Hi MS...
1) What does a CPN do? Meds? Counselling? Refer to a psychiatrist / Counsellor / Psychologist?
A CPN is a Community Psychiatric Nurse (never heard of county, but perhaps that's the term where you are?) who is basically like a nurse on a hospital ward, except it is for mental health issues and working within the community (though they do work on inpatient wards also). Like all nurses, they are not qualified to diagnose, however they can give drugs. I'm not sure about prescribing... I don't think so though. Only a psychiatrist can diagnose PTSD. Not even a GP can diagnose PTSD, as it is considered outside their remit of their knowledge (unless they are specialised), however GP's can prescribe drugs for PTSD up until a point.
I understand your worries about your records... I have the same worries. However, you're EMPOLOYERS can NOT see your medical records. The occupational health department of your place of work can, however. Discrimination is against the law, and whilst it does happen (as all crimes do) it shouldn't and usually isn't soemthign that happens. Occupational psychologists/psychiatrists or workers could be sued for that and so they usually are very careful. Of course it happens, but you have rights should that ever happen. Will it affect your career? It shouldn't, but it depends on the job you are going for. Like me, I will be working in psychology next year as a Psychology Assistant, and after that I want to go onto a Doctorate course to qualify as a Clinical Psychologist... to get on that course I will have to be assessed by Occupational Health to see if I am fit and meet all the requirements to be deemed fit in order to train and work as a psychologist. It shouldn't affect me as far as I can see and I have spoken to people about this (it is stricter for people wanting to work in medical fields). For you, occupational health will want to assess if you are capable and fit to do your job, and how they can accommodate that. There are some jobs, however, where you won't get a job if you are unfit though this is usually in terms of medical fields. For example, its like if you were on a drug that makes you drowsy and disallows you to drive, you probably wouldn't be able to do a job that involved driving... it's that sort of thing.
It is not always the case that you only get 6 sessions... though this is a general guideline these days so that the government keeps time and costs down per patient. If you are deemed to need more, you may get it... but you will have to make it clear that you want and need that. Unfortunately, the current state of the NHS is that you have to fight for services somewhat... almost compete. If you get a decent CPN, it shouldn't be a problem, but it does depend on your area, and the resources and budgets that they have as these differ per PCT. The kind of work a CPN might do with you is assessments, perhaps CBT and some counselling, a referral perhaps (probably) to a Psychiatrist, and various techniques to deal with anxiety and such issues. All is obviously important and valuable... but the likelihood is no, you probably won't 'be better' after 6 sessions. But this is something to discuss with the CPN... the good news is, once you're into the psychiatric services, you're in, and you can be referred and prioritised. Many are still waiting for the initial assessment.
If you've not been referred to psychiatry services before for PTSD issues, then this is how it will most likely go (and you should push for it if it doesn't look like it's going to, but it should go like this)...The chances are you've been referred to a CPN for initial assessments and treatment. The assessments involve them collating what sort of issues you have, what sort of needs you have, and what sort of severity it is at in terms of priority. When the CPN realises that this is likely to be PTSD (or is PTSD if you are aleady diagnosed), you will be referred to a psychiatrist if you don't have one. Your medication will be reviewed, and may be changed or have some added to it. You will stay under the care of psychiatry services until you no longer need it which may be a while, and you'll have anything between weekly to 6 monthly reviews with this psychiatrists alongside anything else. The psychiatrist will also recognise that you need psychological help, and may leave you with the CPN to see how that goes... either the CPN sessions will be extended for more in depth treatment, or you will be referred onto a counsellor, or psychologist for psychological treatment alongside the psychiatric treatment.
My advice to you would be... be very honest, and explain all of your symptoms from the offset so that PTSD is recognised amongst them. Don't try to minimalise what you're going through (though don't exaggerate obviously) and don't try to hide anything... it won't help you or get you the help you need.
My personal experience of a CPN is when I was with the child services. I was referred to a CPN for treatment for self-harm. Unfortunately, I did all the wrong things, wasn't honest, hid things etc. and so PTSD wasn't detected and I was diagnosed with depression. The treatment (obviously) didn't work, I ended up referred to a psychiatrist as well as seeing the CPN, and eventually hospitalised. I got out of hospital and was referred to a psychotherapist. Again, throughout this whole time, I didn't make my symptoms aware to people, and in hospital I was simply misdiagnosed (though that was all one big tragic mess and not a place worthy of the money the government gives it). The hospital I was at didn't fully assess me, and went on the assessment the child psychiatrist had done (which didn't include any of my trauma's as I didn't tell him about them). They just played around with my SSRI's, and let me leave when I did my piece of acting.
So....honesty really is the best policy here. I wasted all those services I had in front of me. It is only NOW, at 22 (and I entered psychiatric services at 17, and left when I moved to uni. at 20), that I am recieving any kind of treatment for PTSD through the university.
Good luck! Don't worry... it's a good thing you are going to see the CPN, as from thereon you can get access to what you need.
