[Lola5]

In the back of my mind, I have always worried about going to see a T because I fear they are only in it for the money. My last T (years ago) was awful and only cared about getting money out of me and my insurance.

I went to see my GP a few days back and she asked me about my GAD and PTSD. I told her how I've been seeing a T for about 6 months and a PDoc for about 4 months, but I don't feel like anything has changed yet. She asked if they participate in insurance and they do not. I actually took out a small loan to be able to see them. My GP then said exactly what I fear. She said, "You see, mental health professionals want to help you, but not too quickly if you're paying them out of pocket. You're a source of income for them."

What do you all think of this statement? Should I be doubting my T and PDoc because I haven't seen any improvement after many months?

[BudFox]

Originally Posted by Lola5

In the back of my mind, I have always worried about going to see a T because I fear they are only in it for the money. My last T (years ago) was awful and only cared about getting money out of me and my insurance.

I went to see my GP a few days back and she asked me about my GAD and PTSD. I told her how I've been seeing a T for about 6 months and a PDoc for about 4 months, but I don't feel like anything has changed yet. She asked if they participate in insurance and they do not. I actually took out a small loan to be able to see them. My GP then said exactly what I fear. She said, "You see, mental health professionals want to help you, but not too quickly if you're paying them out of pocket. You're a source of income for them."

What do you all think of this statement? Should I be doubting my T and PDoc because I haven't seen any improvement after many months?

I'm not sure to what extent therapists deliberately prolong the process to make more money, but the basic process is set up to be very drawn out, given that therapists disclose as little as possible about themselves, their method, risks, outcomes, etc. And this keeps clients groping in the dark and needing a lot of time to figure out who the therapist is and what's happening. With p-docs seems like it's more about hooking you up with drugs and keeping you hooked up for the long haul.

If it were me, I'd walk away from both. But depends what your problems are. I think trusting one's gut is important.

Also, it's ironic that the GP said this, given that mainstream docs are no different than P-docs. They both hand out drugs like candy and do all sorts of things to keep you in the game.

[AllHeart]

Personally, I would be more concerned with why a GP would tell you such a thing. Realistically, a client or patient is a source of income for any working professional. That's just the way things work. Of course some are in it just for the money but certainly not all.

4 and 6 months is not a long time to be in therapy for PTSD. It can take a long time before one starts to see changes. Maybe a better way to evaluate if therapy is working for you is to figure out if you get any relief or benefit from seeing you therapist at all. And are there other avenues for you to pursue to get the help you are seeking?

As for the pdoc, do you see him/her just for meds? Would your GP be willing to prescribe meds so you could save money by cutting out the pdoc?

[Ididitmyway]

A short answer to your question is yes. If there has been no improvement after many months, yes, I believe, it's healthy and reasonable to doubt that your therapy has been working. The reasons why it hasn't been working aren't as important as facing the fact that it hasn't been working and it needs to be addressed.

As to what your GP said, my take on it is that our entire health-care system should be called a sick-care system instead. The way it's designed, it gives professionals all incentives in the world to keep patients coming back to them because that ensures the stability of their income. This doesn't mean that they consciously make a decision to prolong somebody's illness. It also doesn't mean that they are bad people. All it means is that when you are part of the system that compensates you for every minute you spend with the patient, every test and every procedure you give them (the more expensive the better), you will find all the reasons in the world to convince yourself and the patient that they need more time to see you, more drugs, more tests, more procedures and you'd genuinely believe your own reasoning. It's a very simple defense called "rationalization" that allows people to convince themselves that they are doing something good and useful when they aren't.

I can't generalise there's bad eggs in many professions. But even a T need a source of income that's not the crime. Its whether they are a competent T.

It doesnt hurt to keep an eye out for that sort of behavior. I havent seen that personally. And i also think these treatments are not that great to begin with, so not getting better is more likely about the ineffectiveness of the treatments.

Not too long ago i saw a chiropracter who dragged out services. He charged 250 to insurance for cracking my back for 2 minutes, then prescribing a supplement. Next visit, hed do the same except crack a different part of my body. Then again.

So it took me awhile to catch on, but he could make more adjustments in one visit, then a list of supplements rather than 1 at a time. Less than 5 minutes of treatment for 250 is robbery. I am thinking of calling my insurance and reporting him.

Thats what unnecessarily prolonging services can look like. Ive never seen that happen in psychiatry, and have been to a lot.

[Argonautomobile]

Wish I could answer this for you. Sounds like a dreadful doubt to have. I guess you could look at some warning signs of bad counselling/psychiatry and ask yourself it this sounds like your care team:

50 Warning Signs of Questionable Therapy and Counseling

https://www.angieslist.com/articles/...-wrong-one.htm

It sounds like your Dr's comment confirmed a fear rather than brought out a new one. Why did you already fear this? Any other warning signs beyond lack of improvement/ bad experiences with previous T?

