Medical Forum / Diseases and Disorders / Arthritis / April 2007
Counseling
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Donna G. - 13 Apr 2007 19:33 GMT For those of you who have gone through some counseling, how did you find a good counselor? Did you go to individual counseling or group sessions? Did your insurance cover any of the counseling? Did it matter to you whether it was a social worker, psychiatrist, etc?
Were your experiences with the counseling good? Did you achieve what you hoped to achieve during the counseling?
Did you do just the counseling or did you also do the medication route as well? . . . .
Donna G. . . . ANGELS EXIST, but some times, since they don't all have wings, we call them FRIENDS......
jofirey - 13 Apr 2007 19:56 GMT > For those of you who have gone through some counseling, how did you find > a good counselor? Did you go to individual counseling or group [quoted text clipped - 6 lines] > Did you do just the counseling or did you also do the medication route > as well? We have a counselor we have seen off and on for years. A psychologist who was recommended either by our pediatrician or by a school counselor. Its been twenty years so I'm not sure which. Different family members have seen him individually and we have also had group sessions. My oldest daughter saw him when she was in her early teens, and took one of her sons to see him ten years later.
I scheduled a couple of visits with him after I was involved in a particularly gruesome car accident for help in dealing with the flashbacks.
I keep meaning to make an appointment with him for another problem. Nothing huge but I think he could either shed some light on it or help.
None of us have used him in place of or in addition to medication and physician visits for such things as depression.
Our insurance paid part of the cost. I don't recall the percentage or the limits.
But they are only human. At one point he told us he really didn't understand why Charlie and I were still married. Think he's had a couple of divorces since then.
Jo
Diane - 13 Apr 2007 20:00 GMT hi donna, as a former clinical social worker/psychotherapist, i'm biased toward social workers (usually have MSW or LCSW after their names.) depending on their training, they tend to take more of the whole picture into account than a psychologist (meaning family, support network, etc). that said, there are also great psychologists out there doing therapy. psychiatrists, though, lean more toward only prescribing meds and not doing therapy. As a social worker, i'd refer a patient who needed medication to a psychiatrist for the meds, while i continued to do therapy. the psychiatrist and i would touch base occasionally to make sure things were going well and that no tweaking of meds was needed.
as a patient, i've gone to both LCSWs and psychologists, and I've had medication and not, depending on the issues I was dealing with at the time.
to find a good counselor, ask your primary care physician for a recommendation, or ask friends if you're comfortable doing so. good luck!
diane
Carole - 13 Apr 2007 20:26 GMT > For those of you who have gone through some counseling, how did you find > a good counselor? Did you go to individual counseling or group > sessions? Did your insurance cover any of the counseling? Did it > matter to you whether it was a social worker, psychiatrist, etc? I got a referral from my medical doctor. My insurance did cover 50% of the sessions, but the psychologist worked with me on the fees. Many of them have sliding scale. It didn't matter to me what his title was, but it will matter to the insurance company, so make sure that the person has certification that will allow them to bill the insurance company.
> Were your experiences with the counseling good? Did you achieve what > you hoped to achieve during the counseling? Yes and Yes. If I hadn't gone for counseling, I don't think I'd be here. I was very depressed a number of years ago.
> Did you do just the counseling or did you also do the medication route > as well? I did both. I took Prozac as I was so depressed I didn't want to get out of bed, and I had to work. My psychologist and I discussed it, and he worked with my M.D. who gave me the prescription. Having the two of them work together was a good thing. If you decide you want to try medication, you will need to do something like I did, or go to a psychiatrist who can prescribe. Psychologists and social workers cannot write prescriptions.
If you have any questions, you can email me at cm at carmay dot com.
