The Therapist Search FAQ for alt.support.dissociation (http://www.funhouse.com/babs/T-searchFAQ.html)
Feb. 1998
Since this has recently come up again, I'm reposting what I have.
This has not been updated yet since I last posted it, although I did add
some things. I haven't gotten to the research yet on which states have
what legislation governing the issues of privacy of and classification of
records of therapy and Therapists and whose "property" those are. (The
earlier versions refer to the summer/fall of 1997.)
Swiv's leaving hir therapist and struggling with the decision
reminded me both of my own struggles with this late this summer and with
having said I wanted to try to put together notes for an FAQ about just
this set of issues. Here's part of my notes. I want feedback from people
on this, it isn't intended to be just my voice only in the hoped for FAQ
section for the newsgroup. Contact me anonymously if you need to at:
anon-6874@anon.twwells.com, or via babs@funhouse.com.
Below are some things to ask yourself about your current Therapy situation.
(This has been modified some since it was first posted.)
Outline:
1. How do you know when it's time to consider leaving your Therapist?
(Or perhaps rather:
"Some things to ask yourself if you aren't sure what to think about
your current therapy situation.")
1a. Issues of trust or trustworthiness of the therapist.
2. How to terminate Therapy when the Therapy is not going well or is
inadequate to your needs.
2a. Whether to bail and why.
2b. Reasons to leave therapy.
2c. What is a dual relationship?
3. A caution about bodywork.
4. Once you decide it's time to leave.
4a. When it's time to go.
4b. What about transferring records?
5. How do you find a new Therapist who treats dissociation and trauma
issues? (Especially if your Therapist doesn't refer you to
anyone or you have no Therapist.)
5a. Plan, organize, interview.
5b. Don't be hard on yourself.
Some useful addresses.
Some notes from the editor/maintainer.
========================================================================
1. How do you know when it's time to consider leaving your Therapist?
(Or perhaps rather:
"Some things to ask yourself if you aren't sure what to think about
your current therapy situation.")
1a. One gauge is the issue of trust or trustability.
Do you trust your Therapist?
For those who don't trust *anyone*:
Would your therapist be worthy of trust if you knew how to trust?
Do you feel they hear you and listen to you and are able to follow you?
Do you feel safe with your Therapist?
For those who don't know what "safe" feels like:
Do you feel saf*er*, or safe-enough, with your therapist?
Do the techniques they use and the philosophy of how their techniques
work meet your needs well?
Does your personality or system style work well together with the
Therapist's personality and style?
Do you feel comfortable with this Therapist?
Is it more okay to feel uncomfortable in this therapist's presence than
most anywhere else, or with most anyone else?
Is Therapist honest and direct with you?
Is Therapist willing to hash things out with you when something seems
wrong?
Does Therapist accept dissent or questioning about how they're doing the
therapy?
Is there an issue of fear or anger (or some other strong emotions) for you
about some aspect of therapy with this Therapist about which
you feel you should leave therapy?
In other words:
Is this truly a problem with the therapist or the therapy itself,
or is it about something you bring to therapy that you're going to
repeat with any therapist you see (or have repeated with every
therapist you've ever seen to this point)?
Can you communicate with this Therapist well enough to work this out
with them?
Have you made any positive progress toward better functioning and control
in the last 3 months with this Therapist that you can feel?
When you compare your life before therapy with your life now while working
with this therapist, is your life better now?
When you compare how you were functioning and how you felt when you
began therapy with this Therapist, has there been an overall
improvement?
Do you feel this Therapist is the "only game in town"?
Do you feel that if you left this Therapist you would fall apart?
Does the Therapist call you "resistant", even though you know you're
working very hard at therapy?
Are these good questions? What would people change about any of them?
The next comes from my recent experiences.
2. How to terminate Therapy when the Therapy is not going well or is
inadequate to your needs.
If you feel the Therapist or their associated cluster of
Therapists are the only game in town, or they have told you they are,
or they have not disabused you of the notion that they are; immediately
begin to question whether that's actually true or not. They should be
willing and able to offer you referrals to other Therapists near them
or near where you live, or at the very least they should be willing
and able to let you go so that you can look on your own if you live
someplace where they are unfamiliar with the practitioners. In the
ideal, they should be willing and able to provide the client with at
least one referral to a Therapist outside of their cluster of officemates,
group practice, or close associates. If they are in the least resistant
to this, do it on your own. If they are resistant to even the idea of
your leaving, RUN. Part of a Therapist's professional duties include
providing referrals for clients to other Therapists. To not even
attempt to do so is at the very least unprofessional.
