Sigh. Okay, I mentioned that I was going to call up and seek a therapist a few weeks ago. Still haven't done it. Phones stress me out, I have to do it during business hours which is hard to remember, and I'm nervous. Can someone help me with a script, to reduce my anxiety about it? =_= I have a referral from my PCP, I just need to call the number and set up an appointment. I've seen a counselor in college, but I suspect that that procedure is somewhat different. So... I'm looking for someone to deal with spergy diagnosis, trans stuff, and more general depression/anxiety/family stuff. I'm guessing that last one is the easiest to deal with, because it's really common. But is it better to specify that I'm looking for a specialist in sperg stuff, trans stuff, or is it really not necessary to specify? I do want to discuss trans stuff and like, top surgery and stuff, but I also sometimes go nonverbal under stress, so someone who can take things like 'I can't talk right now, can I please type' in stride would be good. I don't know how difficult either of these are to find. Does it matter if the psych person is male or female? They seem to ask that a lot and I'm not completely clear on the relevance. Are therapy hours normally during normal business hours? Is there anything else they're likely to ask?
I can answer one of your questions! Gender of psych person matters to some people. As a child I had a strong fear of and resulting aversion to men. (At the time I was not aware that trans people existed and therefore it did not figure in my feelings.) It´s gotten better over time, but when I first tried to look for a psych in high school I specified that they had to be a woman. If it doesn´t matter to you then just say so, but that´s most likely why they want to know.
Oh! That makes sense. Thank you! I wasn't clear on whether I was supposed to care for some reason, but it makes sense that a gendered preference would just be common enough that they'd ask by default.
You should mention specifically what you want and need, especially because you'll sometimes require accomodation and deserve to have a professional suited for helping you. You can still talk about general things with a professional who specializes in autism and/or gender, and you can still talk about either of those with a professional who specializes on the other, but keep in mind that the more specialized your psych is, the less splaining you'll have to do. If you get a more general psych, even if they're awesome and willing to learn and help, you should prepare to spend a few spoons explaining, for example, why you sometimes need to text instead of talking, or that even pre-transition you are still a dude and not "a girl who wants to be a dude", or any other stuff that might already be established beforehand with a more specialized professional.
I would try asking what the therapist specializes in as an open-ended question first (unless they give that information themselves), and if that question doesn't give you any useful information, ask if they have experience with autistic patients or trans patients. A therapist doesn't necessarily have to specialize in a thing to be competent at it, and they may be just fine at handling something new, but I'd prefer to know up front. Of course, if they do specialize in a thing, that's useful to know. I am going to guess that getting a therapist who gets trans issues correct is going to be more difficult than a therapist that gets autism issues correct, but that's kind of a hard question. I also want to note that not all therapists can give a diagnosis, and very few of them can give a detailed enough diagnosis to get accommodations on stuff at work/school, so you may need to be looking for someone else for that. Yeah, I know, psych issues are a fucking pain. Most therapy places are open after business hours so that people who can't go during the day can go. You'll want to know if a particular therapist stays those hours if it's important to you that you schedule time in that block. But if it's a multiple-therapist practice, then there will almost certainly be at least one that stays late. They might ask if you have insurance and if so what type. Or they might assume you have insurance and just ask you what kind of insurance you have. I'm not thinking of anything else just now but if I do I'll post again.
