Reply to a full psych evaluation and the spouses role

Forum Index » Relationship Discussion (non-explicit)

Reply to "a full psych evaluation and the spouses role"

Subject:

Emoticons





More smilies

Text Color: Font: Close Marks

[quote=Anonymous][quote=Anonymous][quote=Anonymous]Sorry OP, but unless your husband gives permission or you agree to see a counselor together, you are not allowed to get any information from a Dr. and technically you aren't even supposed to make an appt for him (although a lot of offices will allow you to).   It has nothing to do with the therapists.  They may have suggested it to your husband, but if he says no, they have to honor what he says.  He is the patient.

I think what you need to do is agree to see a therapist together (and you will both be considered patients).   Not a marriage therapist though.  Just a regular therapist. [/quote]

PP here.  Same with reporting a reaction.  Unless your husband was in the hospital and unable to call or email himself, they have to go through him, not you.  It's just the law and I'd recommend you read up on it before getting into a huff about it.  You can also get a therapist for yourself and then invite your husband to join you at an appt. [/quote]

This is not true.  OP has said that her husband gave permission for 2 way communication with the treatment providers.  HIPAA (i.e. health privacy laws) do not necessarily prevent all communication with the family member, and certainly permit more than the narrow communications you describe.  Good providers know how to navigate HIPAA to respect the patient and help the patient by involving family members to the maximum extent possible.

Also, your advice about seeing a family therapist is really not helpful, IME.  Really the only kind of therapist that is useful, IME, is a clinical psychologist who specializes in therapy with patients with the mental illness OP's husband has.  Seeing a "regular" therapist often results in seeing a therapist who is not highly trained in mental illness and does not see a high volume of mentally ill patients and who is not knowledgeable about the importance of/impact of medications on other problems.  Often these "regular" therapist mis-characterize problems that are the result of mental illness as something else -- "personality" problems, "denial", irresponsibility, lack of interest in the relationship, etc.

OP, you definitely should be participating in treatment, especially if your DH has given his permission.  If the treating providers are not willing to involve you or hear from you even after DH has given permission, then that is a MAJOR red flag that you should be using a different doctor who is more open to family involvement and more skilled at how to accomplish that.  All the medical evidence (and there is a lot) shows that family involvement in treatment improves outcomes.  There are basically at least 3 major reasons why:  1)  family members are often the people closest to the patient who know him/her the best and therefore can identify the earliest signs that something is not right (relapse, initial diagnosis info, med reactions), 2) family members often need psycho-education about the mental illness, treatment and expectations so that they can be supportive, and 3) family members are often the responsible caregivers outside the doctor or hospital facility so they need to know what follow up is necessary.

Here are some links about the importance of family participation in mental health treatment:

http://www.omh.ny.gov/omhweb/planning/hub/consumer/family_flyer.html (this is NY state, but it is a nice summary of WHY family involvement is important and some comments on HIPAA and specifically states that HIPAA does not prevent doctors from receiving info from family members.)

http://www.psychiatry.org/mental-health/more-topics/warning-signs-of-mental-illness -- from the American Psychiatric Association, which recognizes the importance of family involvement.

http://www.apa.org/monitor/2009/10/mental-illness.aspx - from the American Psychological Association

IME, it's basically impossible to "talk" or explain to these family-participation resistant docs why they should change their ways and be more receptive to your participation.  IME, it's just easier to find a new doc who is cooperative.  Talk with your DH about this.  "Interview" at least 3 pdocs who you have researched.  You can take part in the beginning and the end of these "interview" visits and leave the middle for your DH to talk alone to the doc.  Explain that you and DH want you involved in treatment and want to understand if the doc is open to that and if so, how it can be managed, what kinds of involvement you should have (or not), etc.  A doc who can't talk broadly with you about these issues simply isn't experienced enough to manage the illness, IMO.

During the process of finding a new Pdoc, you will come across docs who suggest that you shouldn't be making your husband's appointments, that you are "co-dependent", that you have a control problem, that your participation suggests that your husband isn't open to treatment, etc.  Cross these people off your list.  They don't get it.

In the meanwhile, I have found that a written note by fax to the office describing the adverse reaction, restating that permission for communication by the husband was given and requesting a call back to you and/or to him, is the way to go.  Docs are sensitive to malpractice, and written documentation that shows that an adverse reaction was reported puts the doc in the position of having to respond to someone (but not necessarily you) because it would basically be malpractice to fail to respond.

One thing you should be aware of, OP, it is not uncommon for patients to suffer adverse reactions on psychiatric meds, but these adverse reactions can diminish over time.  Of course, that is not a reason to not report or discuss the reaction with the provider, but it is not unusual for a provider to say that some reactions will diminish as the body adjusts to the med and to stay on the med.  And, sometimes one has to weigh bad side effects vs. any improvement, and improvement often doesn't begin to show for several weeks.  Of course, only the doc can tell what's serious, what might diminish, etc.

If you're feeling frustrated about your ability to participate, can you talk to DH about it?  I think for awhile I participated for about 10 minutes every 3rd session or so, with phonecalls/voicemails to the doc on occasion. This was because I talked to my DH and he was OK with it and I just showed up to the appointment with him (basically that or the marriage was over).

Good luck.  It is a long process.  A doc and meds are no magic bullet, but overall things can get better.

[/quote]

Options

	Disable HTML in this message
	Disable BB Code in this message
	Disable smilies in this message

Review message

Search Recent Topics Hottest Topics