2a. Whether to bail and why.
The first question is whether or not you want to bail out of therapy
because doing the therapy work is scary and it's really hard to make
life changes. You might just be having a misunderstanding with the
therapist, which could be fixed if you talked it through. Tell the
therapist that you think there is a problem, and what it is. Ask if your
perception of what the therapist is doing is accurate. If the therapist
says it's not, find out what the therapist's perception is. Try to
figure out with the therapist how your two perceptions could be so
different, and what might have been going on. If you and your therapist
have worked on this and you still feel like there is something wrong
between the two of you, and it's more basic than a misunderstanding, then
consider bailing. If your therapist refuses even to consider trying to
work on this difference in perceptions, then *strongly* consider bailing.
2b. Reasons to leave therapy (more than one and the klaxxons should sound
loudly; most of these were reasons I left therapy, in fact.):
A gross mismatch betwen Client needs and Therapist philosophy and skills.
Dual Relationships (see them for therapy, and around town, or socially,
etc.).
Client feels sie cannot trust (or has lost trust in) Therapist (and
attempts to change this prove fruitless after a few weeks or
months).
Poor match of personality styles.
Therapist has actively mistreated Client.
Therapist is defensive about Client questioning how therapy is being
carried out. (Does Therapist become tense, stern, does it seem
like a wall goes down when questioned, do they resist answering
the questions? Things like that.)
Client feels Therapist isn't really listening to hir (and attempts to
change this prove fruitless after a few weeks or months).
Therapist is controlling or manipulative.
Therapist is so dead-set on "knowing what's best for you", in staunch
opposition to what Client knows will help hir heal, or does not
take this need seriously on ClientUs part (an issue of respect
in part and of listening).
Therapist cannot adequately control course of therapy in appropriate
ways, such as only waiting until a preventable crisis to
intervene by then threatening to hospitalize Client, rather than
listening to Client.
Therapist does not recognize serious problem(s) with the therapy.
Therapist does not offer to refer Client if there is a serious problem.
Therapist does not call in a consultant to at least observe the alliance
in action, or to consult with in a supervisory role when a serious
problem occurs.
If the Therapist is in any way invasive in innapropriate ways*
Therapist is either isolated or in a group of closed and otherwise fairly
isolated Therapists.
If Client is able to manipulate Therapist in unhealthy ways.
Therapist becomes lost or entangled in ClientUs dissociation.
Therapist doesn't believe in Client's dissociation, or Client's symptoms.
Therapist doesn't actively treat or know how to treat Client's dissociation.
Therapist repeatedly accuses Client of being Resistant and then focuses
treatment on _breaking_ this "Resistance", to the usual exclusion
of other issues.
2c. What is a dual relationship?
A dual relationship in therapy is things like:
For the retreats my ex-Therapist and his cohorts 'facilitate', some people
with less funds (students, self-employed, whatever), can barter the fee for
the next or previous retreat. What this can involve is things like cooking
for the staff and attendees for the weekend they're working. This means a
lot of contact with staff in a semi-staff position and possibly being privy
to confidential things being discussed by staff about attendees and their
methods of treatment (which otherwise this group is very closed-mouthed
about, not a hopeful sign).
It can also involve doing the childcare for the attendees and staff's
kids during all or part of the retreat.
Another dual relationship is my ex-Therapist having current clients doing
odd jobs around the Center for him, or having a client also work as Center
Secretary/Receptionist, again this also provided possible breaches in
confidentiality. The Secretary/Receptionist job includes seeing client
addresses and financial information and other similar things. They may
or may not still be getting Therapy from him during the tenure at this post.
Being invited to Therapist's (second) Wedding. (Yes. I went. I have
pictures.)
Simply living in a small town or city or area of a larger city and
running into the Therapist, or having them frequent your place of business
or other places you frequent around town, both at random intervals, is
not the same as having a dual relationship. My experiences above, and
that of my friends, all are examples of dual relationships. There are others,
but the definition revolves around seeing them for therapy and having some
other relatively entangling relationship with them (as the above examples),
e.g., a social relationship, a second business relationship beyond the
therapy relationship, etc.
