[Patagonia]

My Pdoc recently told me that she won't see me anymore unless I go back to therapy. I left in March.
She used words like "ethical, moral....needs to talk to her colleagues....not professional.."
Sounded like one big pile of @@$$ to me.

I didn't read anything that said this was her policy & what about her "professional responsibility" to me as a patient.
I do not wanto return to T just so I can get drugs. That's effed up.

Can she do this?

[Victoria'smom]

All clinics I go to require it.

[stopdog]

She can refuse you as a client but you can refuse to be her client too- is there a reason for you to keep seeing this one instead of finding a new one who will not be so controlling? Is this md also trying to get permission to talk to the therapist? How does the md even know whether you are seeing one or not? I would not submit to the tyranny.

[Raindropvampire]

Yes she can do it. I've had it happen to me before.

[shortandcute]

Many psychiatrists do that now. I don't know if there's a law about it or what.

[justdesserts]

My psychiatrist has strongly suggested/required therapy for treatment before.

If all u r seeing the Psychiatrist for is meds. Then yes it's required. Psychiatrist wants somebody monitoring yr reaction to meds, evaluating if meds r still needed etc. Another option would be for MD to take u on as a client for counseling. Most people don't take that option as it is more expensive + not all psychiatrist see private patients outside of a hospital setting. Know of a client who talked MD into prescribing meds without T. MD was in serious trouble when client was arrested for selling the drugs. But I know of no requirement on how often u see T. It could be once a month.

[anilam]

Yeah, as others already said, she can. She obviously feels strongly that you would benefit from therapy and as much as I tend to agree with this opinion I think her giving you an ultimatum is unhelpful.
If you really want just pills from her, maybe finding some other pDoc that has no problem just filling your transcriptions?

[Ididitmyway]

Yes, she can. I don't know if it's the right decision because I don't know the details of your situation, but if it's her clinical judgment that drugs and therapy should go together in your case, she has the right to insist on that.

[NowhereUSA]

My PDoc is in the same clinic as my T and anytime I have an appointment with him, he asks about therapy. Even this last time he was like, "Make sure you and Kyle are working on blah blah blah." (I say that affectionately, he's a good PDoc).

So, yeah, I think he'd probably refuse to see me if I weren't in regular therapy, but since I am, it's never come up.

[PinkFlamingo99]

What if you can't afford therapy?

[unaluna]

Originally Posted by PinkFlamingo99

What if you can't afford therapy?

I dont think thats the issue here. When i was on medicaid, they scheduled my t sessions and then a pdoc session every other t session. But the t sessions were required for the pdoc sessions and all were low cost. The t sessions were every 6 weeks.

[PinkFlamingo99]

Originally Posted by hankster

I dont think thats the issue here. When i was on medicaid, they scheduled my t sessions and then a pdoc session every other t session. But the t sessions were required for the pdoc sessions and all were low cost. The t sessions were every 6 weeks.

Thanks, I'm Canadian.

I see a medical doctor for medications and she doesn't require me to be in therapy. There are no psychiatrists anywhere within a few hours who are taking new patients so it's the only option I have.

A regular GP is probably less adamant about the need for psychotherapy as an adjunct to psychiatric care. Personally, I think it a good thing that pdocs realize medications alone generally aren't sufficient for treatment of serious mental illness and ask their patients to also be in therapy. Most people do need more than a single-pronged treatment for mental illness.

My pdoc has always asked that I stay in therapy or at least stay in contact with my therapist so if needed, I can access his help. And the hospital I have been in requires patients have both pdoc and therapy appointments set up before they can be discharged.

[PinkFlamingo99]

Originally Posted by puzzle_bug1987

I see a medical doctor for medications and she doesn't require me to be in therapy. There are no psychiatrists anywhere within a few hours who are taking new patients so it's the only option I have.

I don't think therapy is always currently the right thing. Even if it's helpful for you there are times you just aren't in the right place. I'd be upset if this was a requirement to get meds.

