipped to handle someone with serious mental health issues.

It's sad that it's so difficult to find a good match but looks like you're going about it the right way. 

These are very good points, and just about where my thinking has been at.  thx

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Yeah, if you can find a place where they're all integrated in one place that's great - go for it!

I just meant if you can't find a place like that, still go and get good care, just in different places.

 

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I've spent probably 6-7 hours the past 2 days, on the phone and on line, reviewing info on doctors and therapists, from my insurance company, calling them, talking to them, etc.

I do have an apt. next week with a behavioral health practice where I do a financial interview first, then meet with their PCP, then they refer me to their in-house psych, and then I think to a therapist.  For some reason, I have misgivings even about this, but am going to the apt.

Other than that, I've struck out with everyone.  My own PCP declined to give me a referral, just saying it was hard, and I should call (!).  Going to talk to him about that - he's been practicing here 25 years.

Every integrated community BH care center so far, I've been ineligible for due to either income, or having insurance (again, way to go crappy private insurance!), or not being a resident (that'll change soon), or not having the right insurance, or not accepting new patients, etc.  Several groups have a single nurse practitioner, because you can't get in to see the psych.

And my calling around is after I had contacted 3-4 government and quasi-government professionals whose job it is to know about the landscape of access to mental health care.  

In my current role, I am not yet established enough to do this unfortunately, otherwise, I'd want to write about this as an advocacy article.  At some point I am going to.  This is atrocious. 

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Yeah, where I live there's often waiting lists of 3 to 6 months to even get an appt with a therapist for the first time. It sucks.

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10 hours ago, gandolfication said:

In my current role, I am not yet established enough to do this unfortunately, otherwise, I'd want to write about this as an advocacy article.  At some point I am going to.  This is atrocious. 

It is indeed! You're still functioning enough to fight for yourself but someone who doesn't have that drive/energy is just screwed unless they have a relative advocating for them. 

10 hours ago, Sophy said:

Yeah, where I live there's often waiting lists of 3 to 6 months to even get an appt with a therapist for the first time. It sucks.

That's why I gave up on looking for one. Got tired of making phone calls just to be ignored and put on a LONG waiting list... When I'm bad enough to need to talk to a therapist I don't have the patience for all this BS. 

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Posted (edited)

If you have financial challenges the YWCA /YMCA and similar organisations have good therapists.   Up here in Canada they ask to see our pay stubs and income tax returns.  One can save some money.

Edited by duck

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On 1/4/2019 at 3:14 AM, lonelyforeigner said:

It is indeed! You're still functioning enough to fight for yourself but someone who doesn't have that drive/energy is just screwed unless they have a relative advocating for them. 

That's why I gave up on looking for one. Got tired of making phone calls just to be ignored and put on a LONG waiting list... When I'm bad enough to need to talk to a therapist I don't have the patience for all this BS. 

That is really sad and unfortunate.  The services aspect of these professionals and their staff often is so poor.

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On 1/4/2019 at 5:37 AM, duck said:

If you have financial challenges the YWCA /YMCA and similar organisations have good therapists.   Up here in Canada they ask to see our pay stubs and income tax returns.  One can save some money.

That's funny, I've been using a YMCA membership here this month.  Pretty sure most don't have this connection in the states though.  Cool though.

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11 minutes ago, gandolfication said:

The services aspect of these professionals and their staff often is so poor.

I was fairly happy with them in the DC area, guess there was enough healthy competition to keep them on their toes. Here demand is so high that they start behaving like oligopolists, no one gives a damn about a patient when there's 10 others waiting in line.

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13 minutes ago, lonelyforeigner said:

I was fairly happy with them in the DC area, guess there was enough healthy competition to keep them on their toes. Here demand is so high that they start behaving like oligopolists, no one gives a damn about a patient when there's 10 others waiting in line.

yes, that's very well said, and my experience exactly....including just having come from 8 years in DC.  Whole lotta more (good) providers there apparently.

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There are some free drop in clinics but that is usually short term.  

Jewish Centre and Catholic Social Services and also good I heard for a discounted price.  

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