3. A caution about bodywork.
*A warning to anyone with a trauma history, who dissociates, or for whom
touch is an issue*:
Absolutely avoid anyone who does anything body-oriented, such as massage
therapy or Bioenergetics (as in Lowen and Reich and followers), breathwork,
rebirthing, deep-tissue massage, Rolfing, and so on (and for some people
even things like dance or other movement therapies are an issue) or any
other body-centered psychotherapy until you have learned coping mechanisms
that allow you to stay whole and centered and able to calm yourself down
when you start to freak out or dissociate.
There are some expressive therapies and some movement and dance therapies
which some people can tolerate, my bias is that the group I was involved
with didn't really distinguish between those approaches listed above. (They
also do no screening for appropriateness, and so all populations receive
the exact same approach, no matter whether it's contraindicated for that
particular kind of difficulty.) Some people find any activity involving
any sort of touch is too intense, some find that any activity involving
movement and breathwork of any sort are too intense.
Make certain to ask explicitly what methods will be used and check that if
it gets too intense you can stop or have the practitioner stop and allow
you to calm down or calm down and leave. If they are at all evasive, vague,
controlling, even disapproving or defensive about your questions, leave.
(It is much better to have your Therapist check this person out and match
their credentials and style against your readiness for this type of work.)
If you proceed and you find they are not stopping when you ask, or not
paying close attention to you (in one to one situations especially), then
leave. You do not have to put up with disrespect or manipulation any
longer.
Once you are able to cope, work closely with your Therapist and have them
work closely with any bodyworker to help you enlarge your ability to
tolerate touch without freaking out in some way. Bodywork of various types
can be very helpful and can aid in healing trauma, if appropriate to your
needs and if timed correctly.
4. Once you decide it's time to leave.
Once you decide it's time to leave, you need to prepare yourself for life
without a Therapist, life without this Therapist, whether or not you
can stand the very idea of another therapist, what the time will be like
between this situation and any new Therapist you might find later, etc.
This is a very stressful time. (I found it utterly nerve-wracking and
terribly frightening, until a while after I began to contact other
Therapists.) If you really do want to leave this Therapist, you need to
formulate for yourself what the reasons, concerns and issues are that
have lead to your decision (writing helps this a lot, so can talking with
friends about it), and then formulate a plan for finishing up with the
Therapist. If you can discuss this with your Therapist, keep to your
side of things in the sense of holding onto your own perspective and making
the decision yourself. It is important to be sure that this is not the
first time that the Therapist is being told that you want to leave, even
if this is the first time they're actually paying attention to you when
you say you want out or are leaving. (If that's the case, and you have
been repeatedly telling them for months that you want out both directly
and indirectly, then you probably should be Terminating. This is what
happened to me.)
4a. When it's time to go.
If you're in a situation which, after 'doing your thinking' and then
discussing this with your Therapist and you feel you're not getting any
resolution to the problem(s), then more seriously consider termination.
Once you feel settled-enough about termination, then talk to your
Therapist and tell them you have decided to terminate with them. This
should not be the first time you are telling them (mine needed to be hit
over the head with it when I did decide it was time to act). My ex
therapist said: "Most Therapists have a set policy of a number of sessions
to terminate," going on to tell me that "Traditional Psychoanalysts have
a set of two years of Termination sessions," but that he was flexible.
It was pointed out to me by a good friend that "most therapists discourage
folks from leaving without processing that decision, but I don't think
there is usually some set number of sessions." So, I would urge people
to decide for themselves what is appropriate in their situation, even if
the Therapist attempts to assert a set standard number of Termination
Sessions. If you've processed the decision, it really doesn't matter if
the Therapist has not and you should not feel obligated to give them any
more sessions if you've decided to leave that situation.
If you have 'done your thinking' and are really certain it's time to go,
don't let them try to obligate you to continue so that they can get more
time to try wear you down. If you tell them you have decided to
terminate with the session during which you make the announcement, feel
free to get up and walk out of the office and the building at any
moment when you are done saying your piece. Be especially prepared to
leave if the Therapist tries to change your mind or in any way attempts
to undermine your decision to leave. No is no. If they can't handle
that, it's time to go right then. If you feel better terminating by
phone, do so. Cancel all remaining appointments and make your
announcement. Do not accept a bill for sessions cancelled by termination
of therapy. Pay only for sessions attended up to the date of termination.
