Is asking for ptsd screening wrong?

[Jamesriley1990]

So I've been seeing a psychologist for three sessions and I asked for a PTSD screening. The doctor agreed and when I went to the appointment it was discovered that my insurance doesn't cover them. I paid out of pocket because getting seen by a mental health doctor down here takes ages and I wanted to cut down on the waiting time with a new doctor. The psychologist once finding out I wouldn't use them began to tell me that they would not diagnosis me or fill anything out because they dont "know me". I just felt lost is it so wrong to ask for this screen? Or do I need to just wait for them to suggest it? Thank you in advance

 

[Abstract]

Hi and welcome. Just trying to make sense of this. The initial person was a psychologist for 3 sessions. You then went to a psychiatrist in the same clinic to be screened for PTSD. Yes? But in that time you found out your insurance wont cover the clinic so you wouldn't be able to continue with either. ? You paid out of your own pocket for the evaluation. They wont diagnose you as they donb't know you well enough.

Sometimes it isnt that clear if PTSD is the issue or not as one has to have certain signs of it that the pdoc observes. It may be that they didnt get the opportunity to observe these. Did they give you a questionnaire asking about previous traumatic experiences? What took place in the evaluation?

You shouldn't need to wait for others to suggest it. In truth sometimes professionals get resistant if someone comes to them with a dagnoses. It could be other stuff happening here though.

What are your symptoms?

 

[Jamesriley1990]

Hi and welcome. Just trying to make sense of this. The initial person was a psychologist for 3 sessions. You then went to a psychiatrist in the same clinic to be screened for PTSD. Yes? But in that time you found out your insurance wont cover the clinic so you wouldn't be able to continue with either. ? You paid out of your own pocket for the evaluation. They wont diagnose you as they donb't know you well enough.

Sometimes it isnt that clear if PTSD is the issue or not as one has to have certain signs of it that the pdoc observes. It may be that they didnt get the opportunity to observe these. Did they give you a questionnaire asking about previous traumatic experiences? What took place in the evaluation?

You shouldn't need to wait for others to suggest it. In truth sometimes professionals get resistant if someone comes to them with a dagnoses. It could be other stuff happening here though.

What are your symptoms?

I brought a questionnaire from the VA regarding PTSD and she did not entertain the idea of filling it out. She did not ask me any questions after I made it known that I would not be continuing my treatment with them.

My symptoms are I have dreams about the event and I think k about scenarios of the event daily. I am also thinking of "plans" about certain scenarios and I get very irritable when things do not go as I planned. I have also developed a invuluntary twitch in my back shoulders and neck. I have went to the VA about being depressed and just talked to a psychiatrist but moved for a job and couldn't continue this.

 

[Abstract]

Was this just with the same therapist?The questionnaire. Not a psychiatrist. If you look at the criteria does the event fit into criterion A? Just trying to understand why they have reacted like this. An evaluation would be planned ahead and involve quite a lot.

It overlaps at times but generally pdoc for diagnoses and medication. Psychologist or counsellor for therapy.

 

[Friday]

So... generally, a diagnostic evaluation isn’t done in a single session. It’s done in a series of sessions over a few weeks, that in addition to extensive testing and interviewing, also include a super complete physical with your doc/GP, possible specialist testing (neurology, endocrinology, etc.), & shared lab results. The tests/interview they’d have you do aren’t a quick checklist, but several 500 question tests that are done one day (takes 3-5 hours), but interpreted a different day, following additional info from your physical, interviews, etc. The average out of pocket expense if you’re private paying ranges from $800 to about $3k. Just on the psych side of things. Not including medical testing.

That sounds like why they first said “sure!” to the eval, and then when your insurance didn’t cover, were saying “no”. Because it isn’t something that can be done in a 50 minute appointment.

 

[Jamesriley1990]

Was this just with the same therapist?The questionnaire. Not a psychiatrist. If you look at the criteria does the event fit into criterion A? Just trying to understand why they have reacted like this. An evaluation would be planned ahead and involve quite a lot.

It overlaps at times but generally pdoc for diagnoses and medication. Psychologist or counsellor for therapy.

Yes it was the same psychologist

 

[MyWillow]

I think the Crit A one has been tricky for my treatment team. Because I will tell you straight out I haven’t experienced any trauma ever. In fact don’t even use the word “trauma” in my presence. Not even Trauma Sensitive Yoga can be said out loud. It’s just yoga.

But I get triggered by very specific things, dissociate, have visual flashbacks, nightmares, amnesia....my psydoc said she doesn’t know WHAT has happened but it’s clear that something HAS.

So diagnosis has taken a long time for me and a real specialist to do it.

 

[Abstract]

In fact don’t even use the word “trauma” in my presence. Not even Trauma Sensitive Yoga can be said out loud. It’s just yoga.

Avoidant maybe? ;) Know those feelings.

James, as Friday said an evaluation would be more complex than just looking at the questionnaire in the usual session. I get that it might have been helpful for you to read through that and in discuss it with them even if it couldn't lead to a diagnoses. Sorry that didn't happen. Diagnoses can be complext and one thing look like another. OCD for example.
If you really want to get evaluated and get a proper diagnoses the best thing is to consult a psychiatrist who specialises in trauma and ask to have this happen when you book. It also sounds like you clearly know the trauma event so you can look up and see if it fits into criterion a. If it doesn't they won't diagnose you with PTSD but that doesn't mean you cant have therapy for dealing with the event regardless.

Ptsd diagnosis

 

[Friday]

...but that doesn't mean you cant have therapy for dealing with the event regardless.

Yep. Exactly.

You don’t need any kind of official diagnosis to enter into therapy.

Same token? An unofficial working diagnosis, enough to code & bill for, but not enough to sign their name to & very subject to change, often happens in a single session or in the first few sessions... and an official diagnosis develops over time as they grow to know you over the course of several months to a year. But in the interim, the working diagnosis referred to as R/O PTSD (rule out), or Possible/Probable PTSD, or Possible/Probable Trauma & Stressor Disorder, or possible/probable Anxiety & Depression disorder, etc. serves.

Official Diagnoses are needed for things like applying for benefits, transferring providers without having to restart with the diagnositic process, etc. But they aren’t needed to start therapy. Most people don’t have them in the beginning, and many people never acquire them.

 

[Abstract]

Totally agreed. I think where diagnoses is most helpful is if the person and the therapists aren't on the right track.

Lets say its a trauma response and they are being treated for OCD. The way the therapy and medical care is being approached is aimed at that. Or its OCD and is being treated as if its trauma. Thats when its really helpful as it will extract the information and head client and treaters off into the right direction.

If the therapy that is being done feels right and you are making progress then that is usually an indication you are on the right track.

PS, some countries of course, such as the UK and unlike countries like the USA, don't work to codes at all so are even less diagnoses focused.

 

[MyWillow]

Yes, same here in Australia. It’s psychological or psychiatric services. Diagnosis doesn’t mean anything for how my costs are covered. But having a probable diagnosis has likely helped my treatment.

 

[Abstract]

@MyWillow my therapy prior diagnoses was very on the wrong track and I was seeing therapists that didn't understand my symptoms. Worked hard for decades and made little progress. Got diagnosed and made masses of progress in many ways in a short period of time. Best thing that ever happened to me but there is no way I would have known to discuss "trauma" as was in total denial and avoidance.