Clinical Psychologists Assessment - Advice please

H

Here today gone tomorrow

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#1
I have no idea if this is the right place to post this, or even if anyone will read it.

I have to attend an assessment with a Clinical Psychologist.

Basically my Primary care Therapist and his 'buy a book' attitude couldn't help, so they've moved me on.

I'm now going to be on another long waiting list, and not have any support if things go tits up in the meantime.

Can someone give me a little insight into this assessment please, and also if there are any 'medical record consequences' regarding seeing a Clinical Psychologist?

Primary care didn't have any declaration consequences when I had my last Taxi medical. Will this next level of care be different?

I'm considering cancelling all care before I have a medical record that closes lots of doors for me.

Considering Primary Care Therapists were totally unhelpful, will a Clinical Psychologist be any different, or should I quit now before I end up with a record?

Thanks

PS.... Silly me.

I nearly forgot lol. What help will they offer?
 
W

Wee Tam

Guest
#2
an all too familiar story im afraid. its the same here where we are, no help, no treatment except meds, and no support.

i would advise however against cancelling all care though, in this day and age, and what with the coming cuts, take any care you can get.

as for the medical records and taxi driving, which is worse, not being able to drive, or getting banged up if you have an accident and they find out you knew you have a psychiatric illness and have refused treatment so you can drive?
 
H

Here today gone tomorrow

Guest
#3
an all too familiar story im afraid. its the same here where we are, no help, no treatment except meds, and no support.

i would advise however against cancelling all care though, in this day and age, and what with the coming cuts, take any care you can get.

as for the medical records and taxi driving, which is worse, not being able to drive, or getting banged up if you have an accident and they find out you knew you have a psychiatric illness and have refused treatment so you can drive?
Why do you think I have a psychiatric illness Tam? Also why do you think if I did it would affect my ability to drive?

My question relating to my job is more a case of what will, and won't, be declarable should I undergo another medical in 3 years time. On the medical form there is a section that the doctor must fill in regarding psychiatric illness etc. My doctor felt my treatment didn't amount to that, so didn't declare any treatment. This is because Primary care isn't really classed as psyciatric care etc in that way.

However, moving on to a Clinical Psychologist may be considered 'secondary' care, rather than 'primary', and the doctor may feel it is significant enough to disclose.

Obviously if my Licensing department were concerned, they would ask me to have a medical with Occupational health. I need to know if it is benefitial to speak to someone in secondary care, knowing it might go on my record, when there is no evidence yet to suggest that anything is wrong with me, other than depression for example.

For the record, I don't yet have a diagnosis, nor has anyone suggested that I'm ill.

Even my therapist felt that some of my issues were 'normal' and that I just needed to address them. My problem is that his help was not really helping, other than being able to talk to someone and be given the title of a book to buy.

He was weak minded, and in my opinion looked like maybe we should have swapped seats.

I'm simply trying to establish what the Clinical Psychologist might offer in terms of help, whether anyone else has benefitted from their experiences with one, and whether the help is good enough to warrant risking having a medical record of secondary care.
 
W

Wee Tam

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#4
my missus isnt allowed to drive sometimes when she is really bad with her bipolar, she literally has to report to the DVLA everytime she feels rotten, so they know she cant drive.

Also, some mental illness have physical manifestations as well as mental, my missus is extremely unsteady, has little or no co-ordination, has the attention span of a cheese sandwhich, sometimes its an effort just to get about because of it.

As for being "nothing" wrong except depression, depression is a complex and misunderstood illness that shouldnt be taken for granted or underestimated, so as i said in the previous post, i would be inclined to take any care you can get, i look at it this way, it cant do any harm can it? and it may just help...
 
maxitab

maxitab

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#5
Hi, some of this is unfamiliar territory to me but I will answer what I know.


You are right, this is secondary care...as to what will go in your records, well, it will be whatever the psychologist decides on the outcome of the assessment.
Two things about that. One - you have the anti-discriminatory law on your side if they try to fire you becase you get a diagnosis - you could take them to a tribunal if they try this on......
Second - the thing that I know about driving is stuff about medication or psychotic episodes - and I would be very surprised if anyone tried to say that is your dx!
Because of the attempt at schema and stuff you have said in your posts I would think a dx of Personality Disorder was more on the cards than anything else but then that is only my opinion. If so, it should not affect your work I know lots of people who have all sorts of diagnoses and are working......

