Should a therapist have done this?

[DLgal]

Is it considered "kosher" for a therapist (a psychologist) to tell a patient that she feels the patient has a specific mental health diagnosis and that she is going to speak to the doctor about a different medication protocol? In this instance, the therapist has a direct connection to the treating psychiatrist.

The patient has been under the care of a psychiatrist for over a year. This particular diagnosis has never been suggested, nor is it likely at ALL. The standing diagnosis is accurate, and the patient has been responding to treatment.

I was just shocked to hear that a therapist came right out and essentially said "I think you have X." Is that something therapists are qualified to do? This suggestion has thrown the patient for a loop and caused increased stress and anxiety, even after reassurance that the therapist is way off. The suggested condition is a very serious one.

I don't know enough about the scope of therapists, but this seems to be way beyond and borderline irresponsible, considering the patients resulting distress. I think if the therapist had concerns she should have brought them to the doctor directly, and let the doctor evaluate for the suspected condition or provide his basis for the diagnosis that exists.

 

[tcufrog]

I'm not an expert but I've never had my or my son's psychologists or counselors do that. If they wished to reevaluate the diagnosis they recommended going through the diagnosis process again.

 

[DLgal]

I'm not an expert but I've never had my or my son's psychologists or counselors do that. If they wished to reevaluate the diagnosis they recommended going through the diagnosis process again.

I have never had a therapist do this either! I have seen therapists as has my son. This made me livid. I am just wondering if this particular therapist "broke a rule" or if this is considered an acceptable practice. I don't know enough about it to know for sure.

 

[Gracedis1]

Some therapists are licensed to diagnose, but if a psychiatrist is involved, the therapist should consult with the psychiatrist before changing a diagnosis. It would be helpful for then to talk anyway. The patient will need to sign a consent form.

 

[sonnyjane]

Is it considered "kosher" for a therapist (a psychologist) to tell a patient that she feels the patient has a specific mental health diagnosis and that she is going to speak to the doctor about a different medication protocol? In this instance, the therapist has a direct connection to the treating psychiatrist.

The patient has been under the care of a psychiatrist for over a year. This particular diagnosis has never been suggested, nor is it likely at ALL. The standing diagnosis is accurate, and the patient has been responding to treatment.

I was just shocked to hear that a therapist came right out and essentially said "I think you have X." Is that something therapists are qualified to do? This suggestion has thrown the patient for a loop and caused increased stress and anxiety, even after reassurance that the therapist is way off. The suggested condition is a very serious one.

I don't know enough about the scope of therapists, but this seems to be way beyond and borderline irresponsible, considering the patients resulting distress. I think if the therapist had concerns she should have brought them to the doctor directly, and let the doctor evaluate for the suspected condition or provide his basis for the diagnosis that exists.

I really can't comment on the protocol but am curious how you know the standing diagnosis is accurate?

 

[LSUmiss]

Is it considered "kosher" for a therapist (a psychologist) to tell a patient that she feels the patient has a specific mental health diagnosis and that she is going to speak to the doctor about a different medication protocol? In this instance, the therapist has a direct connection to the treating psychiatrist.

The patient has been under the care of a psychiatrist for over a year. This particular diagnosis has never been suggested, nor is it likely at ALL. The standing diagnosis is accurate, and the patient has been responding to treatment.

I was just shocked to hear that a therapist came right out and essentially said "I think you have X." Is that something therapists are qualified to do? This suggestion has thrown the patient for a loop and caused increased stress and anxiety, even after reassurance that the therapist is way off. The suggested condition is a very serious one.

I don't know enough about the scope of therapists, but this seems to be way beyond and borderline irresponsible, considering the patients resulting distress. I think if the therapist had concerns she should have brought them to the doctor directly, and let the doctor evaluate for the suspected condition or provide his basis for the diagnosis that exists.

I’m a licensed clinical social worker & in the state of Louisiana I can diagnose any mental health condition even those that require Rx. So, yes, here a psychologist could definitely do that.
Eta: However, although legally I could, I wouldn’t tell a client that unless they specifically asked me especially if I would cause the client harm as in the scenario you presented.

 

[Pea-n-Me]

It probably depends on local regulations, and of course those can vary from place to place, but I'd think it depends on what type of relationship there is between the therapist and the psychiatrist, as in, do they work together on these types of cases regularly? It might be more common for people to see a therapist than a psychiatrist. You could always request another opinion, too.

 

[DLgal]

I really can't comment on the protocol but am curious how you know the standing diagnosis is accurate?

