10 Frequently Asked Questions (FAQs)
Can I trust that everything I say to you stays between you and me?
Mostly yes, EXCEPT in instances where you are an imminent danger to yourself, a danger to someone else, or are expressly unable to care for yourself anymore due to your psychiatric illness. In those instances I am legally obligated to breach confidentiality to protect you, the person you intend to harm or people that surround you. We keep notes like all other medical provider but they are completely confidential and mostly done for insurance purpose.
If you have so many patients, how do I know I will receive a care that is individually for me?
The training in this field teaches us to multitask. We look at each individual person and their experience, don’t associate them with a particular diagnosis and disease. In my case I give the same empathy, attention, thought, equivalent place value on each and every interaction. If at any point you feel that the provider might not be listening to you; is ok to express you feeling to make sure both parties are in the same page.
Are you willing to push medication on me?
In the case a patient is referred to me for posible medication it will present as a medication evaluation. The word evaluation means that I will ask many questions and try to collect as much information possible such as family history, social history, hospitalizations, previous diagnosis/treatment plans and any adverse reaction to posible medicine in the past just to name a few f the questions. If I think the medication will benefit you I will present my case to you as well as alternatives that don’t involve medication. It is ultimately your choice and I’m just here to present what is the best and help you the most.
Will I be on the medication forever?
The time length a patient is on a medication mainly depends on the type of diagnosis. For example, a patient with schizophrenia will generally require a long-term treatment plan that the patient will tolerate well, benefits outweigh risk and will prevent a relapse of the symptoms. We might have patient that have a experienced a depression episode for the first time in the life and will only require 6 month of medicine; will try to come off the medication with my guidance/monitoring only.
How do I know your advice is good enough that I should take it?
Providers are not technically considered advice-givers. Think of us as tool-givers to help you identify existing strengths within you, but you will actually do most of the work. Consider the clinic as a safe place and a work shop where you can work through things you have been struggling by trying different tools and see which one works best for you. Is completely normal and acceptable for patients to gut check your experience on the internet; let me warn you that there are far too many pages with false information that is misleading. The best way to clarify concern or question is to ask providers directly.
If I’m being prescribed medication, do I need to have therapy as well?
Unfortunately, there is no magical drug that will make disappear instantly things you have been struggling to work with. For example, antidepressant medication can take on average 6 week to start noticing their effects. Also, studies suggest the the combination of medication + therapy is more effective than medication alone. Therapy is directed and tailored to the diagnosis that the patient and their preference. For example, a patient with OCD will have an exposure response prevention.
If I see you in the mall or a public space what should I do?
If by any chance I see one of my patients we typically don’t acknowledge each other. I make sure to talk with my patients in the first visit that if that happens I will not wave, call their name or have any type of conversation. There is a stigma of mental health providers that everyone who visit one is severely mentally ill that is required to be hospitalized. I wouldn’t ever put any of my patients in that position in such a complicated society. Also, mental health providers understand that the information that has been discussed in the visits will make patient feel vulnerable if their provider acknowledge them in public. Is very important to discuss with your mental health provider the possible scenario.
What should I do if I don’t like you as a provider, I am obligated to stay with you?
If there are other options accessible to you I would encourage to search for a provider if you feel you are not connecting with me. Studies suggest the Therapist-Provider relationship is essential for positive outcomes in the treatment. The first few visits are designed to establish patient-provider relationship and also for data collection.
Why I wake up of a dream screaming and recall details sometimes I don’t recall?
Nightmare disorder:
Recurrent frightening dreams during the 2nd half of the sleep cycle (usually during the middle of the night or early morning). Patients will remember the dream after awakening. It will cause functional impairment or distress. The treatment is reassurance if mild. If it is associated with PTSD an antidepressant or prazosin will be very helpful.
Sleep terror disorder:
Presents with recurrent screaming/crying suddenly upon awakening. This will usually take place during the first part of the night. Patient will experience increase heart rate, rapid breathing, and excessive sweating during episodes. Patient wont recall details of the dream. Treatment is education, reassurance and removal of dangerous object in the room.
Can you hospitalize me against my will?
If a patient is an active psychiatric episode and presents imminent harms to self or another person, then a health care provider can initiate the process of involuntary hospitalization. The criteria will vary by state and can range from not being able to care for her/himself to hurting him/herself. Patient will not be forced to undergo treatment for their mental illness, except for those required on an emergency basis. Being hospitalized should not be seen as a punishment, rather should be consideration and commitment for the patients safety and well-being.