I think the advantage of a dx is that is does get you the correct treatment/therapy......

I have been in the care of a Clinical Psychologist/Psychotherapist for the last eight years. He was my DBT therapist and we now have contact on an ad hoc basis if I feel I need some input from him. I don't think I would be here if I had not had formal therapy with him, and I think lots of people will say that they have been helped by their clinical psychologist - but then I suppose its a bit like plumbers, there are crap ones too! I would definitely say that for me the benefits have been positice, and worht the outcome. But then I did wait untill I was 49 before I asked for help!
 
H

Here today gone tomorrow

Guest
#6
my missus isnt allowed to drive sometimes when she is really bad with her bipolar, she literally has to report to the DVLA everytime she feels rotten, so they know she cant drive.

Also, some mental illness have physical manifestations as well as mental, my missus is extremely unsteady, has little or no co-ordination, has the attention span of a cheese sandwhich, sometimes its an effort just to get about because of it.

As for being "nothing" wrong except depression, depression is a complex and misunderstood illness that shouldnt be taken for granted or underestimated, so as i said in the previous post, i would be inclined to take any care you can get, i look at it this way, it cant do any harm can it? and it may just help...
I don't take Depression for granted matey. There just comes a point where we need to acknowledge that most people on a MH forum are well aware of many disorders, so we don't have to give each one 'special attention' when discussing it so to speak. In other words most of us here don't underestimate 'anything'.

'It can't do any harm' can it?

That's kind of what I'm trying to establish. I'm currently self employed. The job is very bad at this time of the recession, yet the overheads increase every year. As a Hackney driver, we have to be squeaky clean. No criminal record, no Health Issues that might be considered detrimental to the saftey of passengers etc etc. CRB checks, medicals, 2 MOT's per year etc etc.

I need to know what I'm 'opting in' to. If what I'm about to undergo would concern my licensing department, and they had cause to withdraw my license, then not only would I lose a license that cost me the best part of £20,000, but my prospects for future employment may be severely damaged too, and as my daughter is nearly 15, many benefits that help out will soon stop. I can't afford to be up a creek without a paddle because I didn't 'think of the consequences before signing on the dotted line.

Hope you and your missus are having a better day BTW.
 
W

Wee Tam

Guest
#7
I don't take Depression for granted matey. There just comes a point where we need to acknowledge that most people on a MH forum are well aware of many disorders, so we don't have to give each one 'special attention' when discussing it so to speak. In other words most of us here don't underestimate 'anything'.

'It can't do any harm' can it?

That's kind of what I'm trying to establish. I'm currently self employed. The job is very bad at this time of the recession, yet the overheads increase every year. As a Hackney driver, we have to be squeaky clean. No criminal record, no Health Issues that might be considered detrimental to the saftey of passengers etc etc. CRB checks, medicals, 2 MOT's per year etc etc.

I need to know what I'm 'opting in' to. If what I'm about to undergo would concern my licensing department, and they had cause to withdraw my license, then not only would I lose a license that cost me the best part of £20,000, but my prospects for future employment may be severely damaged too, and as my daughter is nearly 15, many benefits that help out will soon stop. I can't afford to be up a creek without a paddle because I didn't 'think of the consequences before signing on the dotted line.

Hope you and your missus are having a better day BTW.
the world would be a better place if everyone thought like you pal, instead of making comments like "its only depression" etc

and thats not just from the general public either, Bes's GP made a comment of something like "its just a state of mind, pull yourself together" and "you going between here and the hospital is boring me"

ignorance to these issues by the majority of people can more often than not make things worse for the people who suffer form it both directly and indirectly.

and thank you for your best wishes, Bea has had to go to liverpool today to see her children so im not gunna get to see her till new years eve again, but i could tell when she phoned me earlier she was anxious :/
 
H

Here today gone tomorrow

Guest
#8
Hi, some of this is unfamiliar territory to me but I will answer what I know.


