Just because I'm curious, and I suspect that my locale may be an outlier.
If you have (or know of others who have) gotten your child to visit a therapist or counselor, how long was your wait for an appointment? I mean for an initial appointment.
From phone call of inquiry to going to an exploratory/initial appointment-- what was that elapsed time? Is it typical, or was it much longer/shorter than the local norm?
TIA.
(As for what it is here, I'd rather not say until I have a few responses from others.)
It has been a few years, but I want to say it was about a month for a child's apt with a therapist.
Depends on the clinic. At some, you can get an intake appointment in under a month, while other clinics have a waiting list of 3-6 months. If your PCP sends a pre-approval, you may get an earlier appointment than if you just walk in. Unless you threaten harm to yourself or others while you're in the clinic, of course.
I am familiar only with appointment by the primary physician's referral - when they do that, they categorize the referral with a priority code - it can range from same day appointment depending on urgency to a wait of 2-3 weeks. If the physician (or pediatrician) feels the situation demands it, it is possible to get a same day or next day referral for appointment.
Depends on the therapist/counselor and if they have an opening. When I was calling around last summer, some well recommended therapists had no openings and couldn't tell you when they would be available. Others it would take weeks to get an appointment. We ended up doing the testing with someone who could work with our schedule last summer, and we lucked out that that the psychologist DS was recommended happened to have openings in her schedule when I was looking.
It all depends on WHO you want. If you want someone who everyone recommends it could be months.
I should clarify-- this is for counseling/treatment, NOT for testing/evaluation with a neuropsych/evaluator (the latter seems faster).
With the situation that ashley references-- that is, with a referral. The bad news is that the referring professional just handed DD a list of providers and apparently told her to start cold-calling. (Yeah, really.)
We seem to have a situation much like that described by bluemagic.
I've tried this now on three different occasions, and in each of them, the waits for "urgent" patients (that is, those who have significant risk factors for a psych hold if they don't get help/resolution) seems to STILL be some 6-12 weeks out, if you can get someone to even tell you if they've got openings.
Calling in the first week in April, the answers were:
a) no openings until late June. Oh, no-- we won't see a person like that after all.
b) we'll call you back in May.
c) we'll call you back. Sometime.
d) how does July sound?
e) We don't have any openings.
f) leave a message.
g) An urgent appointment? Well, maybe we could get you on our cancellation list, with the understanding that you might still be waiting until June-- there are others on that list, too. What is your schedule like on Tues/Thurs between 10 and 4, anyway?
h) We don't see adolescent patients anymore.
i) We can put you down and if the doctor has any openings before the end of summer, he'll call you.
.
.
.
(These are for INTAKE appointments, mind.)
That's awful. I assume that she is having issues that need attention now. Is there anything available through the university?
For us, one of our kids was having issues near the end of last school year (maybe April?). We were willing to wait for the provider that came most highly recommended for the issue that we were hoping to address. The provider called us back within a few days and told us that we would have to wait until some other patients finished up, probably some time in the summer. We had our intake in June.
Universities may talk a great line to parents and prospective students about the availability of wonderful mental health resources, but what they mostly mean is inspirational webinars about how to get along with your roommate, and easy prescriptions for Adderall or Xanax (or both!!) over at student health.
Frankly, given what we've seen, college suicide rates make MUCH more sense to me now. For all of the hand-wringing of administrators, and the appointment of more people to "examine" the problem, there is actually some erosion in on-the-ground support for students, as compared to a couple of decades back, from what I've seen.
They offer NOTHING in terms of talk-therapy in-house. They also aren't offering referrals-- more like a strong recommendation to "get professional help with that," and a list of local providers. The result is what I listed above.
Sorry if I sound a little bitter. The thing is, colleges and universities are GREAT at patting themselves on the back for all that they are doing for "student mental health intervention/prevention/awareness," but-- well, let's just say that they're doing just as great a job at this as they have sexual assault interventions over the past few decades.
I find the hypocrisy of it pretty galling.
Sorry, HK. That does sound incredibly frustrating.
Any kind of initial specialist appointment can take months here, especially if the doctor has a great reputation. We have only gotten around waiting many times when we have a doctor who spoke directly with the specialist and he/she has more than a passing acquaintance. Sometimes another way around is paying in cash.
We were able to get in within a couple of weeks with the people we have seen, but it did take some calling around.
I'm sorry to hear that your daughter is experiencing this, HK!