My father has had the condition in question for 40 years (the one suggested by the therapist). The patient is my husband. The hallmark criteria for diagnosis is something I am VERY familiar with observing/experiencing and it has NEVER happened to my husband. The current diagnosis is one I also have had in the past myself, and it has had a very predictable presentation and timeline of symptoms developing.

 

[DLgal]

It probably depends on local regulations, and of course those can vary from place to place, but I'd think it depends on what type of relationship there is between the therapist and the psychiatrist, as in, do they work together on these types of cases regularly? It might be more common for people to see a therapist than a psychiatrist. You could always request another opinion, too.

It's military medicine at an overseas base. Resources are limited. There is no "second opinion." The medical records are shared between all providers openly within the organization. They all work in the same building (a Naval hospital).

 

[Pea-n-Me]

It's military medicine at an overseas base. Resources are limited. There is no "second opinion." The medical records are shared between all providers openly within the organization. They all work in the same building (a Naval hospital).

Then they work together. You at least have the right to speak with the psychiatrist about any concerns you have with the diagnoses.

 

[DLgal]

Then they work together. You at least have the right to speak with the psychiatrist about any concerns you have with the diagnoses.

I am aware. I told him when he sees his psychiatrist again, he should tell him that he thinks the therapist is way off and that I (his wife) has no reason to suspect this alternate diagnosis. I told him under no circumstances should he just go along with it and accept new medications. FWIW, this particular diagnosis often relies on input from people close to the patient who can speak candidly on the symptoms they have witnessed. It is not diagnosed by a psychiatrist alone unless a patient is hospitalized as the result of an "event" and has directly witnessed it.

 

[Pea-n-Me]

I am aware. I told him when he sees his psychiatrist again, he should tell him that he thinks the therapist is way off and that I (his wife) has no reason to suspect this alternate diagnosis. I told him under no circumstances should he just go along with it and accept new medications. FWIW, this particular diagnosis often relies on input from people close to the patient who can speak candidly on the symptoms they have witnessed. It is not diagnosed by a psychiatrist alone unless a patient is hospitalized as the result of an "event" and has directly witnessed it.

I would want to know, then, what supporting evidence the therapist has to make such a diagnosis. How does your husband feel about it?

 

[gwynne]

....

 

[DLgal]

I would want to know, then, what supporting evidence the therapist has to make such a diagnosis. How does your husband feel about it?

The explanation is, this was a second session. My husband was trying to get her up to speed with his entire history/situation/reason for being referred to her. He was speaking fast, as he tends to do when he has a lot of information to give someone. It was a 1 hour session and he has a LOT of baggage, for lack of a better word. 40 minutes in, she interrupted him, pulled out a checklist and said "I'm going to ask you a few questions." At the end of the questions, she said "I am going to discuss your current meds with your doctor because I'm sure you actually have (condition)."

He left completely flabbergasted and worried and called me. I don't know what the questions were, but I suspect his rapid fire speech pattern concerned her and he "checked the boxes" enough on the questionnaire. The rapid fire speech is ONE of the symptoms of the defining criteria for this condition, but it is literally just how my husband is. She doesn't know him well enough to know this about him. He literally has none of the other symptoms, and this diagnosis requires several criteria to exist.

Like I said, he had previously been under the care of a different team and neither that doctor or therapist (who he saw weekly for a YEAR) suspected this alternate condition.

 

[DLgal]

@DLgal If it's ok to ask--is your husband's tour over soon, or does he have awhile to go before rotation?

He will return this summer.

 

[tarheelmjfan]

First, let me say I mean this with the best of intentions. Considering the fact your DH is a military officer, you should delete your posts. From the information given, it's easy to guess what the new diagnosis was. I know it concerns you both, but having that information out there isn't in his or your family's best interest. I wish nothing but the best for all of you.

 

[sonnyjane]

First, let me say I mean this with the best of intentions. Considering the fact your DH is a military officer, you should delete your posts. From the information given, it's easy to guess what the new diagnosis was. I know it concerns you both, but having that information out there isn't in his or your family's best interest. I wish nothing but the best for all of you.

Great advice.

 

[gwynne]

In respect of your privacy, I deleted my post. It's perfectly ok if you'd like to delete my quote and reply.

 

[fly girl]

@DLgal I am with the others, @tarheelmjfan is giving sage advice.

hugs from one military wife to another

 

[DLgal]

First, let me say I mean this with the best of intentions. Considering the fact your DH is a military officer, you should delete your posts. From the information given, it's easy to guess what the new diagnosis was. I know it concerns you both, but having that information out there isn't in his or your family's best interest. I wish nothing but the best for all of you.

I appreciate your concerns. He's retiring later this year. It doesn't matter anymore as far as his career is concerned. He's done. Just riding out the clock, so to speak.