Private or NHS?

My dad finally seems to have come round to the idea of me wanting therapy, but he's got me worried about seeing an NHS therapist. According to him this will go on my medical record, which will be a Big Deal because insurance companies and solicitors can ask to see it, plus I'll probably have to wait longer to see someone. So he wants me to go private, because apparantly that way it won't go on my medical record and I might get seen more quickly. But if I do go private I've got no idea what therapist to choose (there are quite a few round here, much more than I thought there would be), and it'll probably be expensive. Is it worth seeing a private therapist, or are NHS ones just as good? And how much of a problem is it that seeing a therapist will go on my medical record?

I would follow your Dad's advice. He has made a very valid point!

I speak from personal experience.

For instance..in the future..I believe it might say..keep you from boarding a plane. I think in the future it is quite possible that those who suffer from mental illness will be added to the "no fly" list.

Believe me..it is a possibility!!
That's just one of the possible scenerios! IMHO.-Dottie

We don't have NHS here in the States but we have insurance and that can be an equal pain. The insurance companies share stuff and there's pre-existing conditions, etc. and they get to decide how "sick" you are and/or how much therapy you get, not your doctor/therapist. The therapists often exaggerate to make you look sicker so you can get "enough" therapy. I was fortunate and could afford to pay out-of-pocket so there was no one involved except my therapist and me. We have a silly quote here in the States, "I'm from the Government and I'm here to help you" which means, "Run for your lives!" :-) and is kind of what your Dad is saying; if it can be mucked up, the Government will be able to do it, they can't help and do things right for themselves, what chance do individuals in their clutches have? They want to collect taxes is about all they're good for.

Were I you, I'd find a psychiatrist and get a whole medical evaluation/education; whether meds could help, what kind of therapist might be most helpful for your problems, if he has any suggestions of one, how much different private ones cost, other programs, etc.

> The therapists often exaggerate to make you look sicker so you can get "enough" therapy.

Yes. That is a shame from a research point of view because it means the samples aren't pure...

But understandable from a treatment point of view.

I think it is a good idea to go private if you can afford it.

People typically say that the best way to find someone is to get a referral. Do you have a doctor you can trust, or someone else you can trust to give you a referral?

Otherwise...

An option could be to have a bit of a look online for what kind of therapy you would like. CBT, psychodynamic, etc. That will help you narrow the list down a little.

What are you wanting to see a therapist for (what kind of issue?)

I've heard people (who didn't have a referral) would just phone people fairly much at random. Or phone people who were close to where they lived or wherever.

I think it is wise to not have a public record if at all possible. A therapist should be able to figure whether you would benefit from a psychiatric consult for medications too. I think it can be a good idea to try therapy before trying medications because there can be lots of side effects etc associated with medications.

Good luck.

Private definately sounds like the better option... why not ask for references from you r local doctor? You can call all the dotors offices and ask them who they recommend.

Thanks for replying, dottie. I hope that won't happen about the "no-fly" list!

Thanks for replying, Perna. That's bad the insurance companies are the ones who decide how much therapy people get!

That's a good idea, but is it possible to see an unbiased psychiatrist who won't try and convince you to see them? When I asked my doctor about getting therapy a couple of weeks ago, she said I'd probably be going to a psychologist, not a psychiatrist. She said she'd refer me, but it'd be to an NHS therapist.

Thanks for replying, special_k. Like I said to Perna, my doctor offered to refer me to an NHS psychologist. I'm guessing if I do go private, I'm going to have to arrange everything myself, which is quite daunting! But I've got a pretty good idea of what kind of therapy I'd like, at least, which should help - CBT is supposed to help with both trichotillomania and PTSD symptoms. I want to avoid medication completely if possible - I'm scared it'll change me too much, and also of the side-effects.

Thanks for replying, TanyaGrave. I'm starting to think private sounds better as well. I'm not sure if NHS doctors can refer you to private therapists, though.

Yes it will be a part of your medical record BUT just anybody CANNOT get into your medical records. There is a federal law called HIPPA Privacy Law.(by the way this is not the same as HIPAA they are two different laws) You can contact the Civil Rights Department for more information about HIPPA but what it boils down to is that your treatment professionals CANNOT disclose to ANYONE with out your signed and updated every 6 months release of information form. One of my DHS caseworkers violated this law and was fired and can no longer work as a caseworker for any DHS angency in the USA now because of her violation of that law. and the DHS agency in my area must now promentently display the HIPPA law and complaint proceedures including phone numbers and addresses of the civil rights department overseeing the protection and prosecution of this law in their public access areas.