[Patsfan]

I just see a Pdoc, but my appt is 45 minutes. She has never required me to see a T and I have been seeing her for over 20 years. She knows me pretty well.

[ThisWayOut]

PDoc's affiliated with clinics often have that requirement, but PDoc's in private practice don't necessarily push for therapy.
That said, perhaps if you want to stay with PDoc, you could find a different T? I know you had a bunch of issues with previous T, but I also think you might benefit from continued therapy with someone you click better with...
It's the general professional consencus that meds work best when accompanied by therapy (with a competant therapist who you work well with).

You might want to check out psychiatrist APA ethical guidelines if you are in the USA. I believe they are responsible to help you transition to alternative care, and not to abandon you, etc.

I personally would not want any doctor or therapist to be involved in who I see once I left their care if they are booting me out because of their Bad behavior or my refusal to be force fed what they are demanding of me, and I don't agree. Their ethics guidelines I believe speak against this arm twisting.

[Lauliza]

A pdoc can insist you see a therapist since research shows medication to be more effective when used in conjunction with therapy. No one can force you, but if it's the doctor's policy you may need to find another one.

[Partless]

It depends on why you were seeing this doc and why she wants you to see a therapist. It's hard to judge if it's ethical or not. In general this is a nice thing, as usually the opposite is true, Pdocs not having much respect for Ts and what they bring to this, seeing the problems as being biomedical more than talk related. I mean they won't tell you not to see a T, but would not care at all about what happens there, prescribe their meds and do their own thing.

[Patagonia]

I see my Pdoc maybe once every 4 wks. We don't do therapy. I finished w/my T bec I thought I was ready, we didn't click anymore. I haven't been back w/March & I'm happy to be away from therapy all together.
Now to hear that I have to go back just to keep my Pdoc prescribing is exasperating.

My T was nice enough in her summary letter to my Pdoc to inform her that I'm "having an ongoing extra marital affair & that this is being used to separate herself from therapy."

My Pdoc didn't know of this. Needless to say I was in shock. Looking into my "release of information" I guess that "reason for discontinuing T" can really be anything my T chooses.

I, personally, see it as sweet revenge. I'm in the perfect corner.

[Lauliza]

Originally Posted by Patagonia

I see my Pdoc maybe once every 4 wks. We don't do therapy. I finished w/my T bec I thought I was ready, we didn't click anymore. I haven't been back w/March & I'm happy to be away from therapy all together.
Now to hear that I have to go back just to keep my Pdoc prescribing is exasperating.

My T was nice enough in her summary letter to my Pdoc to inform her that I'm "having an ongoing extra marital affair & that this is being used to separate herself from therapy."

My Pdoc didn't know of this. Needless to say I was in shock. Looking into my "release of information" I guess that "reason for discontinuing T" can really be anything my T chooses.

I, personally, see it as sweet revenge. I'm in the perfect corner.

That's so odd for a T to state this in a letter to your pdoc. Sounds pretty judgmental to me but also explains why your pdoc wants you to continue with therapy. Not that an affaire means you needs it, but your T and pdoc seem to have some strong thoughts on it. Has your pdoc actually verbalized why she wants you to get a new T? This is obviously part of the reason.

[AncientMelody]

I don't think ultimatums are ethical per se.....so I think your psychiatrist was too harsh. On the other hand I can understand the idea that more has to be done beyond medication. I work in primary care and it's one thing if my patient can't or won't follow one of my treatment recommendations (ie physical therapy for pain) it's another thing if for example, I have also recommended yoga, meditation, antiinflammatories, and therapeutic massage and they have resisted all of these...well then I won't be overly inclined to be the dealer of their pain meds and do nothing else. But I work from an integrated model and therefore offer a lot of options. maybe talk to your psychiatrist about trying other therapeutic approaches such as journaling, meditation, etc?

[unaluna]

Its like we should at least get a Miranda warning: "Anything you can and do say will be held against you." So if you go into t and say, "i'm in love, i wanna quit, i dont need you anymore" - now thats being held against you. Cant say i havent done it myself, but it was just to ts, i wasnt on meds yet.