You are right, this is secondary care...as to what will go in your records, well, it will be whatever the psychologist decides on the outcome of the assessment.
Two things about that. One - you have the anti-discriminatory law on your side if they try to fire you becase you get a diagnosis - you could take them to a tribunal if they try this on......
Second - the thing that I know about driving is stuff about medication or psychotic episodes - and I would be very surprised if anyone tried to say that is your dx!
Because of the attempt at schema and stuff you have said in your posts I would think a dx of Personality Disorder was more on the cards than anything else but then that is only my opinion. If so, it should not affect your work I know lots of people who have all sorts of diagnoses and are working......

I think the advantage of a dx is that is does get you the correct treatment/therapy......

I have been in the care of a Clinical Psychologist/Psychotherapist for the last eight years. He was my DBT therapist and we now have contact on an ad hoc basis if I feel I need some input from him. I don't think I would be here if I had not had formal therapy with him, and I think lots of people will say that they have been helped by their clinical psychologist - but then I suppose its a bit like plumbers, there are crap ones too! I would definitely say that for me the benefits have been positice, and worht the outcome. But then I did wait untill I was 49 before I asked for help!
Thanks Maxitab.
I'm not sure where I would stand regarding 'discriminatory dismissal' etc, as I am self employed. The Licensing Authorities have a debt to the public to ensure their safety at all times. As you can imagine, an Airline pilot wouldn't be allowed to fly if he had certain issues. The same fine line applies to me.
As it stands, I'm perfectly ok to do my job, but a diagnosis could prove awkward. I'm hoping that you're right regarding a personality disorder. I don't think I am Bipolar for example, or many of the other illnesses that exist.

Regarding my other point, has anyone here been to see a Clinical Psychologist for assessment? If so, what happened please. Can you ellaborate a bit Maxitab or is it too long ago to recall?

I've had 3 assessments already, and my confidence in the folks who undertook them has fallen dramatically. How can someone know what's up in just over 1 hour?
If I'm low, they'll probably get a barrage of 'woe is me' information. If I'm feeling ok (like I have for 1 week) then I'll be sitting there thinking 'this does not apply to me - get me out of here'.
 
H

Here today gone tomorrow

Guest
#9
the world would be a better place if everyone thought like you pal, instead of making comments like "its only depression" etc

and thats not just from the general public either, Bes's GP made a comment of something like "its just a state of mind, pull yourself together" and "you going between here and the hospital is boring me"

ignorance to these issues by the majority of people can more often than not make things worse for the people who suffer form it both directly and indirectly.

and thank you for your best wishes, Bea has had to go to liverpool today to see her children so im not gunna get to see her till new years eve again, but i could tell when she phoned me earlier she was anxious :/
Tam, in the nicest possible way, the Depression I spoke of was my own depression. I retain the right to call it 'only' if I want to, though I think the term I used was 'other than' Depression. The day I give it too much importance will be the day it defeats me, but I do understand where you're coming from.

GP's can be idiotic. I first asked my GP for help 3 years ago, or there or there abouts. He told me not to be silly, and pull myself together. I eventually had to question his integrity as a GP to get him to listen to me, some years later.

A few weeks ago, I had a bit of a panic attack, or similar. I was a bit suicidal after my therapist told me he couldn't help etc, and went to the doctors for help. Instead of realising I was having a little 'moment', they banned me from the clinic. I'd been registered at that surgery for 30 years. That tells me that GP's aren't always on the side of the patient.

Regarding Bea, I can't speak for her, nor would it be on topic to discuss her in this thread, but Christmas and New Year are very trying times for people with Mental Health Issues. I wish you both luck and hope all comes good.
 
piglet

piglet

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#10
Hiya hun, I have had two psychological assessments and am due for a third (three sessions starting on the 5ht). The first one was back when I was about 17 and I was diagnoses with clinical depression, she saw me for 6 sessions to work through my issues after the assessment and although I found it useful I felt that 6 hours wasn't really enough time. The second time I saw a guy for two sessions, he was a bit rubbish and said said that I was depressed, put me on ADs and then left me to it. I am hoping that my next assessment will be more successful as my GP said my earlier ones prob weren't successful because I was a teenager. When is your assessment due? If it is after the 5th I could PM you about how mine went so you can get some more information.