They can be brought up fraud charges for billing for sessions not held
and for which there is no contract. Tell them you will be contacting
them about your records and they are to send you a bill for only x-number
of sessions.
Do not accept a bill for sessions cancelled by termination of therapy.
Pay only for sessions attended up to the date of termination. If you have
any reason at all to think that this Therapist is at all likely to try to
bill for "missed" sessions after you've Terminated their employment by you,
make sure the Termination and Cancellation notice to them is in writing,
and keep a copy of the letter. If you can, make copies, then send one by
registered or certified mail to the now-ex Therapist, because they have to
sign for it at the post office and there will be a paper trail indicating
that they did receive it. If they don't pick it up, you have a receipt
from the post office that you sent it, plus a copy of the document itself.
Date everything. They can be brought up fraud charges for billing for
sessions not held and for which there is no contract. Tell them you will
be contacting them about your records and they are to send you a bill for
only x-number of sessions.
Depending on what you need to do for yourself you may want to have a
short phase of continued involvement with the now-about-to-be-former
Therapist to finish up. Ideally the wrapping-up sessions would occur long
before this, my bias in this paragraph is that this was indeed not my
experience. You may find that you have had to sort this out on your own
because you have not been able to get the Therapist to listen to how
seriously you were considering leaving in the first place, as was my
situation. In that case, some people decide to leave the session they
come right out and announce their decision to terminate this Therapist's
employ with this client, and if that's what you feel you need to do, do
so. (Mine tried again to get me to stay, but my mind had been made up by
then for some time to end it with him.)
Bring your chequebook and settle the bill (or have them bill you, whichever),
gather your writings (I had leant mine my journals that he basically never
read over a period of many years), and get a copy of a release form to
fill out so that your next Therapist can help you get your records
transferred to them. You can also simply send them a letter requesting
that your case notes and whole clinical file go to whoever you designate
at whatever that address is. Make sure to have copies for ideally each
party involved (you, new, ex-Therapist), all dated and sent registered or
certified mail, so you have a receipt and the letter has to be signed for
and you know it arrived.
The letter, as on the request form, should state exactly what records
(include dates or date range, type of records --e.g., "all psychological
/psychiatric" or "case summary" or whatever) kept by which professional
at specified agency and address regarding which client (specify your full
name, note change of name, former and change(s) of address during course
of treatment, birthdate (only where absolutely necessary)) you want sent
to which professional at specified agency and address. Include the date
of your request and the date they must send your records by. Thirty days
is probably a good minimum notice.
4b. What about transferring records?
If you move on to another Therapist, they can only forward their own notes,
not those of any previous Therapists. The first Therapist must keep a
copy so that if requested to forward their notes on you to someone else,
they can forward their own notes to the designated destination and party.
Therapists are under legal obligation to maintain their records for the
number of years specified in their state legal or administrative code.
They are under legal obligation to transmit copies of whatever records you
authorize by written release to any professional or agency you designate.
They may also be under legal obligation to release copies of your records
to you unless they can show a court that such release will be harmful to
you, in which case a court would probably require them to release said
records to your proxy (My friend writes: "I'm not totally certain of this,
tho, but I do know that the courts have pretty consistently ruled that the
patient is entitled to access to their own medical records"). They might
discourage you from asking, but push the issue and tell them you will get
a court order for the release, if you really want to see the records.
The one thing you *can't* expect a therapist to do is give you their
originals and not keep anything.
Depending on the state you're in, you may never get to see what the
previous Therapist's notes say about you to your next Therapist. (Apparently
this is the case in my state.) The next Therapist is supposed to have
forms for releasing your records to them or someone you designate, there
is a seperate release you will need to draw up allowing the previous
Therapist to talk to this one about you. If you don't get the forms on
exit from the previous Therapist, the next one should be able to get you
however many you need. They usually won't let you take your records
home with you, they don't want you to read what they've written about you
in your records. The law in some states at least is that those notes are
the Therapist's property. Personally, I think this is bogus, but in at
least some states you have to have your records sent to the next doctor
and then they won't let you read the clinical notes, either. I'm not sure
Clients ever get to see them in fact. In my state, I was able to walk out
of one doctor's offices *with* my physical medical records. It seems that
not all states may consider mental health related records medical records.