[kecanoe]

Obviously there is no way for us to know if your t or pdoc are just stringing you along. I am sure there are some who do. I am also sure there are some who don't. Have you researched PTSD treatment? Have you had a chance to ask people (here or elsewhere) what treatment for PTSD is like and how long it might take? I know that there are some threads on PC for success stories, that would seem like a possible source of good information. I have been told that trauma takes a while. In my case (not PTSD, buT DID) talk therapy was going very slow and I am experiencing much faster improvement with somatic based treatment. I have heard the same is true for other trauma cases.

[Lola5]

Originally Posted by AllHeart

Personally, I would be more concerned with why a GP would tell you such a thing. Realistically, a client or patient is a source of income for any working professional. That's just the way things work. Of course some are in it just for the money but certainly not all.

4 and 6 months is not a long time to be in therapy for PTSD. It can take a long time before one starts to see changes. Maybe a better way to evaluate if therapy is working for you is to figure out if you get any relief or benefit from seeing you therapist at all. And are there other avenues for you to pursue to get the help you are seeking?

As for the pdoc, do you see him/her just for meds? Would your GP be willing to prescribe meds so you could save money by cutting out the pdoc?

My GP suggested originally that I need to see a PDoc because she said she is not well-versed in psych meds and I need a specialist. Yes, I only see the PDoc for meds.

Originally Posted by Argonautomobile

Why did you already fear this? Any other warning signs beyond lack of improvement/ bad experiences with previous T?

I am actually realizing I am more concerned about my PDoc. He started off by saying the goal is for me to be on 1 med (Prozac), but later he added 1.5 Klonopin a day (split up in 4 doses) because I wasn't feeling an effect. When I still saw no improvement, he added 50mg of Seroquel. Still no improvement. I had such high hopes about finally getting the right meds by seeing this PDoc and several months later there is still no change. I worry he's not trying hard enough to find the right meds for me since he seems to be using trial-and-error.

Originally Posted by kecanoe

I have been told that trauma takes a while. In my case (not PTSD, buT DID) talk therapy was going very slow and I am experiencing much faster improvement with somatic based treatment. I have heard the same is true for other trauma cases.

I'm in CBT therapy right now. Originally, the therapist told me it would be a 2-3 month treatment for my anxiety. Now, after meeting me, he's not giving a definite length and says there's a lot for us to work on.

[Argonautomobile]

Originally Posted by Lola5

I am actually realizing I am more concerned about my PDoc. He started off by saying the goal is for me to be on 1 med (Prozac), but later he added 1.5 Klonopin a day (split up in 4 doses) because I wasn't feeling an effect. When I still saw no improvement, he added 50mg of Seroquel. Still no improvement. I had such high hopes about finally getting the right meds by seeing this PDoc and several months later there is still no change. I worry he's not trying hard enough to find the right meds for me since he seems to be using trial-and-error.

That's a toughy. It's not something I've personally experienced, but doing the psych drug trial-and-error merry-go-round sounds terrible. I hope you find a solution that works for you soon.

Ah, i can see what youre questioning here. Also, strange your GP made that comment.

I have been to more than a few psychiatrists, and it is always trial and error. There is little science behind these treatments.

You can google the algorithms used by psychiatry. They vary slightly by hospital, organization, but its pretty much the same.

There is a genetic test you can get that lists propensities, but they only offer vague guidance and dont take co occurring health problems, other medications, and other things into account.

Trial and error can go on for years, sorry to say.

Prozac can be activating for some, you could maybe switch to zoloft or celexa. PTSD is more difficult to successfully treat than anxiety.

I worry he's not trying hard enough to find the right meds for me since he seems to be using trial-and-error.

[BudFox]

Originally Posted by Lola5

I am actually realizing I am more concerned about my PDoc. He started off by saying the goal is for me to be on 1 med (Prozac), but later he added 1.5 Klonopin a day (split up in 4 doses) because I wasn't feeling an effect. When I still saw no improvement, he added 50mg of Seroquel. Still no improvement. I had such high hopes about finally getting the right meds by seeing this PDoc and several months later there is still no change. I worry he's not trying hard enough to find the right meds for me since he seems to be using trial-and-error.

I can't believe this is considered accepted standard of care. If you're interested in alternatives to being on the drug train, could google "orthomolecular psychiatry".

Finding the right psych med or combination is usually not a trivial thing and something psychiatrists should just know straight away, due to the wide range of individual reactions to the drugs. But if something is not working, then trying to change and explore other options is the logical thing to do. Unfortunately mental health issues do not work like something like a fever, where the same simple treatment will predictable provide relief.

I don't blame mental health professional (or anyone else) for wanting to earn high money if they can do it. Of course the income is part of the motivation to do the work. I often think many of them overcharge but then I compare it with, for example, a hair color appointment... which costs similar amount of money or more where I live than a T session for me. Is it similarly or more valuable? Question of personal needs I guess.

I did have the experience with both of my therapists that they did not want to let me go when I decided it was time to end it. I listen to their reasoning but will decide what I will invest into and how long. I think if a treatment has no benefits after several months, it's good to question it and look at changing or alternatives. But it does seem like your pdoc is trying. Responses to these meds can be unpredictable so trial and error is really what it usually takes.