Hugs, Carole :)
RhondaM - 13 Apr 2007 20:58 GMT I agree with Diane on this. I have seen a LCSW and had a good experience. I think they are well qualified to do therapy. If you do need meds they can see that and send you to someone for help. I have also had a bad experience last year with a new counselor. I believe in word of mouth references. I would find one that has similar beliefs and ideas and that can guide you to where you need to be. Best of Luck, RhondaM
> For those of you who have gone through some counseling, how did you find > a good counselor? Did you go to individual counseling or group [quoted text clipped - 17 lines] > ANGELS EXIST, but some times, since they don't all have wings, we call > them FRIENDS...... Donna G. - 13 Apr 2007 23:36 GMT Thanks, everyone, so far for your input. I did finally put a call into my pcp today. Actually talked to his nurse and I feel like such a fool. She asked me was I feeling depressed or did it feel more like anxiety or what. Told her I just didn't know. That I am having some fears about some things---namely my health and where it is all headed and lately I have just been getting a bit overwhelmed with it all but I wasn't really sure what was driving the force behind it all. And, since it just started a few weeks ago and kind of comes and goes, not all consuming, I just couldn't quite put my finger on it. Sheesh, how's that for looking like an idiot. Don't even know WHY I need counseling, just feel like I do need to talk to someone to help me sort it all out. Does that make any sense?
I think I would be more inclined to talk to a social worker as well. Not really preferring to go to a psychiatrist.
I did call medicare and they said they will pay for some of it. Will call my secondary insurance to also see if they cover any of it. Called another friend of mine who has her masters in social work and she gave me the numbers of several low income places that definitely do sliding scale work.
Ugggh, I just want to be done with all of this stroke stuff and nonsense. I want to go back to life before stroke and the additional health issues!!!
Whaaaaa, whaaaaaa, whaaaaaaa........I know, I know, quit the whining!!!
Donna G. . . . ANGELS EXIST, but some times, since they don't all have wings, we call them FRIENDS......
Adelle - 14 Apr 2007 04:13 GMT > Thanks, everyone, so far for your input. I did finally put a call into > my pcp today. Actually talked to his nurse and I feel like such a fool. [quoted text clipped - 23 lines] > > Whaaaaa, whaaaaaa, whaaaaaaa........I know, I know, quit the whining!!! No, Sweetie. Whining is perfectly appropriate right now.
Check the local hospital or public health clinic and see if they have support groups for arthritis people or those in stroke recovery. Those are usually free. Then you can take your time about finding someone for private consult. Read recently that many, many people develop depression after a brain 'injury' either through trauma or stroke. Common enough that it has been well documented.
And no wonder you are having trouble working things out and feeling stressed. You are recovering from brain injury and your brain is trying to forge new pathways. Its busy doing that. So doing everything else needs to take a back seat - and that includes coping skills.'
Be patient and kind with yourself. You are working hard!
Adelle
Donna G. - 14 Apr 2007 06:02 GMT Thanks, everyone for your sharing your experiences with me and for the encouragement.
Keep pushing me!!!
I am feeling a little better tonight as I did find an online group to look in on and just reading a lot of the others posts already has made me feel not so alone and not so completely nutso.
Whew, what a relief. I really need that right now.
Hugs to you all!!!
Donna G. . . . ANGELS EXIST, but some times, since they don't all have wings, we call them FRIENDS......
GARY Z - 14 Apr 2007 13:56 GMT > Ugggh, I just want to be done with all of this stroke stuff and > nonsense. I want to go back to life before stroke and the additional [quoted text clipped - 3 lines] > > Donna G. Hi Donna,
Looks to me like you found your answer to why you want to talk to someone! I've had an assortment through the years and everyone was different. One guy I saw once and never went back. Didn't care for him at all! Another I liked alot, but he was unreliable. Sometimes he'd show up and sometimes he wouldn't. Not good. Some have different "methods" of treatments depending on what they studied. Find one to your liking and hang on to him/her. By the way, I tend to prefer males. That is just a personal choice, but I believe they can relate to me better in some areas. GaryZ
Nann Bell - 15 Apr 2007 13:24 GMT > That I am having some fears about > some things---namely my health and where it is all headed and lately I [quoted text clipped - 5 lines] > feel like I do need to talk to someone to help me sort it all out. > Does that make any sense? It makes A LOT of sense, Donna! And frankly, the first sentence I left in the quote from you sums it all up pretty well to me. I think you did better telling her than you think you did. I suspect you did better than most folks who make that call on their own. They just needed an idea of which direction to send you and whether you needed immediate intervention.
I admire you for taking steps to protect your health ALL AROUND!
 Signature Nann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare
Kelly - 14 Apr 2007 01:37 GMT Hi Donna, I have been to counselling through the Arthritis Society here and also through a stress management class. The counselling was on a need basis and was individual. She was a social worker and always has her door open to me - a wonderful woman and I learnt so much from her. She taught our 2 stress management classes and I truly don't think I would have survived as well as I did in the last 12 years without those. Our government picked up the tab on those -the joys of social medical programs.