Thank you, guys; that helps a lot. Less splaining would definitely help, but as long as they're not actively hostile, I think I should be able to do that. Just need to go in with the spoon-plan prepared, so I don't get flustered and panic. I have few enough verbalization issues that most people don't notice, and enough that I carry around a notepad at all times in case I become unable to talk. So... accommodations. Yes. It's quite embarrassing. =_= I'm currently planning to go through my doctor's office psych department, so I... suspect it's more 'call the general number' than actually talking to an individual therapist, but I'm not quite sure how it works. I may end up hunting around, if the doctor's office doesn't work out. Tad bit nervous about that, because I'm not sure what ends up on one's Permanent Record Forever. Thankfully, my workplace is cool enough that a diagnosis would be helpful, but I think my coworkers would be okay with accommodating without formal legal requirements. They've already been lovely about letting me not handle user-correspondence and phone calls, because it eats all my spoons. After business hours is awesome; that helps a lot with my stress, because I'm always unhappy and upset about missing work. Feels like I'm shirking my responsibilities, even though I know I get sick leave for this exact reason. Thank you; I'm going to try to call up tomorrow and get things set up.
If you're in the US, I can talk a bit about privacy laws as they apply to mental health, if that would help. If not, I can't help much. But in most of the world that's wealthy enough to have psych offices like this, privacy laws specifically inhibit things like mentioning that so-and-so called asking for appointments today. One of these days I'm just going to make a huge fucking thread of everything I know about the US mental health system.
Yep, I'm in the US, so that would be awesome. I know that HIPPA means that psych folks can't tell your parents about your treatment without your permission, and they can't tell people anything that would be personally identifiable. But I'm not sure about the interdepartmental procedures - like, does everything you say go in your medical record forever? :\
Your therapist's notes, and probably some other information like your insurance info, will go into the records of that psych office. They will not go into Your Permanent Medical Record because among other things you don't really have a centralized medical record, just a bunch of medical records at various places. (This is really good from a privacy standpoint, but also people die sometimes because they forgot to tell Doctor Such-and-Such that they have a medication allergy, or because they bought their prescription from Dr. Such-and-Such at Wal-Mart and their prescription from Dr. So-and-So at CVS and those two drugs are lethal in combination and no one had access to enough information to prevent this.) When you go to a new health professional of whatever kind, they'll often give you a form that asks you for places you've been treated for anything and everything before and please sign your name so that we can collect your records from them. But you don't have to tell the new place about every old place, and you don't have to give them permission for anything. And one time I actually filled out all that paperwork truthfully and completely only to have a previous location call me up and ask me if I was okay with releasing my records to the new place. Professionals will want your old records, for a long list of very good reasons, but it's up to you whether they're allowed to have them or not. As far as I know all of my records from before I turned 18 are rotting away in a cabinet somewhere. Within a particular practice, assume that everyone who works there will have access to your information, and that they're bound by the exact same privacy laws as your therapist. HIPAA doesn't just cover your therapist: it also covers people like the secretary that checks you in when you show up for an appointment or the person who works in the billing department or pretty much anyone who would know something about someone who walked into the building. So let's say that you make an appointment at Location #3 of Seebs' Competent Mental Health and you go and spill your guts out to your new therapist, Sock Puppet. I AM NOT A LAWYER AND I COULD BE GETTING THIS WRONG, but this is my understanding of how this shit works: Obviously, Sock Puppet is going to know everything you said, because you said all of it to them. Other counselors/therapists at Location #3 have access to and are allowed to read your records, but probably won't because they have their own goddamn jobs, unless you switch therapists within the practice or Sock Puppet isn't sure about something and wants to consult with one of them. Sock Puppet is allowed to use identifying information when talking about you with them. The support staff (check-in, billing, etc) can see the information directly pertaining to their jobs as a matter of course. They can talk about the stuff relevant to their jobs with your therapist (ie, "your 6 PM is free because Albedo called in to cancel, would you like me to bump someone up or leave the block free?") If they see you (for example) carrying in