Switch From Psychotherapy To Cbt?

[EvenStrongerNow]

Thanks @Hashi :) Thanks for saying that.

 

[EvenStrongerNow]

OK. I did get contacted back from one lady today who is a trauma T. She says she provides both CBT and DBT, and could work with me on a sliding scale. I'm going to ask her the questions first and schedule a consultation. I'm still waiting on other places to contact me back. I will let you know.

 

[EvenStrongerNow]

Here is her resume. Can you tell me what you think of it?

(Doctor Name Removed), PsyD's Summary
Dr. (name removed) is a California licensed clinical psychologist specializing in the practice of Cognitive Behavioral (CBT) and DBT approaches for adults and adolescents experiencing eating disorders, traumatic stress and/or mood and anxiety spectrum disorders. She is currently practicing independently in her own private practice, (practice name removed), which is located in both (location removed) and the (location removed). Additionally she works as a Clinical Associate for (name removed), where she primarily treats Anxiety Spectrum disorders & Insomnia utilizing a Cognitive Behavioral framework.

(Name removed), PsyD's Experience
Licensed Clinical Psychologist and Clinical Director
(company name removed)
Sole Proprietorship; Myself Only; Mental Health Care industry

June 2013 – Present (8 months) (location removed)

(practice name removed) is a professional private psychotherapy practice dedicated to providing Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) and evidence based treatments for a range of psychological problems including: Anxiety Spectrum Disorders, Mood Disorders, Eating disorders, traumatic experiences & PTSD, Interpersonal and relationship struggles. CBT and DBT are goal oriented, are a practical and active approach to therapy based on a collaborative effort between the therapist and client. Therapy is present focused, time-limited and collaborative in nature

Clinical Associate
(company name removed)


July 2013 – Present (7 months) (location removed)

Providing evidence-based treatment for Obsessive Compulsive Disorder, Anxiety and Sleep Disorders utilizing a cognitive behavioral framework.

Assistant Clinical Director, Primary Therapist,
(company name removed)


April 2007 – July 2010 (3 years 4 months) (location removed)

Nationally recognized Joint Commission Accredited residential treatment setting.
Assistant Clinical Director and Primary therapist for Residential program providing intensive individual, family and group psychotherapy to clients whose primary diagnosis is anorexia or bulimia nervosa. Treatment program was based on the implementation of evidenced based treatment approaches including CBT & DBT.
Interim Director (7/2008-4/2009)

Primary Therapist, Adult Eating Disorders Unit, Trauma Recovery Program
(company name removed)


November 2005 – April 2007 (1 year 6 months) (location removed)

• National Treatment Center therapist providing intensive individual, family and group
psychotherapy for the Trauma Recovery Program and Eating Disorders Recovery Program.

Psychological Assistant--Outpatient Therapist
(company name removed)


January 2006 – March 2007 (1 year 3 months) (location removed)

Pre-Doctoral Intern
UCSF- SFGH Department of Psychiatry, Psychosocial Medicine Clinic


June 2002 – July 2003 (1 year 2 months) San Francisco Bay Area

Provided direct psychological services to a culturally diverse clinical population with co-morbid medical, psychosocial, psychiatric & substance use problems. Cognitive Behavioral primary training track; Trauma focused secondary training track.
Emphasized brief individual and group psychotherapy, intake assessment & diagnostic skills, consultation & coordination with healthcare providers, and crisis intervention & case management.

Therapist
Haight Ashbury Psychological Services
Nonprofit; 11-50 employees; Mental Health Care industry

2001 – 2002 (1 year)

Clinical Research Interviewer, Research Assistant
STANFORD UNIVERSITY SCHOOL OF MEDICINE, Department of Psychiatry and Behavioral Sciences,
Educational Institution; 5001-10,000 employees; Higher Education industry

2001 – 2002 (1 year)

(doctor name removed), PsyD's Organizations

• American Psychological Association
  Member
  • September 1996 to Present
• International OCD Foundation
  Member

 

[Abstract]

Very much agree with what Hashi said Strongernow. You should be proud of you. :tup:Shall comment on this t later but just quickly wanted to mention a couple of things which I didn't get to yesterday.