I also went through marriage counselling 2 years ago with a psychologist. She was incredible - recommended by our doctor but we did have to pay for her. It would not have worked as well if we hadn't been committed and done the homework (same as above) and we achieved much of what we needed. My husband needed the medication route - that was a basis of the problem and he now sees that. We never completed the sessions as we probably should have as that was when I had the reaction to enbrel. We did continue to work on our problems after on our own and I believe we have worked through most of the problems in our marriage and hope it is as strong as ever. Neither of us will hesitate to go back to counselling though.
Good luck and for the record I would not hesitate to take the meds. Unfortunately the meds caused a reaction on me (duh) and we didn't try another this time around. Still might be an option.
Kelly
> For those of you who have gone through some counseling, how did you find > a good counselor? Did you go to individual counseling or group [quoted text clipped - 17 lines] > ANGELS EXIST, but some times, since they don't all have wings, we call > them FRIENDS...... spodosaurus - 14 Apr 2007 05:58 GMT > For those of you who have gone through some counseling, how did you find > a good counselor? I'm going to take counseling to mean psychotherapy.
> Did you go to individual counseling or group > sessions? Individual. Group may work for some things, I guess, but I never liked it and I don't believe it to be effective for many issues.
> Did your insurance cover any of the counseling? Not applicable in my case.
> Did it > matter to you whether it was a social worker, psychiatrist, etc? Yes, it matters a lot. What kind of 'counselling' are you looking for? If you're looking for psychotherapy, go to a clinical psychologist.
> Were your experiences with the counseling good? Some good, some bad. Just like finding a rheumatologist, finding a good clinical psychologist can take some shopping around.
> Did you achieve what > you hoped to achieve during the counseling? Sometimes, though it wasn't really 'counselling' in the standard connotation of the word, so I'm still assuming you mean psychotherapy, which is much much different.
> Did you do just the counseling or did you also do the medication route > as well? Medication for what???
Ari
 Signature spammage trappage: remove the underscores to reply Many people around the world are waiting for a marrow transplant. Please volunteer to be a marrow donor and literally save someone's life: http://www.abmdr.org.au/ http://www.marrow.org/
Cindy - 14 Apr 2007 15:48 GMT You have had plenty of advice here, but will just put in my 2cents... I have been seeing a counselor since Jan 04...Randy really helped me get through some very difficult times...My dad had just died, we were helping out my husbands family and had 2 of my bils and 1 sil living here as well as our reg Boarder...Mike was trying to get his SSDI and wasn't working and I was fighting my LTD all the time...My FM, Anxiety and depression was at an all time high...At first I saw him every 2 weeks. I was already taking an antidepressant prescribed by my OB/GYN. But after a while he suggested that I see the psychiatrist also. She worked with Us and got my meds right and with counseling I started to climb out of the hole...Now I only see him about every 6 weeks if that... One thing though....it does depend on "What" he is...because medicare will not pay for his fees at all...He also works with his church as a counselor and they provide him the ability to see patients on a Pay as you can Scale...So I have been able to continue seeing him even after my insurance changed to Medicare..
How I found him? Well my mom had used him when she was having problems a few years earlier... And so I knew he was good before I saw him...
Oh and Medicare does pay 50% of the psychiatrist fees...And I see her every 3 months for my medications..And I make sure that she knows what my Rhuemy has me on and visa versa...so they know what I am taking...
Donna, I hope that you consider talking to someone...It does help and when you start sliding into that hole...It is very easy to let it swallow you...But always look up...Never stop looking up...
Cindy
> For those of you who have gone through some counseling, how did you find > a good counselor? Did you go to individual counseling or group [quoted text clipped - 17 lines] > ANGELS EXIST, but some times, since they don't all have wings, we call > them FRIENDS...... Donna G. - 14 Apr 2007 21:29 GMT Cindy,
Medicare won't pay for a psychologist? Why the heck not, they are a educated registered professional?! I am really surprised to hear this. . . .
Donna G. . . . ANGELS EXIST, but some times, since they don't all have wings, we call them FRIENDS......