The subsequent Therapist usually only gets a photocopy of the previous one's
notes, since they are required to hold onto their notes for a legally set
amount of time. It's basically to cover their butts.
5. How do you find a new Therapist who treats dissociation and trauma
issues? (Especially if your Therapist doesnUt refer you to
anyone or you have no Therapist.)
This book just came to my attention as I have been writing this essay,
which I wish I had known about while going through all this:
_the consumer's guide to psychotherapy_ by Jack Engler, and Daniel Goleman,
published in 1992 by Simon & Schuster.
The friend who passed along the title wrote: "it's got some good, basic
information about making decisions about therapy." [I haven't read it yet.]
(http://www.amazon.com says:
Availability: This title is out of print, but if you place an order we may
be able to find you a used copy within 1-3 months.
We will notify you via e-mail and request your approval
of the price and condition. We will also notify you if we
are unable to locate this title within 6 months.
Each order is for one copy of this title and author only,
rather than a specific binding or edition. (Publisher
information is provided to help you verify the title.)
PLEASE NOTE: Each out of print title is shipped and billed separately.
The Consumer's Guide to Psychotherapy by Jack Engler, Daniel Goleman
Published by Fireside
Publication date: July 1992
ISBN: 067177851X
Fortunately, there are some other titles on the subject that they do
carry, none of which I've read, most of which are hard to find, though.)
Start with any references you can get from your current one (and if they're
defensive about your even asking for them, bail), and hit the yellow pages
under psychologists, psychotherapists, even psychiatrists. Goto the ISSD
web page (http://www.issd.org/) and ask them to send you their current
listing of Therapists for your state. Compile as big a list of potential
Therapists in your area as possible. Starting with the ISSD and Sidran
lists (see their web page (http://www.sidran.org/index.html), too), call
these Therapists up and start talking to them and always ask the ones you
talk with for further references.
[Oct. 2001:]
What if you don't have a Therapist to begin with?
If you DO have one, ask them for referrals (this is in part a test, if they're
defensive or put you off or string you along, etc., then they don't have your
best interests at heart and leaving is indeed the right thing to do). Follow
up on those referrals by asking each of them for referrals as well, and
develop a tree of referrals. Look for connections between them, such as who
refers each other and why and whether they refer you to the Therapist you're
leaving and why and if you tell them you're planning on leaving your own
Therapist how the referred one reacts to this. You will need to note the
following at least, and this may sound very elementary until you recall what
a distraction stress is and just how much it can lead you to forget of the
most basic things:
1. Name of referral
2. Phone number and office address of referral
3. Who referred you to them and their reasons why
4. Credentials, training, experiences, specialty of referral
5. Same as above for who is referring you to the above Practitioner
And make this into a tree of sorts to keep straight just who is referring you
to who, in case you need more information or more information leads you to
reassess connections between Practitioners based on affiliations between them,
with methods or approaches you want or don't want, or with other Practitioners
you want to avoid or pursue; or anything else you feel is relevant. If you
want to make a yes column and a no column to sort them or something similar,
it might help in sorting at a glance as you accumulate more information.
Do you get a "find out what the issue is, go in, fix it, get out" kind of
sense of this Practitioner, or do you get the sense that therapy with them
will be open-ended and endless? Do you have the feeling that working with
them has the ultimate goal of your being able to regain your independence
and your being able to emerge able to cope on your own? If not, then you
probably will want to put them in the "No" column and go down your list to
the next one until you find a reasonable match. Then go meet them and see
how it feels face to face. If it feels ok, then give them a shot. If any
of these Practitioners takes your screening them out at all personally,
then they're definitely not the right one.
If you DON'T have your own Therapist yet, you'll have to start with the yellow
pages, although you can also ask friends for recommendations or referrals,
which may be less harrowing than cold calling with the yellow pages. Once
you can get one referral, keep building a tree of referrals from there.
Will it be nerve-wracking? Oh, most likely. Do you want to feel better in
the long run despite this being so frightening? Yes? Then you'll work your
way through the process. By all means, pace yourself. Maybe only one call
a day for a while is all you can cope with, or one call that results in a
week of phone tag. That's ok. Nobody said the process was fun and easy.