Firstly that a T wouldn't have to be CBT or DBT t as your only option. I thought with all this talk about skills that may have been lost. For me I won't be doing either and will be getting talk therapy with a trauma t. There are lots of different approaches when it comes to talk therapy. Many use a combination of approaches. I thought I would mention this as I was just noticing that you process things a lot through talking through them. If therapy is skills focused as the main or only focus would you miss the interaction that is part of talk therapy? Would you be able to self motivate and find what you need for yourself and bring it to T when you need to skills wise?

As Hashi mentioned grounding skills are a stand alone topic to CBT or DBT in some respects even if both would include them (if the CBT is trauma focused). That is something you can start teaching yourself and using straight away. Any good trauma T would also be using some grounding in t when you need it.

There are other ways of getting skills. Some t's do a combination of approaches and a good trauma t who is a talk therapist will still have conversations about what you can do to help yourself in-between. Pure, strict psychodynamic are probably the only ones that are not going to do that but there are not many of them around.

If you want to look at how different talk therapy can look then watch the gloria tapes where someone has therapy with 3 different styles from the creators of the styles.

The other two are listed at the beginning of this one. Many T's will use a combination of different approaches according to what their client needs and benefits from.

I would suggest you look a little at CBT cognitive distortions etc and think if these impact your life significantly or if other things are much more important. Don't worry about what others say you should be doing and rather take a look inside yourself and see what you think you most need. If they are then doing something would be important. If not then maybe not. I think awareness is key too. Some people are able to be much more aware of when these things are a problem and deal with them appropriately and others not. If someone can't be aware that they are reacting, how they are reacting or why then that needs to be dealt with.

Remember too that you can do a few different things such as do a short course before starting with a talk therapist; teach yourself CBT or/and DBT whilst doing other therapy, do an online course of CBT, teach yourself and just refer to CBT or DBT in therapy when relevant.

People who are pure CBT therapists tend to have a more distant, less soft way of approaching things so you need to think if that would be good for you or if you need something different. Id shame is a big issue then how would this approach effect that? Pure DBT is particularly good for someone if they are not able to manage their impulses or have big problems on an interpersonal level as well as if they are at high risk of serious self injury and suicide. Many times someone would be in talk therapy at the same time so that they get to talk about what they are doing and feeling other than skills training.

There are lots of different ways to make sure you get what you need. It's hard to figure out what we need when we have not experienced something but feel free to be as creative as you want to be about what would work and feel right for you. I think its very helpful to figure out where your key problems are.

I realise this is a lot of information and probably quite confusing. Just making sure you are aware of all the many options available to you. The good thing is that any experienced trauma therapist is going to be much more able to meet your needs and walk along side you in your journey than a newly qualified relationship t without specialist trauma knowledge.

It's trauma knowledge and experience for your t and you getting and using grounding skills that are the most essential thing in this.

 

[EvenStrongerNow]

Actually, that makes perfect sense to me. You know, the harsh (rational) approach that you and @Hashi took with me is just what I needed lol

I don't have anyone doing that in my life and when I'm flashing back, I am unable to at the moment. At this point, I fear teaching myself because of how much time I've already been in T and having these issues. I don't trust that I will be able to teach myself properly while these flash backs are taking me out for this long. I know there is a sense of empowerment that can come from teaching myself, but I also know there is a sense of empowerment in giving over the reigns and admitting I need help (because that is not easy for me).

So, even at the very least, getting CBT for a brief time period for the skills, and then going back to my T to finish processing the rest seems ideal to me because I trust her. The other option is just to leave her and process the rest during CBT.

BUT, I am more just worried about leaving her again completely because of what happened with the Psych. That's something I will have to get over because this is my life here, not hers. She doesn't have to go through what I go through in between sessions.

 

[EvenStrongerNow]

Just to be clear, I don't think that my experience with the Psychiatrist was that Psych's fault. When I first called her, I told her that I felt like I was frozen and stuck somewhere in trauma, that the depression and anxiety were unbearable.

At the time, I was processing my childhood with my T and being triggered by my last trauma at work. So, when I went to her, I was trying to run away from my current T and I was rattling off my history to the Psych. When she suggested anxiety medications, I told her no to all of them because I can't take narcotic anxiety meds. They have a bad reaction in me. I asked her if she could prescribe Buspar because it's non-narcotic and worked for me well before.

She said, "Ick!" about the Buspar and then started rattling off anti-depressant meds. I had no education about any of them and probably really gave her a run for my money and her time since I was in the middle of a flash back.