Anyway Therapists have a specific form they must fill out for insurance. it does not go into detail about "this session we talked about ...."

It is basic - name address phone number insurance ID number of the client (so your insurance company knows which insurance clients file the paperwork goes into)

Then like mine would say

diagnosis - PTSD, Dissociative Identity Disorder, Depression/anxiety

treatment plans - working on nightmares, flashbacks and intrusive thoughts and other memory problems, depression/anxiety.

Just basic and just enough that will tell the insurance where their money is going so the insurance company will continue to pay for my therapy sessions.

My DHS caseworker cannot even get into my files at my therapy agency without going to court. And then if my file is court mandated my therapy agency has a form that they fill out after ever session with just the basics - name, diagnosis and "today we worked on depression management skills". Or "Today we did a relaxation visualization for PTSD" Nothing that can do harm to me in court is ever entered into my files.

Ditto to what others have posted.....your dad is definitely being smart about it.
I could see, though, why it seems so much simpler (less work, less initiative on your part) to just go with the NHS therapist. I guess the equivalent to that in the U.S. would be like seeing a T in a clinic setting. Been there done that.

Firstly, the T's in the clinic I went to stay there for a year or so and then move on to better-paying positions or open their private practive (in most cases).
Also, everything of significance is put on the record, (I requested a copy of my records when I withdrew from therapy at the clinic).

While it's daunting to choose a T, you will definitely feel more in control of your treatment. I like to suggest to ask a friend for a referral. And go for a consultation, and see how you feel about working with that particular T. You can try a few T's to see who you feel most comfortable with.
Recently, I've had the ocasion to consult with 2 T's, both of whom were very highly recommended by friends and others. One of them is supposedly a top psychologist. Well, turns out I felt quite uncomfortable with both of them.

I, too, experience ptsd and other issues. I've had much success working with a psychologist who normally utilizes a cbt approach but has been utilizing mostly a psychodynamic approach with me, as this is what is most helpful to me.

Wishing you the best of success in finding the right therapist for yourself!
Do keep us posted, if possible....

Dear Rio,

I'm going to go against the grain here.

I'm not sure what your Dad is worried about. Everything that is discussed in therapy is confidential. At the very worst all that would be disclosed is that you had PTSD.

The beauty of the NHS is that they will refer you to the right person. The downside to the NHS is that there are long waiting lists.

I would only go private if you don't think you can wait for the treatment.

It's a good idea to keep in contact with your doctor to try to hurry the appointment up with the psychologist that you are waiting to see.

It's up to you of course, but I think your Dad is over-worrying about this.

PM me if you need.

NHS psychologists might see some clients privately too. I'm not sure... I know that it was common back home for people to work in the public service and then have a day or two working privately.

Have you asked your doctor for a private referral? It might be that he doesn't know anyone... Can be hard to tell with referrals, sometimes they are little more than 'you scratch my back and I'll scratch yours'.

The upside is that you will get some choice rather than being stuck with who you are assigned to.

Thanks for replying, myself. That's great about the HIPPA Privacy Law...I don't know if there's a similar law in the UK or not. (I don't know much about this whole thing, really. )

Thanks for replying, 9874. It does seem a lot simpler! Still, I managed to email a private psychologist who lives quite close to me today, hopefully I'll hear back from him soon. Nobody I know has any experience of therapy apart from one of my mum's friends, but she lives in England so can't really recommend any local therapists here! The consultation is a good idea, if/when I hear back from the therapist I emailed I'll ask about that.

Thanks! I'll try and keep you updated.

Thanks for replying, pegasus. My dad doesn't particularly like therapy because he thinks it stigmatises people, so that's probably why he's worried about it going on my medical record.

That's a good point. Anyway, I've got until November to get back to the NHS people - if I don't hear from the therapist I've emailed or any other I find by then I may as well reply to their letter.

Thanks!

Thanks for replying, special_k. I haven't asked my doctor for a private referral...it took me a while to get an appointment with her in the first place, I'm not sure if it'd be worth trying to get another appointment just to ask that! Still, it's worth considering.

you're welcome

if your country has an agency like our civil rights department - a government agency that oversees the country's citizens rights - they can tell you if HIPPA applies there or if you have something simular to HIPPA.

I think that what can be concerning is potential changes in law...

Also...

Private investigators.