(I recommend the "Feeling Good" book by David Burns, and the workbook that
goes with it. The various charts and such are useful to track how you're
coping when stressed and to help you cope better with that stress. It was
designed originally for dealing with depression, but it also works well for
anxiety and some other things. It takes a Cognitive approach, which really
seems to be quite a powerful approach to a lot of things.)
[end Oct. 2001 addendum]
Explain briefly about what's been going on for you in therapy, any dx
(although you may rather lay out some of the symptoms and the current
reasons for leaving therapy or seeking a Therapist and let them make their
own dx), and about what you're looking for in a Therapist that your current
one if you have one doesn't provide. Be sure to ask about their treatment
methods and their training in treating Clients with a trauma history and
dissociation issues. You will also want to know about fees and any
restrictions on off-hour phoning, although you may decide to wait until
a subsequent phone call before you ask about these.
Pay close attention to whether or not you feel ok with the person
on the phone and take notes about the calls you make. Then weigh out both
your finances (I'm spending too much on interviews, but I have to find
someone), logistics, issues of compatability between your needs as a
Client and their skillset as a Therapist. If you are paying by insurance
make sure you know what your insurer covers for mental health care and
how little help they actually offer. Also, make sure you're financially
prepared in case you need to pay your own way, and ask them about any
sliding-scale fee arrangements they may have, or the possibility of some
other reduced-fee arrangement you might be able to mutually negotiate.
My friend also writes: "especially since most mental health insurance
*severely* limits the professionals you can see and the number of
sessions they will pay for (and note that even if a contract says up to
20 sessions per year, getting those sessions is usually not automatic and
usually more painful than tooth extraction)". Be prepared to possibly
have to fight your insurer for the health care you need.
[Oct. 2001: Check with your insurer or their coverage packet, to be sure.]
If you have some money to do so, please go in and interview the ones who
seem best from talking with them on the phone. I found this helped me
decide more precisely. Only then make a decision who to try out for say 6
sessions or something and set up an agreement with the Therapist to do this
and then reassess the fit and any other concerns you may have together. If
this is a satisfactory situation so far, then set up more appointments.
Depending how you feel, you might decide to extend the probationary period
another 6 weeks and reassess things again, before making up a more permanent
schedule. If that works out, then you can decide about sticking with that
candidate.
If not satisfactory, go back down your list and see the next best candidate
for a bit, asking this candidate for referrals (which, incidentally can be
a test). Or try calling some of the referrals you didn't call earlier, or
calling others back. [Also ask each one you call for references to other
Therapists and call them, too.]
5a. Write things down about your symptoms and read up on current treatment,
attitudes, research findings, to be better prepared to interview
prospective Therapists.
I found it helpful to have things written down about my dissociation handy
when I spoke to these people. The first one I saw had asked me on the
phone: "How do you dissociate?" and I kind of sputtered and gave a vague
basic answer. It spurred me to try to list it out as thoroughly as I could
so the next time it was asked there'd be notes to refer to in order to give
them a more coherent sense of what happens. I would also suggest reading up
on dissociation and its treatment if you haven't already. This helps you to
know the right keywords they should be answering with and whether or not they
know the literature about the fields of trauma, memory, dissociation, and
treatment issues to do with those issues. Also ask how long they've been
doing this and whether they have a lot of Clients who have a trauma history
and have issues of dissociation. Also, find out if they have a problem
treating someone who has had a previously bad therapy experience, some feel
this makes for a more difficult Client to deal with and will not take us on
so easily or happily, if at all.
5b. Don't be hard on yourself.
This is a nerve-wracking and terrifying process, so don't be hard on yourself
if you get scared during all this (I'm struggling with that). It *is*
scarey. I'm going ahead with this, but I've mostly also been incredibly
uncomfortable during all this.
The things I've outlined above were what I ended up doing on my own. My
ex Therapist wasn't listening to me and created or allowed crises to build
and get out of hand repeatedly. Once I realized there were other Therapists
who might be better for me, I decided to hunt them down until I picked one
to use. I hope this helps someone else in a similar situation find the
help they need without having to re-invent the wheel as I did. Let's just
say it wasn't a lot of fun.
-babs
===========================
Some useful addresses
The International Society for the Study of Dissociation
4700 W. Lake Avenue
Glenview, IL 60025
Telephone: 847/375-4718 Fax: 847/375-4777
E-mail: info@issd.org
http://www.issd.org
The ISSD has a page listing the guidelines for treatment of dissociative
disorders at (it focusses on DID): http://www.ISSD.org/isdguide.htm
The ISSD does not give referrals as such, but they do have a listing
of practitioners by state and you can ask for it for your state or
for the whole country. Most people ask for just their state's listings.