I quickly told her about my childhood history with being medicated for ADD and I reached. I was desperate. I told her that maybe this is what is really going on and maybe it's why I'm freaking out at work. So, she did what any good doc would do, she prescribed it with the expectation that I would be coming to do T sessions with her. When I told her I was going back to my old t, she turned me away because those were her requirements. I completely didn't remember her saying that because I was in a flash back. I got mad at her when it wasn't her fault.

You know the rest of the story. I can see it clearly now. Back then, I couldn't. I've been wanting to apologize to her over the last week or so, but she'll probably think I'm crazier than I was then hahahaha :D

 

[Abstract]

Well done for your self knowledge! Yes, we shoved you over the cliff to see if you could fly didn't we?! ;) And you are flying nicely...

Last time you did not go to another t after. You can also test the water to see if you feel OK with a new t before leaving this one.

 

[EvenStrongerNow]

OK. To stay accountable today even though I don't want to :D Right now, I am feeling a bit better being out of my flashback, but it does not matter. I know my pattern and my pattern does not help me get better.

Here are the things I am going to do today as well as getting dressed for the day, taking a walk, responding to the call I got from my landlord regarding them needing to fix the gas leak in my stove and furnace (my gas has been shut off until the fixes happen), calling one person to reach out, cleaning one thing, and doing a task for my husband.

1. I got a message back from my current T because I had emailed her about my plan. She wanted to know if I wanted her to give up my Saturday T sessions to someone else and also wanted to speak with me about my plan. I will need to be responsible and return her call because it's the adult thing to do and maybe she has an idea.

2. I also got an email back regarding a trauma group that I can be a part of. I'm reluctant, but it would be a great thing for me to do.

3. I also got a voicemail from a call I put out to a DBT center that has some programs I could take part in. Their message was to discuss what their fee is, etc. I will call back because I need to in order to get the help that I need to get better.

4. I got an email back from a DBT/CBT T (the resume I posted above) who said unfortunately, she couldn't accept my fee and her words were that she was frustrated because she really wants to hep me. I will respond back to her and let her know that I would be willing to drive to her new location once per week in February or March if the back channeling she submits doesn't work out just so that I'm leaving no stone unturned.

Here is her email response:

<Email content removed by Staff due to breaching another's right to privacy.>

 

[EvenStrongerNow]

I just emailed back the trauma group T. One down.

Update. I called my landlord and scheduled a repair appointment.

I also just emailed back the T who said she could backchannel some Psychologists in my area to see who can accept my fee. I thanked her for her encouragement and let her know that I'm working on accountability right now and that if she doesn't get a response from the back channeling, I will drive to her new location in Feb or Mar as a plan B and told her about the trauma group that I found to attend in the meantime until I get going with a new T.

I returned my current T's voicemail and left her another voicemail.

 

[EvenStrongerNow]

I'm going to put on some spiritual music and clean so my hard working husband will not have to come home to a messy house again. Plus, I will feel so accomplished!

 

[EvenStrongerNow]

My current T just called. She is sooooo sweet. She basically just said that I gotta do what I gotta do for myself and that her door is always open if I ever feel like I need her again.

She told me she thinks that something with more structure would do wonders for me and that she knows that part of my experience with her is maybe that I don't trust her with the really difficult part of my trauma and she wants me to know how normal that is. She did say that I have trusted her with my childhood trauma and that's amazing because that so needed to be processed just as well.

She also expressed her concern that I really just try to feel out a lot of Ts by interviewing first and that she thinks me getting into a trauma group is a really great idea because then I won't feel like such a lone ranger all of the time.

It was emotional. I told her how much I will miss her. She said she will miss me too. *tear*

 

[EvenStrongerNow]

@Abstract and @Hashi, in finding a trauma group to attend, are these good questions to ask the group leader?

1. What approach do you take with the group?
2. How many years of experience do you have with PTSD and trauma?
3. How do you deal with flashbacks and triggers within the group?
4. Do any of your members come to group hopped up on drugs/alcohol (trigger for me)
5. Do any of your members have a personality disorder from cluster B? (trigger for me)

What other questions would be a good idea to ask?

Obviously, I know that all of my triggers cannot possibly be removed. I just want to know ahead of time and let her know ahead of time. Also, there are certain triggers that cause full on panic attacks and flashbacks every time.