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Author Topic: An Apology and Question
Phanto
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Hi,

First, I want to apologize for some bizarre posts I made over the past year. I was suffering from some irrational thoughts and now realize that pretty much everything was to a degree delusional (I still believe a part of it was due to unholy forces, due to certain things that happened, but that's a story for another day)

I was wondering if I could get some advice. I'm looking for a therapist in the Boston area who is fluent with medications. I'm not sure how to go about doing this. In particular, my case is complex and I have bad ADHD, so I want to be sure to get someone who is good (I was badly burned by Freudian psychoanalysts who don't know much about psych meds and just want to meet 4 times a week to discuss things I find pointless)

Any advice would be greatly appreciated.

Thanks [Smile]
Phanto

[ April 17, 2012, 03:27 PM: Message edited by: Phanto ]

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SteveRogers
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A medical doctor or psychiatrist will be the only people who will actually be able to prescribe medications, so that'd be the path to choose if that's your main concern.

Any other psychologist or psychological professional will have to work with a medical doctor to get any prescriptions made.

And I would definitely avoid psychoanalysts. There's almost no empirical research support to suggest their interventions are helpful in diagnostic cases.

I hope this helps you to at least narrow things down; I wish I could do more, but I'm unfamiliar with the Boston area and would be hesitant to suggest any specific practitioner on that basis.

Edit:

Also, I want to express my feelings that, though I haven't interacted with you personally as of late, it's not necessary for you to feel the need to apologize on here. We're a community. Most of us tend to be pretty forgiving. [Smile]

[ April 17, 2012, 03:40 PM: Message edited by: SteveRogers ]

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The Rabbit
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Phanto, I'm so glad to hear you seeking the help you need. There is no need to apologize for being ill.

I'm afraid I can't give you any advice about doctors in the Boston area. I'm sure someone in the community can help with that better than I.

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SteveRogers
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I did find this link, but I can't vouch for the effectiveness of any of these practitioners or for their credentials. But hopefully it at least gives you someplace to start looking. [Smile]

Edit:

Also, keep in mind what sort of things your insurance, if you have any, will cover. Some will only cover work with certain professionals, and some professionals will be more inclined to work with you on matters of insurance and payment than others.

And another thing to keep in mind is that, as a general rule of thumb, psychiatrists may have a better grasp on the medication and medical side of psychology while a psychologist will have a better grasp on diagnosis as well as other treatments aside from medication which can also be effective or even more effective in conjunction with medication. Either would be qualified to help you, but you're going to get a mixed bag either way.

[ April 17, 2012, 03:55 PM: Message edited by: SteveRogers ]

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dabbler
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I am a psychiatrist in the Worcester area (1 hr west). Sadly I don't know the names of specific psychiatrists in the Boston area that would be appropriate. But I can tell you what to do:

If you have insurance (which, since you're in MA, you really should have), I would go to your insurance's website and look up psychiatrists who take that health insurance. If you need help finding the list, post the brand of insurance you have and I'll take a look. Some health insurances use a carve out for mental health (not BC/BS, but Tufts does) so look out for a specific mental health tab/link. Search for local psychiatrists in the area. Then start making phone calls.

I don't know what the wait list is in Boston. Probably not bad since Boston has some of the highest # of psychiatrists/population. The problem is avoiding the bad ones. Ideally a psychiatrist you trust can take a look at the list of providers that take your insurance and do a thumbs up/down on the names. You can try a training hospital like MGH (Outpatient Psychiatric Services at 617-724-7792) which is probably full of decent psychiatrists.

You will want a psychiatrist for medications, and consider someone for therapy. Most psychiatrists don't do therapy (a topic best saved for another thread). Once you meet a good psychiatrist, they should be able to refer you to a therapist they trust that practices a type of therapy they think is right for you.

Good Psychiatrists:
- Take at least 1 hour to meet you on the first visit.
- Have availability to see you more often when needed
- Don't rush through follow ups in 5 minutes. A complicated follow up should take no less than 20 minutes.
- You trust
- Give you the risks and benefits of the medications or therapies they recommend.
- Don't recommend brand new medications because of pharma influence. (In my opinion, Invega is not a first line choice for example)

If you need more specific recommendations for providers, I can see who I know in the Boston area to take a look at a list of people who take your health insurance.

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dabbler
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What I would do if it were Worcester, is call the local Emergency Mental Health room and request that they let me know which psychiatrists they recommend from the insurance provider list. They tend to know who the "bad" psychiatrists are. Problem is that Boston has like half a dozen equivalents to Worcester's EMH. So I don't know who I'd call and they don't know me from a sack of beans.

But, I'll think of who I know in Boston who could take a look at names. I think I know a couple.

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SteveRogers
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Being in the North East, you'll have to make sure to mention to a psychiatrist that you don't want to see a psychodynamic practitioner/psychoanalyst if/when he refers you to a therapist or psychologist. Demographically speaking, they tend to be more prevalent in that area than in others.

If they have a picture of Freud anywhere in their office, then you're probably in the wrong place. [Smile]

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dabbler
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It depends. Your average psychiatrist who does psychoanalysis or psychodynamically informed therapy isn't going to be clueless about psychiatric medications. It depends how niche they feel like being. Clearly Phanto should see someone with a firm grasp of medications, whatever else they do.

I actually have met/know some of the analysts in Boston because I've taken classes at the Boston Psychoanalytic institute.

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SteveRogers
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I actually said psychiatrists would know more about medication. [Smile] I was just responding to the original post: "I was badly burned by Freudian psychoanalysts who don't know much about psych meds and just want to meet 4 times a week to discuss things I find pointless," in regards to psychoanalysis.

Treatment is going to vary depending on if you visit a psychologist, a master's level psychological professional, or a psychiatrist. And even within those careers, the training will vary based on what paradigm or perspective in which the professional was trained. But, ultimately, psychiatrists who can prescribe medication will know more about medication, and psychologists will able to help with treatments like Cognitive Behavioral Therapy or what have you.

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dabbler
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Ah sorry, that makes sense now that I read it correctly [Smile]

Yeah I agree with you. I thought you were saying that a psychiatrist who was psychodynamic/psychoanalytic would be clueless about meds. That's me reading too quickly.

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SteveRogers
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It's all just a matter of training really. People will be competent in different types of intervention.
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SteveRogers
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I hope all this information wasn't overwhelming. [Smile]
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Geraine
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Phanto,

I wish you the very best, and I hope you get the help you are seeking.

Don't forget us here! Though a lot of us disagree with one another, I'm sure most of us would till go out of our ways to help others on this board if we were able.

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Phanto
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Thanks for all the help and support! Been looking through a bunch of resources; right now my plan is to get a list of 10 or so names that are covered and ask a shrink friend to look it over.

Cheers,
Phanto

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SteveRogers
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Let us know how things go. Hope things go well. [Smile]
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dabbler
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That sounds like a good plan. Let me know if you need any more eyes on your list.
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scholarette
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Seeing this post and that you were getting help made me very happy.
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dabbler
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Phanto, a suggestion that you don't have to agree with: Print out some of your previous blog entries or forum posts and bring them with you to see your new treater. It will help them understand you better.
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