From: pbarach@sprynet.com (Peter M. Barach, Ph.D.)
Subject: Re: Searching for therapist/reply
Date: Fri, 27 Feb 1998 12:13:27 GMT
Reply-To: pbarach@sprynet.com
Newsgroups: alt.support.dissociation
anon-16368@anon.twwells.com (Crackers) wrote:
>I just want to mention that the ISSD doesn't give referrals.
Of anyone has had trouble in the past (or has trouble in the
future) getting names of ISSD members from our organizations,
please contact me backchannel and I will straighten it out. ISSD
is willing to provide this information. Membership in ISSD
doesn't guarantee expertise, only interest in the fields of
dissociation and dissociative disorders.
Peter
Peter M. Barach, Ph.D. (pbarach@sprynet.com)
Clinical Psychologist
President-Elect, International Society for the
Study of Dissociation (1997-1998)
5851 Pearl Road, Suite 305
Parma Heights, Ohio 44130
voice: 440-845-9011 (press 6 if you get voice mail)
fax: 440-845-9013
Opinions in this post are not an official statement of ISSD
From: pbarach@sprynet.com (Peter M. Barach, Ph.D.)
Subject: Re: Searching for therapist/reply
Date: Fri, 27 Feb 1998 12:11:07 GMT
Reply-To: pbarach@sprynet.com
Newsgroups: alt.support.dissociation
Federation of C wrote:
>I know that the T I want to see is listed with ISSD (International
>Society for the Study of Dissociation. at www.issd.org (I think)
ISSD will supply people (via phone or letter) with the names of
members in a particular geographical area. However, as is true
with any professional organization, ISSD doesn't evaluate the
degree of expertise possessed by its members. A list of ISSD
members is a starting point for doing your own interviewing by
phone.
Peter M. Barach, Ph.D. (pbarach@sprynet.com)
Clinical Psychologist
President-Elect, International Society for the
Study of Dissociation (1997-1998)...................
Sidran Foundation
2328 W. Joppa Road, Suite 15
Lutherville, MD 21093 USA
email sidran@access.digex.net
http://www.sidran.org/
(A national non-profit organization devoted to education, advocacy
and research related to the early recognition and treatment of
trauma-related stress in children and the understanding and treatment
of adults suffering from trauma-generated disorders)
Sidran has a number of brochures and other written material of use
at their Trauma Resources Area page: http://www.sidran.org/trauma.html
http://www.schizophrenia.com/ami/advcacy/Fedreg.html is from Dec. 1997
and is an article about parity regulations in mental health insurance
coverage from the Federal Register.
http://www.magnet.state.ma.us/sec/cis/ciscig/h/h24h29.htm#h28
H28 Disabled Persons Protection Commission
99 Bedford Street, Room 200
Boston, MA 02111
(617) 727-6465
Toll free: 1-800-245-0062
Abuse Reporting Hotline: 1-800-426-9009 (24 hours)
FAX: (617) 727-6469
The commission is responsible for the protection of disabled adults in
state care and in private settings, and for the investigation of abuse
by caretakers in those settings. Its functions include receipt of
mandated and voluntary reports of suspected abuse; investigation and/or
monitoring of investigations of reports, including monitoring of criminal
investigations which result from commission reports; insuring that
disabled persons are protected and receive protective services with
their consent, if needed; conducting investigations of problems relating
to abuse in the state human services system; and enforcing the provisions
of MGL Ch. 19C regarding the criminal penalties for failure to report
and retaliation against reporters.
http://www.kersur.net/~mhci/newslett.html
Mental Notes
Newsletter of the Mental Health Consumer Initiative (MHCI) Volume IV
November 1, 1997
Mental Health Consumer Initiative
PO Box 291
Danvers, MA 01923
http://www.kersur.net/~mhci
===========================
Some notes from the editor/maintainer.
A few comments on some books and some people that and who helped me a lot
(these may or may not seem off-topic, they helped me greatly, especially
the first one):
An important thing to do in anything you're doing is "doing your thinking".
