[zooropa]

Ok, so. I used to have a case manager who left to go do DBT training and to work in the same agency's DBT program. Turns out the agency just shut down that program (which makes me feel reallllly bad for their clients!) and that T has returned to the branch where I live.

My current case manager told me today that I could start to see that T again if I want, and yes, I want. I think in some ways this is not the perfect ideal situation, as she doesn't have a ton of experience with trauma, but she knows me, I know her, and she knows DBT. I think as far as transitional therapy goes, this will do nicely.

She's going to call me on Mon and make an appointment, and I'll be seeing her weekly.

I have the option of continuing with my current-T and follow the gradual stepping down timeframe that we talked about this week, or I can just see one or the other. I really don't know what I will decide, I don't know what the best thing to do is, but I DO know that I feel really good about having a sort of safety net in place.

I really need to relearn the emotion regulation skills, and now I don't have to see current-T to do that unless I want to. It gives me more options and more choices, and that's always good.

[zooropa]

just wanted to add that even if I continue to see current-T for the next 9 months as we agreed, it is going to be really nice to also have weekly sessions with new-T so that I have a place to process my thoughts and feelings about ending therapy and whatever else is going on. Or, it might make it easier for me to make the clean break that I'm pretty sure deep down is what I need. I'm just scared.

[WePow]

VERY awesome!!

[TayQuincy]

In DBT, they don't allow you to have two individual therapists at the same time. This is because patients have a tendency to split the therapists, like when a child plays one parent against another.

it is going to be really nice to also have weekly sessions with new-T so that I have a place to process my thoughts and feelings about ending therapy and whatever else is going on.

this is also why it's not done. You need to deal with your feelings about what is going on with your therapist with her, as long as she is still your therapist. It doesn't work to go to one about the other (that's where splitting comes in). I do understand you are terminating, but 9 months with two therapists seems counterproductive. I could see if you were seeking consultation with a DBT skills trainer to get help using DEAR MAN skills to help repair your relationship, but you wouldnt be discussing your other issues with both at the same time.

[elliemay]

I agree with Tay. I would stick with one or the other, for no other reason then that one therapist is hard enough to manage (at least for me) I simply can't imagine after to deal with the crap from TWO!

[zooropa]

well, Tay, that's your opinion but it's not true. Here's what Linehan says in her book:

There is nothing in D B T that proscribes the patient from
obtaining additional professional or nonprofessional treatments.
If the additional treatment is offered by a therapist w h o regularly attends
D B T consultation meetings and w h o applies D B T principles, then the D B T
treatment is simply expanded to include these additional components.

[TayQuincy]

It is true, zooropa.

What you quoted doesn't mean the patient can have more than one individual therapist. It means the patient can have other professionals treating them in other capacities. For instance, I have had other professionals as part of my treatment team who were also therapists, but their job wasn't to do ind. therapy with me. Like I had my ind. therapist, plus I has my DBT instructor therapist, plus I had my vocational therapists...all professionals and trained in DBT. They had different roles. But I wouldn't be surprised at all if your T doesn't follow DBT protocol since she never has before.

[zooropa]

But I wouldn't be surprised at all if your T doesn't follow DBT protocol since she never has before.

LOL. That made me laugh, Tay, thank you.

I get what you're saying about not having more than one individual therapist, but this new/old T of mine is not a DBT T, strictly speaking. She has had DBT training, but her official position is that of case manager/supportive therapist.

I guess if my T doesn't think I should see both of them, then I obviously won't, in which case it will be really good for me that I have a new T lined up. I'm just trying to establish as much support for myself as I can, trying to accept that this is how DBT is ending for me whether I like it or not, trying to get through it with as little damage to myself and my life as possible.

[TayQuincy]

Originally Posted by zooropa

I guess if my T doesn't think I should see both of them, then I obviously won't, in which case it will be really good for me that I have a new T lined up. I'm just trying to establish as much support for myself as I can, trying to accept that this is how DBT is ending for me whether I like it or not, trying to get through it with as little damage to myself and my life as possible.

I think that's a good idea too. It's always better not to have all your eggs in one basket. My T has always encouraged me to have multiple supports.

[zooropa]

So, what Tay said, that my T isn't going to go for my new plan, just won't get out of my head. I'm trying really really really hard to not contact T, so I'm trying to avoid asking her even though I would really like to just call or text her and do just that.

Anyway. It might help me to keep talking about it here instead. Here's the situation, in case I wasn't super clear about it yesterday.
I have plan with T to see her on a gradually reduced capacity for the next 9 months.

I have, all along, had a case manager through the agency that oversees mental health in my county. This agency has contracted with my T, who is not in my county, to provide DBT services and they pay her directly. That's how it's always been. I've seen my case manager 1-4 times a month during the 3 years I've been in DBT.

I had one case manager at first, and she left so I got another one. Now the first one is back in this county, and she has agreed to be my case manager again and to provide therapy once I'm done with DBT. I met with my current case manager yesterday and she said that her supervisor thinks it's a good idea, and that they will continue to pay for DBT until I'm done. Everyone there seems to think it'd be good to see my new/old case manager, in her capacity as a supportive therapist, during the transition (and afterwards, obviously). She is not a DBT therapist and will not be doing DBT with me, although she does have some training and she knows the skills.

The question that Tay brought up is whether this is going to be a problem for my current T. Let's just call her DBT-T for the sake of clarity. Like I said above, I'm trying to avoid contacting DBT-T, but now I am full of doubts and questions. Is she going to say no, that's not ok, you have to stop seeing me or wait to see her until you are done here? Is she going to go along with it because it is clearly what is best for me? Is this just another sign that what I need, and what DBT-T is avoiding, is a clean break from her?

I'm really confused, and really really struggling because I want to just ask her and at the same time I want very much to not ask her.

[rainbow8]

I think it's a good idea, zoo. I have a question, though. Did you like this old case manager better than the one you've been seeing? Or is it that she couldn't see you weekly for supportive therapy but the "old" case manager can?

Wouldn't your current case manager have told you if she thought your T would object or if it is against the rules? Or, would your old case manager tell you?

I think you should see the old/new case manager T first before you tell your T. Then you will know how you feel. Maybe she can help you make a decision about staying with your T for the 9 months or not. Having another professional opinion may be the deciding factor for you! Good luck!

[zooropa]

Rainbow, my current case manager isn't a therapist, but even if she were, I was seeing DBT-T, so there was no need for her to take that role. Now that I'm being phased out of DBT, I need to be seeing somebody.

My case manager doesn't know DBT, and my DBT-T doesn't work for the agency. They know each other, but to the extent that she would know what dbt-T thinks would be a good idea.

I called dbt-t last night and left a message asking her about this issue, because I couldn't stand it any more. Which was really dumb, because she didn't reply and so now I have just increased my own emotion misery.