your How to Life when you are Trans and Autistic and Depressed Workbook when you check in, they're not allowed to discuss that with other people using identifying information. If, in a legal sense, locations 1-3 are all the same practice, then information flows freely between the locations, everyone is bound as above. (This can happen but it's pretty rare.) If you see a Meds Person, and they prescribe you Psychfix, the pharmacy that you go to knows that you got prescribed Psychfix by Meds Person, and any other prescriptions that you have brought to that particular location of that particular pharmacy. They aren't even supposed to be told why you got prescribed Psychfix, although it's not hard to speculate that people taking Psychfix have some kind of mental health thing going on. Those records can be transferred to other pharmacies or your doctor but only if you sign for it. They're also bound by HIPAA. Even the guy at the counter who rings up the pills. Your insurance company will get the information deemed relevant for whether they'll pay for you to be there. They do not get to see Sock Puppet's notes; they do get to see your diagnosis and any treatment (appointments or meds) that get submitted as a claim. Your insurance company is ALSO bound by HIPAA and can't talk to anyone about shit all unless it's relevant to their jobs, etc. The secretary at Seebs' Competent Mental Health probably had you fill out a form letting the office submit claims for you the first time you visited, and this is for a good reason, because that paperwork is so stupid confusing that no one would ever get that shit done if they had to do it themselves. In theory, if you don't want your insurance company to know about a health thing at all, all that you have to do is not submit a claim (and pay for everything out of pocket). In practice this is more or less impossible to do unless you're making completely disconnected single visits to an after-hours clinic or what have you, and of course you have to pay out of pocket, and it's just not goddamn worth it. If Sock Puppet decides to change practices from Seebs' Competent Mental Health to Unrelated Other Practice, you can decide whether to follow them. If you decide to follow them, you'll be filling out the exact same paperwork that you did when you first came to Seebs' Competent Mental Health, and your records will be copied from Seebs' Competent Mental Health to Unrelated Other Practice and continue from there. If you stay with Seebs' Competent Mental Health, so do your records, and Sock Puppet only has what's in their own memory, and isn't allowed to talk about you using identifying information with anyone. If you decide, by yourself, that you want to see someone at Arbitrary Mental Health Place now instead of anyone at Seebs' Competent Mental Health, all your records from Seebs' Competent Mental Health will stay there in their filing cabinets until the end of time or something. If you sign the right paperwork, then Arbitrary Mental Health Place can get a copy of your records from Seebs' Competent Mental Health and add that to their records. Does that help?
Thank you so much for the explanation, @Aya. That very much helps; I've been a little paranoid and nervous about it, because the regulations are pretty confusing. I've had some kind of mental image of being followed by whatever I said to Sock Puppet in confidence forever, and if I said something in a way that came off strangely, I would never be able to correct it. Brain stuff is stressful!
>< I finally did the thingggggg. We'll see how it works out, but I made the phone call so. Yay. Thank you guys.
Thank you. :) Took me a month and a half to work up the nerve, so it's really nice to finally have it dealt with.
Darn im a bit late to this thread and coulda offered mad advice but im glad you made the call @albedo! I kmow all about the brainstuff stress >. <
@Missfortunate Thanks. :) The thought is much appreciated, anyway. And if this doesn't work out, I may have to pester the forum again when seeking out someone else. I'm not sure how scary it's going to be.
It shouldnt be too scarry sweetheart, but youl geel anxiius as hell right before it i think, but definetly post about it! Plenty of feed back here
Definitely; I was pretty stressed out when I tried to do it in college, and that was a little less... 'real', in a way, since I was just seeking triage strategies and not actually trying to sort through anything. I'm still pretty awkward about the trans thing, for one, and nervous about how that'll go. Sigh. It's not for a month yet, but I'll definitely post about it. :) Thanks.
Dont worry about being awkward about trans stuff :) im still very awkward about trans stuff and ive been medicaly transitioning for a little over four months and built up to it for two straight years of sorting my stuff with my therapist before gettig to this point so id say your on the right track :3
Much appreciated. :) Seems like everybody's got everything together already, and I'm woefully behind, sometimes. BRAINS.
@albedo: believe me, the rest of us really don't have our shit together either :P I had two years of therapy, and while it got me reasonably undepressed, it didn't magically fix all the autie stuff, and those kick my butt most often.
