This post is a follow up to a response I made in the ADHD thread and now a bunch of residual thoughts are bouncing around the synapses in brain. In writing my earlier post I started reflecting on the care I’ve been receiving for my ADHD and …. whatever it is that I am being treated for in psychotherapy. I work/teach in an allied health field and I have some fairly strong opinions about what constitutes quality health care. I find it ironic that I’ve ignored some of these beliefs and standards in my own health care. With regard to the diagnosing and managing my ADHD, I’ve become quite complacent about PLAYING MD. Now I am wondering… should I be the one directing and assessing the efficacy of my treatment plan?? After all what are my qualifications? Would I recommend myself to others? What actually constitutes “quality” ADHD care or “quality” psychotherapy for depression, anxiety, general malaise? Hell, I don't even know what I have??? Is any one else in a similar situation?

Like I said in my own field, I have some very clear criteria for judging the quality of care I render my patients. The clinical decisions and judgments I make are influenced by many different things. However, If a patient or student were to ask me, “Why did you choose this treatment approach over another one?" I would be able to confidently explain my rationale and could likely dig up at least some evidence support it. I don’t know the more I reflect on the treatment I’ve received over the past year, more with regard to the ADHD but also the psychotherapy to some extent, I realize I AM TOTALLY CLUELESS about what I am doing! I have very little information on how pharmacological & clinical decisions are made (or should be made) and then assessed for efficacy in mental health care. For example is it standard procedure for a neurologist to determine medication dosages by simply saying to the patient, “How do you feel, do you want to experiment with increasing your dosage of … Adderall?"

I know in this psychotherapy thread we have discussed characteristics of good therapy a few times. My questions today are:
1) If you were asked if you thought you were receiving the BEST possible care available for your pathology (illness), how would you answer?

2) What criteria do you think are important to consider when judging the quality of your overall mental health care? (pharmacology and psychotherapy) Look deeper than just whether you like or dislike your therapist-- Is just being licensed, nice, and a good listener enough to all it quality care?

3) Do you have the same quality standards for your personal treatment as you do for others (i.e. your children or other family members)?