As for how it would affect your job, I am not 100% sure. My dad is a taxi driver and he knows a few people who have left due to MH reasons but I don't know if that was their decision or not, I could ask him if he knows what the score is if you like?
 
maxitab

maxitab

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#11
I can remember it well. My psychologist talked (or rather listened) to me, then he had me fill out a formal personality inventory (much more complex than the ones you see on the web). This is analysed by computer so it is a little less subjective...you either meet the criteria or you don't. He gave me a copy about 10 days later and we went through it together. It measures for psychosis, various personality disorders, and stuff like bipolar, major depression, Schizoid etc, so it is comprehensive.

My score was literally off the page for BPD, and major depression. I scored below the norm for all the rest.
We did a follow up 18 mths later after DBT, and it had changed considerably, with much lower (but still high) for BPD and depression. We then did it again about two years ago and the depression was within the norm....

Oh, I just found it. It has written on it : MCMI-III Autoscore Profile.

It has all the PD's on it, and PTSD which I had forgotten about. I like this as I feel more comfortable with something a little less just someone's opinion, and it is adjusted to score us against ordinary people.....any fully qualified Clinical Psychologist should be able to administer and score it......
Am just noticing, I scored high on Bipolar too......but not anywhere near as high as the BPD.
I hope that helps.
 
Jimbob`

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#12
Can someone explain the terminology primary care secondary? I assumed primary was in a psychiatric hospital when talking of psychological problems.
 
maxitab

maxitab

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#13
Yes, you are correct....some people come out of hospital and continue to see a psychiatrist as an outpatient.......however, you can also be referred to the CMHT or to secondary services in the community.
 
Jimbob`

Jimbob`

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#14
So I'm confused, the original poster (hi) was hospitalised but has no problems whatsoever or only insignificant minor depression?
 
H

Here today gone tomorrow

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#15
Hiya hun, I have had two psychological assessments and am due for a third (three sessions starting on the 5ht). The first one was back when I was about 17 and I was diagnoses with clinical depression, she saw me for 6 sessions to work through my issues after the assessment and although I found it useful I felt that 6 hours wasn't really enough time. The second time I saw a guy for two sessions, he was a bit rubbish and said said that I was depressed, put me on ADs and then left me to it. I am hoping that my next assessment will be more successful as my GP said my earlier ones prob weren't successful because I was a teenager. When is your assessment due? If it is after the 5th I could PM you about how mine went so you can get some more information.

As for how it would affect your job, I am not 100% sure. My dad is a taxi driver and he knows a few people who have left due to MH reasons but I don't know if that was their decision or not, I could ask him if he knows what the score is if you like?
Hi, and thanks for the reply.
I don't have an appointment yet, and I guess I'm simply back on the waiting list. I don't really think (from my perspective) that my disorders etc will affect my ability to do my job. I think it's more a case of how others see it. In either case, I've decided to sell up, and will hopefully find a buyer soon.
 
H

Here today gone tomorrow

Guest
#16
I can remember it well. My psychologist talked (or rather listened) to me, then he had me fill out a formal personality inventory (much more complex than the ones you see on the web). This is analysed by computer so it is a little less subjective...you either meet the criteria or you don't. He gave me a copy about 10 days later and we went through it together. It measures for psychosis, various personality disorders, and stuff like bipolar, major depression, Schizoid etc, so it is comprehensive.

My score was literally off the page for BPD, and major depression. I scored below the norm for all the rest.
We did a follow up 18 mths later after DBT, and it had changed considerably, with much lower (but still high) for BPD and depression. We then did it again about two years ago and the depression was within the norm....

Oh, I just found it. It has written on it : MCMI-III Autoscore Profile.

It has all the PD's on it, and PTSD which I had forgotten about. I like this as I feel more comfortable with something a little less just someone's opinion, and it is adjusted to score us against ordinary people.....any fully qualified Clinical Psychologist should be able to administer and score it......
Am just noticing, I scored high on Bipolar too......but not anywhere near as high as the BPD.
I hope that helps.
Once again thank you Maxitab.
 