When I was at MIT, I was able to get talk therapy (in conjunction with medication) for depression with a renowned psychiatrist as part of my student health benefits. (On the other hand, it was needlessly difficult and expensive to get an IUD.) That was a few years ago, but I don't think that things have degraded that much. This is one of those questions that it doesn't occur to anyone to ask when they are looking at colleges, but there can be big differences from place to place.
Good luck!
I think that is probably true, Elizabeth. The thing is, now that parents and students know to ask-- most colleges are CLAIMING that they offer such benefits. Most point to shiny new "centers" for students (though they may fail to note things like "an appointment takes just minutes to MAKE... but might be seven weeks away..." or that "this isn't really an office that is staffed full time" or that "this service is only for student athletes," etc.) but that just muddies the waters.
So sure; most campuses are aware that they have a problem in this regard and have appointed administrators to handle it. With predictable results...
They don't. If anything, there seems to have been a dramatic shift toward pharmacology and one or two "counseling" appointments as your limit. Beyond that and you need to go outside the university-- and they don't seem to know how to do a referral. It's puzzling to me.
DD has expressed tremendous frustration-- she frankly thinks that the two professionals that she has been dealing with are borderline in terms of basic competence to start with (and so do we, given what she was initially "diagnosed" with) and they have been more interested in poking and prodding at her as an interesting laboratory specimen than in HELPING her. She's tried asking for "tools" or "things to try" etc. to manage her anxiety-- to no avail.
She is six weeks into "getting help through the university" after a major Hail Mary effort last term that involved me going with her, and a professor petitioning the registrar for a late course withdrawal, etc.
She's a student with a disability already, and has pointed out to the mental health professionals that there is known comorbidity with it and anxiety disorders (which seems like news to them-- yikes)-- so why are these people not communicating with that office? I have no idea.
The one psychiatrist has apparently never done any work with a student who has perfectionism like DD's. It was news to this person that such perfectionism could result in anxiety disorders, or that it might be connected in some way to her underlying disabling condition. The clinician wants to see DD for a third "diagnostic" appointment in ANOTHER two weeks (this makes it 8 since she requested the appointment after being referred by the on-campus counseling center). This clinician is "going to request* some literature" and "read about" the possibility of a connection (the one that DD pointed out to her that research supports) in the mean time.
It was also news that DD might have suicidal ideation without being depressed. Like-- at all. When asked if she had thoughts about it, she answered in the affirmative (and by the way-- a fair number of excellent clinicians WILL NOT WORK WITH such adolescents-- period) and when asked if she had a plan, she retorted (truthfully) that she hardly needs more than a buck in her wallet and the nearest vending machine-- does that count as "planning" in this context? Because there's no bright line when you have DD's disabling condition. It's a lot easier to attempt suicide than to do all that you need to do to ensure your survival day to day. KWIM? Again-- news to the doc. (Maddening.)
They seem VERY interested in the fact that she had relatively few friends and was educated at home as a child. Initially, DD found this mildly amusing, but now it is just ticking her off that they won't listen to her.
* when DD told me about this, I confess that I rather snidely asked if she offered to show the doc how PubMed works.
I have some insight into thIs problem. My father's a psychologist, and i have some experience as a patient. I know im perfectly capable working out WHY i feel the way i do by myself. Ive never found that that helps fix my problems.especially when the problem is how i act in the face of stress. one sees a psychiatrist for meds. For practical advice about proactively changing your emotional response to situations or thoughts, for self work on your habits of mind, she will need a good psychologist with a strong background/focus in cognitive behavioral therapy, or maybe a precocious and passionate grad student with adequate supervision. Try a support group for recommendations, or someone from the psychology department on campus. or try calling a nearby hospitalfor suggestions. The cognitive behavioral therapy thing is important. If you get a therapist with a psychoanalytical background, they help you figure out why, instead of how to make things better. Also important is rapport. If a therapist doesn't seem like it's working out, you should try to find one who you can work with asap, because it's likely a waste of time and money if that isn't there.
the wait may be a problem But more so if she's seeing a psychiatrist for therapy,there's less of them to go around. It could be an insurance issue.or just a matter of making enough phone calls. In the meantime, there are always books, or message boards, or research papers if that's her cup of tea. she could go to taichi or yoga or do meditation or breathing excercises other things that promote mindfulness, which would give her a head start on cbt anyway, and might help in and of themselves. Hopefully you figure something out soon.
good luck.
Thanks-- that makes a lot of sense.