Diane - 14 Apr 2007 21:47 GMT > Medicare won't pay for a psychologist? Why the heck not, they are a > educated registered professional?! I am really surprised to hear this. > . Donna, Cindy didn't say he was a psychologist, which is probably the problem. There are some very capable counselors working with churches or in other settings, but if they are not "licensed" clinical social workers or "licensed" psychologists, insurance/medicare will rarely cover them. licensing means they've gone through rigorous training and passed exams in the state in which they practice.
to address ari's statement that there's a difference between counseling and psychotherapy: he's right. i'd define counseling as more of a discussion of a problem and an offering of advice. a psychotherapist, while he or she may appear to be doing the same thing, is always looking at what's going on on a deeper level--the core personality, the psychological and social history, etc, and intervening in those areas as necessary. where i disagree with ari is that a psychologist is the best choice. most mental health services in the US are provided by licensed clinical social workers and as a group, they're equally competent.
what it boils down to, donna, is not just the skill level or degree of the person, but the personality fit between you and him/her. sometimes the first one is not the best fit. if you're lucky, it is.
keep us posted on how you're doing.
diane
Donna G. - 14 Apr 2007 23:03 GMT Thanks, Diane, that really does help me better understand things. Appreciate your input and help so much!!!
Appreciate everyones input and help!!! . . .
Donna G. . . . ANGELS EXIST, but some times, since they don't all have wings, we call them FRIENDS......
Cindy - 15 Apr 2007 21:47 GMT Donna, I only know that my when I had Cigna, they would pay...but Medicare wouldn't...I don't know his exact...Initials on the end of his name. I was looking around here trying to find something with it on there...But apparently he doesn't qualify...I went to Medicare's site and put in for mental Health Outpatient in OK and this is the result I got.... Information provided is for the state of Oklahoma The Medicare coverage information matching your selection criteria is shown below.
Mental Health Care (Outpatient) Coverage under Medicare Medicare covers mental health care given by a doctor or a qualified mental health professional. Before you get treatment, ask your doctor, psychologist, social worker, or other health professional if they accept Medicare payment.
Outpatient Mental Health Care: Medicare covers mental health services on an outpatient basis by either a doctor, clinical psychologist, clinical social worker, clinical nurse specialist, or physician assistant in an office setting, clinic, or hospital outpatient department.
Medicare covers substance abuse treatment in an outpatient treatment center if they have agreed to participate in the Medicare program. The amount you need to pay You usually pay 50% of the Medicare-approved amount.
You pay a separate copayment amount for the facility service.
For more information, you may call 1-800-MEDICARE (1-800-633-4227). The part of Medicare that pays for this service or supply Part B Benefit Medicare Contact for additional information State of Oklahoma Carrier: 1-800-633-4227 1-800-MEDICARE Important notes
1.. You must pay an annual $131 (in 2007) deductible for Part B services and supplies before Medicare begins to pay its share. 2.. Actual amounts you must pay may be higher if a doctor, health care provider, or supplier does not accept assignment.
> Cindy, > [quoted text clipped - 10 lines] > ANGELS EXIST, but some times, since they don't all have wings, we call > them FRIENDS...... Donna G. - 16 Apr 2007 01:43 GMT Thanks, Cindy, that really helps a lot!!! . . .
Donna G. . . . ANGELS EXIST, but some times, since they don't all have wings, we call them FRIENDS......
Donna G. - 14 Apr 2007 21:30 GMT Diane,
When you did counseling work, did you get reimbused by insurance companies at all? Did you get payed by medicare? . . .
Donna G. . . . ANGELS EXIST, but some times, since they don't all have wings, we call them FRIENDS......
Diane - 15 Apr 2007 16:26 GMT Donna, I left private practice before the big HMO boom. At that time, people paid me directly and filed for their own reimbursement. coverage was more spotty than it is now, since there has been a big push for better mental health coverage from insurers. Since I worked primarily with teens and their families, medicare was not an issue. Sorry not to be more of a help!
diane
Diane - 15 Apr 2007 18:57 GMT Donna, since my clients were mostly teenagers, I didn't have any dealings with Medicare. My patients paid me, then filed their own insurance. That has changed, for the most part, since insurance carriers must cover mental health care to a greater degree now than they did then. Let us know how you do finding the right person.
diane
Kelly C. - 15 Apr 2007 02:24 GMT I started taking medication before seeing the counselor, mainly because I was so anxious that I couldn't even think straight enough to decide which counselor to see.:(
She is a LCSW, and just the neatest person to chat with. We discussed a lot of things, and she helped me immensely. The medication made it easier for me to 'sort' the pile of stuff in my head into manageable pieces, and deal with them one at a time.