H

Here today gone tomorrow

Guest
#17
Can someone explain the terminology primary care secondary? I assumed primary was in a psychiatric hospital when talking of psychological problems.
Hi there.
No, I wasn't hospitalized. By 'Primary' I meant 'Primary Care and psychological therapy'. This is very light care which is mainly chatting to a therapist. The therapist is trained in various approaches to personality disorders etc, which might include Cognitive Behaviour Therapy for example, but he 'isn't' a Clinical Psychologist.

By secondary care, personally I look at that as being the clinical psychologist, or similar. These aren't set in stone terms regarding my own use, and mainly my own interpretation of the situation.
 
pepecat

pepecat

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#18
Hi

I had an assessment with a Clin Psychologist in the summer. She saw me three times - for about 50 mins each time over maybe a month. Before I went i had to fill out quite a long form with various sections: any eating disorders, what family / friends did i have, any history of alcoholism or domestic violence when i was growing up, current relationship, current job, how my 'condition' (they called it that) affects me, any sexual difficulties - stuff like that. It was pretty involved.
At the assessment she asked various things - one was what my earliest memory was, how i'd come to be there (i.e - what was my 'story'), what was my mother like when i was little. She pushed fairly hard, and it wasn't a nice experience, but they have a v limited time in which to work out what the main issues for you are and whether they can help you or not.
She also talked quite a lot about how the whole process of psychotherapy works, what to expect, stuff like that.
 
H

Here today gone tomorrow

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#19
Thank you Pepecat.

I've already had 3 or 4 assessments in the past leading up to my last course of therapy. The first was with the Crisis team when I first needed assistance. Then I had another at a site that I never returned to, which gave me my Primary Therapy course. Then I had an assessment by one of the managers there, and then finally by the therapist.

By the time the therapist got to me, I was fairly drained of emotion. The 3 other assessments had been when I was very upset, and during the assessments I had been upset talking about things too.

I wasn't able to 'spill the beans' so to speak with the Therapist. I wasn't as low as I had already been, and I guess I was a little pissed off that I had to go through it all again. I think I asked him "Don't you guys take notes?" or words to similar effect.

At first, I felt the guy was gay, and that put me off a bit, but he seemed ok after a few sessions and I started to warm to him. After a few weeks, he told me to buy a book. I did, and he went on holiday, so I had to miss a session. The following week, I overslept, and then quarrelled with the missus and missed another session, but to be fair I had early sessions and had told them I struggled to wake up in the morning because of the Morphine I have to take.

Another few sessions, and though I was enjoying the chats, I felt as though the sessions weren't helping me that much, and said so. He was very weak, and caved in saying he didn't think he could help me either. (If you're reading this Tom you're a whimp and a fake).

He agreed to continue the sessions as support despite them not particularly helping. This was the 2nd cop out as he had already decided not to try CBT after I told him my doctor had agreed with me when I told him it was a bit cheesy. Basically, the guy allowed me to condemn everything, instead of standing up for his profession and telling me to give it a go. Sometimes I felt like we should swap chairs. He was a nice guy to be fair though and I liked him.

I'm not sure how I will be able to communicate to someone in my next assessment, especially if I'm noy on a low.

I've thought about cancelling it, but then realised that I could swing towards a low if luck turns against me, and might do well being open minded and seeing what they can offer me.

I couldn't do groups. I'm too embarrassed about having Mental Health issues to do that, and besides, I want to try and keep my therapy private, especially as I deal with the public, and even had accounts with the very hospital that will be helping me until I parted company with certain people.

My thoughts are that I should write down my thoughts on the whole issue, and take them with me. When I first joined here, I made some observations about myself. I should revisit them and see if they still ring true. I've tried to avoid this so as not to get myself depressed again.

At the moment it's all waiting lists, which is why I'm so determined to help myself.
 
T

Tonka

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#20
I have a friend who has suffered from clinical depression for years...she has found a lot of help from some books written by Chris Williams who has written book and workbooks on "Coping with Depression" and "Coping with Anxiety".....one can order them from Amazon aarently, I have ordered them for me to help my husband with....hope this might help you. Tonka
 
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