We had already concluded that DD's personality and DIY outlook on things tend to make her a CBT candidate-- and a tough sell with any other therapeutic approach.
There are only a couple in town that work with adolescents, though-- so we've gotten her a few CBT oriented workbooks that seem to address the underlying issues, and are still looking while she does that.
Would online programs be of any help while you wait? There are a number that have been developed in Australia for children, adolescents and adults which have a CBT basis eg the BRAVE program and ecouch.
http://www.beyondblue.org.au/the-fa...d-websites/online-support-and-treatmentshttps://brave4you.psy.uq.edu.au/teen-programhttps://ecouch.anu.edu.au/welcomeMood gym is for depression but teaches CBT to adolescents.
https://moodgym.anu.edu.au/welcomeThis review looked at efficacy of such programs but there was a limitation that many had small sample sizes. Still, useful resources and tools.
http://www.cphjournal.com/archive_journals/v5_1_187-231.pdfNot sure if you have similar programs in America. The ones above are hosted by respective Universities but may be location specific, I don't know.
Where I work in Australia - where of course the system is different - it'd be most efficient to see a paediatrician/physician urgently which isn't too hard if your GP knows them and get a psychology referral via them. Even though everyone is always booked out it ensures that the doctor also takes on some of the responsibility and can also recommend the therapist they think would be the best fit.
Free PTSD and mindfulness apps developed by the VA:
http://www.ptsd.va.gov/public/materials/apps/index.aspThere's a CBT app, too, but targeted at insomnia.
Text resources on various adolescent mental health issues, written to both adolescents and caregivers at
www.copecaredeal.org, now
http://www.annenbergpublicpolicycenter.org/aci/copecaredeal-org/
Good to know about these Aussie resources. I may pass some of them on to my students.
Here in Canada psychiatrist visits are covered under public health care, whereas psychologists are not. A psychologist visit can be easily had within a week and is paid for out of pocket, whereas the wait for a psychiatrist (or even a GP with separate training in counselling) spans 1-6 months and cannot be accelerated through private payment.
The This away Up program is well reviewed aeh and may be of interest to your students. Gavin Andrews is a psychiatrist who has been at the forefront of using the Internet to reach patients with mental health needs. He reports an 80% improvement rate across thousands of participants.
It certainly interesting given how long it can take to get an appointment, if the resources exist at all in your area. There are many areas of Australia where there are no resources at all.
http://www.australianageingagenda.com.au/2014/07/18/elderly-succeed-internet-depression-treatment/https://www.virtualclinic.org.au
HK.. I was talking about both the psycologist DS is seeing and finding someone to test him. Very hit & miss and to find someone can required making a lot of phone calls. Every time I've needed to find someone it's been like what you describe, calling a list of psycologists. The insurance gave me a list that is almost useless. Although I did get this to work our first time round it 6th grade, the problem was while he was good at working through the anxiety he knew little about gifted kids.
This time a person I trusted suggested this woman who worked with gifted teens, and we called her and she had a spot. Luck really because she is currently teaching two courses this semester as can't take on any more private patients at this time. But when we called she had spots. So far she has been really good for DS. She has a 2E kid who is in college & a teenager. And she shares a lot of our same values. But she doesn't take insurance and isn't cheap.
Good Luck
We had already concluded that DD's personality and DIY outlook on things tend to make her a CBT candidate-- and a tough sell with any other therapeutic approach.
There are only a couple in town that work with adolescents, though-- so we've gotten her a few CBT oriented workbooks that seem to address the underlying issues, and are still looking while she does that.
HK, so sorry about DD's anxiety.
Have you actually talked with any of the CBTs that treat adults? With her profile and maturity level, you may be able to get one of them to work with her even though it's not standard in their practice. They do know there's a shortage of people in their field...
Best wishes,
DeeDee
I suffer from anxiety and it was hard for me to overcome perfectionism in college and graduate school. When you're on a scholarship that will be taken away if your grade dips below B+ (or A-, etc), it's not exactly irrational to feel the pressure.
It's easy enough in our area to get an appointment but finding a competent therapist who actually cares about his/her clients is very, very difficult.
Have you looked into therapists in your area who specialize in eating disorders? Depression and anxiety are common co-morbitities and most of them would be highly trained in CBT and they should be open to working with adolescents.
I hope your DD finds the support she deserves very soon.
CBT helped my DD to gain perspective and 'step out of herself' she still has episodic relapses at times but who doesn't?