This comes to me from the text of a college course I took, perhaps an
unlikely source of insight for the process of therapy: "I become part of
it, sacred dimensions in Native American Life", edited by D.M. Dooling and
Paul Jordan-Smith. Parabola Books, NY, NY. (C)1989 by The Society for the
Study of Myth and Tradition. ISBN: 0-930407-07-5. Parabola Books, 656
Broadway, NYC, NY, 10012. Third Printing 1991. The article was written
by my former professor and this is one of the rare non-academic or technical
books I return to with any frequency. I want to publically thank my
professor for assigning us this book. (I'd also like to thank Professor
David Lisak for his course on Trauma several years back, which while quite
tough was just *incredible*. I learned a huge amount there as well. It
was another thing that helped me decide to leave the ex-Therapist, in the
long run because I still have my notes.)
This particular essay was written by my wonderful professor, a man
called Thomas Buckley. Tim, as he is known, is a remarkably centered and
gentle person. At the time I took the course there was a lot of upheavel
going on for me on various fronts and Tim's classroom was about the only
place I felt calm and even felt centered. Rereading this sometimes helps
me regain some of that, and it helps me remember my old professor in the
bargain.
Basically "doing your thinking" is the process of observing your world or
the task or issue at hand in all aspects (feeding your head as best you can)
and then thinking about what you've gathered and learned on your own and
gathering into this process any insights you've had about the issue. Your
gut instincts must factor into this as well. Sometimes they give you
everything you needed to know from the first blush, but you have to assemble
the why of it and you "do your thinking" in order to do so. Reality-check
with others and gather more information, and at some point after you've
"done your thinking" a synthesis of what you have learned and your insights,
versus consensus reality will form. This is the current result you then
apply to the issue.
This comes from the perhaps unlikely source of: "I become part of it,
sacred dimensions in Native American Life", edited by D.M. Dooling and
Paul Jordan-Smith. Parabola Books, NY, NY. (C)1989 by The Society for
the Study of Myth and Tradition. ISBN: 0-930407-07-5. Parabola Books,
656 Broadway, NYC, NY, 10012. Third Printing 1991. The article was
written by my former professor and this is one of the rare books I return
to with any frequency. (Also see the piece called "It's where you put
your eyes", by Sam Gill.)
I also recommend the chapter on power struggles in the book "When to say
goodbye to your Therapist", by Catherine Johnson, PhD. [Simon & Schuster,
USA, (C)1988, ISBN:0-671-61888-1]. Some of you may encounter power
struggles when you try to leave your Therapist and I found this helped me
recognize some important behaviours on the part of my ex-Therapist and
helped me decide whether to stay or not.
David Burns has some books out, notably "Feeling Good" ((C)1980, First
Avon Books printing, June, 1992)ISBN:0-380-71803-0), and "The Feeling
Good Handbook" ((C) 1989, ISBN: 0-452-26174-0) which I've been finding
helpful. In the "Handbook", there is a section on Therapist Empathy.
Something someone can do, and he encourages this with his own clients, is
to bring the Therapist Empathy Scale into a session and fill it out and
hand it to your Therapist then and there. Then they know much better
how they come across to you and how they're doing. One point he makes
in the discussion around this section is that the majority of Therapists
honestly believe they can read clients far better than it turns out the
clients feel they're being read, and so communication is lost along with
the client's trust (I certainly found this with the ex-Therapist). This
is one way therapy fails.
It is not safe to assume as a Therapist that because a client doesn't
come out and tell you you're a compleat dunce and they actually cannot
stand you and don't even trust you, that they are not thinking this to
themselves. It's also not a good idea to ignore it once they do come out
and tell you this. My ex-Therapist did this.
I'd also like to thank Professor David Lisak (UMass/Boston) for his course
on Trauma several years back, which while quite tough was just *incredible*.
I learned a huge amount there as well. It was another thing that helped
me decide to leave the ex-Therapist, in the long run, because I'd saved my
course notes. My friends were invaluable in their love and support and in
their challenging me on the issues as they arose without trying to get me
to change my opinions to what they wanted for me, but instead by their
guidance, support, and reflecting back to me what I was telling them.
They left it to me to 'do my thinking' and decide for myself what to do.
If you have such resources during the Therapist search, make the best use
of them you can. The ones who stuck by me during my search remain my
closest friends.
===========================
-babs
babs@funhouse.com
=================
babs@jfwhome.funhouse.com