I only had 5 or 6 sessions, and I'm not taking the meds anymore, but I would not hesitate to do either again if I felt things were getting wonky.
Oh, I have BCBS and they have an excellent mental health network program. They helped me find the counselor, paid 100% for the first 5 sessions, and have an emergency counselor available by phone 24 hours a day.
Kelly C.
> For those of you who have gone through some counseling, how did you find > a good counselor? Did you go to individual counseling or group [quoted text clipped - 17 lines] > ANGELS EXIST, but some times, since they don't all have wings, we call > them FRIENDS...... Kate - 15 Apr 2007 16:56 GMT > For those of you who have gone through some counseling, how did you find > a good counselor? Did you go to individual counseling or group [quoted text clipped - 17 lines] > ANGELS EXIST, but some times, since they don't all have wings, we call > them FRIENDS...... Donna I have both seen therapists and as a psychiatric nurse practitioner do therapy myself for a living. Therapy is a wonderful way to find a new perspective on your problems and I found it especially helpful; in dealing with health issues. medications work as well and the combination of the 2 is often best. My advice find a therapist or provider you are comfortable with. Like any other professions there are good ones and bad and some who we just don't "click" with. Kate
Donna G. - 16 Apr 2007 04:17 GMT Thank you, thank you, thank you, to all of you for all of your input and suggestions. It really has been most helpful to me!!!
I will wait to hear from my pcp about suggestions he has for who I might go see for counseling.
Have also made an appointment to go talk with my pastor. He has been so incredibly helpful and supportive to me since the stroke and I feel like he can at least help me start sorting things out a bit.
Will let you all know!
Blessings to you all!
Donna G. . . . ANGELS EXIST, but some times, since they don't all have wings, we call them FRIENDS......
Donna G. - 16 Apr 2007 14:51 GMT OK, say some prayers!
PCP's office just called and I am going in to his office tomorrow morning. Apparently they have a social worker that works between 2-3 different offices and sees patients. She will have a session with me to help my pcp determine whether she would be helpful to me, whether she thinks I need to see someone higher up (ie: psychologist or psychiatrist) whether see thinks she can handle the case and/or whether she thinks I need meds along with counseling. Then will go talk with my pcp and hopefully make a plan of action. It's at least a start, and my pcp's nurse said she thinks that I will really like this social worker. We shall see! Acck.....I'm a little nervous about it all, but I know it is a start and what I need to do. Also have an appointment with my pastor, so will be talked out by the end of the week...lol!
Thanks everyone for all of your support, it truly does mean the world to me.
Hugs,
Donna G. . . . ANGELS EXIST, but some times, since they don't all have wings, we call them FRIENDS......
jofirey - 16 Apr 2007 16:14 GMT > OK, say some prayers! > [quoted text clipped - 13 lines] > Thanks everyone for all of your support, it truly does mean the world to > me. Just remember, it isn't just up to her if she is the one who can help you. You are the one who has to feel that the right connection is possible. Make sure you tell them what you need rather than just the other way around.
Jo
sweetpickleNO@SPAMknology.net - 16 Apr 2007 17:14 GMT Donna, I do pray that your apointment tomorrow will go well and be helpful to you. And pray that you will find whoever is just right to work with you. Can only imagine how you're feeling. Gwen
> OK, say some prayers! > [quoted text clipped - 22 lines] > ANGELS EXIST, but some times, since they don't all have wings, we call > them FRIENDS...... Diane - 16 Apr 2007 19:49 GMT donna, it's EXCELLENT that your pcp has a social worker working with her! i hope you feel good about the appt. good luck.
diane
Nann Bell - 17 Apr 2007 00:02 GMT I think it sounds great that they are talking about *whether* she would be helpful. That indicates folks who realize there isn't just one fit, which a good counselor should. now then, don't be nervous, she won't bite or otherwise attack you! LOL Yeah, you're a bit peculiar, but you aren't really nuts. heehee (hey, we need some laughs on this day!) And you are phenomenally good at coping - nothing wrong with wanting a bit of an assist after all you've gone through.
 Signature Nann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare
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