Psychiatrist Appointment and Referral for DBT

Upon discharge from the psych ward, I was told by the nurse that the referral for DBT would have been sent off to Dr T, my psychiatrist. Evidently this was not so, as she was not even aware I had been an inpatient in late December. I should’ve known they would not be this efficient. Neither have I received contact from the hospital Self Harm and Crisis Counselling Service. According to their pamphlet ludicrously entitled Care After Discharge, ‘We would like to contact you after discharge, usually within three days after you leave hospital.’ Right. It’s been how many days now? It’s becoming something of a farce how many times I manage to fall through the cracks.

But not to worry, I informed Dr T of my psych ward admission myself and was asked what led to me being admitted. Because I overdosed, why else? Was questioned as to why I OD’d, the third time she’s had to ask that in the seven months I’ve known her. It’s probably getting tiresome for both of us…

I reported I was put back on the Lexapro at 10mg daily and the doctor recommended I give DBT a go.

We spent a while discussing the options for DBT. I was told some public hospitals run outpatient DBT programs, but you must fall in their catchment area. Otherwise she suggested there are DBT type groups run through the private hospital, one of which is more ACT, but unfortunately because I do not own private health insurance it’s a no go. I do fall into the catchment area of one public hospital that runs a DBT program though so Dr T told me she’d send off a referral today.

I was given by Dr T the numbers of two other private clinical psychologists, as I concluded therapy with my now ex-psychologist in December, and was advised not to wait for the DBT referral to come through as there’s no telling how long that could take. So now I face the dilemma of choosing between the two. How do I go about doing so?   I’ve consulted good ol’ Google. One of the psychologists have a website whereby they describe the work that they do and even have a photo to match, the other does not.

Given this is my forth OD this year (third as far as she knows), and I’m about to embark on the Occupational Therapy course at Uni, I was warned by Dr T that this could affect my registration. “How will they know?” I asked her. “It’s mandatory that we report depression and suicide attempts.” Oh. “If you had leukemia, we’d have to report it too if it can impact your work. It’s not just mental health,” she told me.  “So can they stop me…?” I queried. “They can’t stop you from taking the course at Uni and they can’t stop you from graduating, but it means that you’ll come to their attention and be monitored,” she replied. Dear oh dear oh dear.

Because Google has all the answers, once home I attempted to find information about the DBT group run through the local public hospital. I found an information sheet written by said hospital on their DBT group. What is written includes a bit of information on the components of DBT and this,

This group is specifically for women who present with Borderline Personality Disorder or ‘Borderline traits’.  Experiences for these women may include intense instability of mood, a pattern of unstable personal relationships and a self-image that is not clear.  They may fear abandonment, have chronic feelings of emptiness, and often experience depression and anxiety.  They may act impulsively and have difficulty seeing things any other way than in ‘black and white, good or bad’ terms. The feelings of confusion and pain may lead to feelings of guilt or shame, at times trying to cope with these feelings with self harming behaviours.

As well as this,

To attend you must have a diagnosis of Borderline Personality disorder or Borderline Personality traits diagnosed by a psychiatrist.

So either I have BPD or at least ‘Borderline Personality traits,’ whatever that means, or I do not have the correct diagnosis to be able to access this type of therapy.

Either way, it’s a lose-lose situation.

13 thoughts on “Psychiatrist Appointment and Referral for DBT

  1. oh babe- don’t think that. I have bpd- it is a struggle but there are lots of ways to manage either it or the tendences. I will admit- it’s truly a bitch- the label is a bitch as well but if i can manage- you def can. We all know I’m all types of crayyy zahhh so, you can get through this. DBT CAN help a lot- it really depends on the person and what one gets out of it. You’ve got support around you and you can get through all of this.

    xoxo
    -Lisa

  2. Excuse my language, but what the flipping hell does she mean that it is mandatory to report depression or suicide attempts? Whose fricken business is it?! Are we not faced with enough stigmatization that we have our personal lives on display for the sake of an education to better ourselves?

    *severely pissed on your behalf*

    I think it’s a load of bollocks. Do you know for sure this is true? I have never heard such rubbish!

    • Well. I went to the website of the national board and found this,

      “If health practitioners or students have a health impairment, conditions may be imposed upon their registration to ensure that they are able to practise safely.

      Impairment is defined as a physical or mental impairment, disability, condition or disorder (including substance abuse or dependence), that detrimentally affects or is likely to detrimentally affect a:

      -registered health practitioner’s capacity to safely practise the profession
      student’s capacity to undertake clinical training.
      -student’s capacity to undertake clinical training

      Practitioners, employers and education providers are all mandated by law to report certain notifiable conduct relating to a practitioner or student. This includes a health impairment that may place the public at risk of substantial harm.”

      So… I guess it’s true?

      :/

  3. hey
    been there done that, got the t shirt on this one! one thing you can ALWAYS rely on is the fact that when a mental health professional says that will call in a few days, what they actually mean is a few months. or more likely, never. However, they should have given you crisis line contacts when they discharged you? if they did, get in cntact with them and have a chat about things. if you feel like it, obv. I just mean there is never any point in waiting for them to ring you!!

    The BPD thing-everyone who has self harmed and come to the attention of a psyc ends up with this diagnosis at some point. The thing is, if you read through the diagnostic criteria, they seem to fit in a lot of cases-but as they like the phrase so much ‘its not that bloody black and white’!!! and Trauma based illnesses and depressions are often misdiagnosed as BPD. which is a bitch cos they dont like to treat BPD, because they think it feeds into the attention seeking cycle. I’ve just been lumped with this one for about the 5th time now and it pisses me right off. And the problem is, the more you argue you are not BPD-the mpre they think you are, cos of the whole denial thing. All im trying to get at is dont just assume this is what they have diagnosed you with, and if they have, and your not happy, question it. I’m told DBT is supposed to be very helpful for people who self harm-though, to be honest, and feel free to shout at me blog world, i really cannot be doing with DBT. it really gets my back up, and i hate mindfullness. Though to be fair, my bias comes from being in a group run by a trainee, attempting a distress tolerance session in an ED CBT group, and her mindfulness exercise triggered the most god awful flashback of my life.

    the OT/Uni thing. DONT WORRY ABOUT IT!!! when i applied to my physiotherapy course, i got sent a ton of forms that had to be filled in by my GP. its to check your health for the course, and your fitness to engage wth patients. Of all the dogy situations ive been in, none have stopped me getting on and doing my course, and actually, from them being aware of my difficulties and anxieites right from the start, ive got some really good support from the uni. They dont want to stop you from doing the course, they just need to know stuff. All that will happen is that they will get your health check forms, and will prob refer you for an assessment with occupational health (docs for hosp workers, based on site) and ask to see you every now and again. But they do find everything out, so it is best to be open about it, and use it to your advantage-motivation to change, move on etc etc. we also had to fill in CRB checks-and sometimes psyc admissions show up on there (though i think its only if youve been sectioned) so its always best t just admit it and then not worry about it:)

    sorry for the massive comment
    xx

  4. I did DBT twice. Once within a group setting though my hospital at the time and once with a private psychologist. DBT is hard work though it can be rewarding if you put yourself in to it with all your heart. I think giving it a go would be good. Could you maybe ask the doctor what you diagnosis is?
    *hugs*
    Sarah

  5. I am so sorry you are hurting right now. Please dont think it’s lose/lose. I’ve done DBT and I dont suffer with BPD. There are some good components in the course. It helped me to stop cutting. And WTF does your pdoc mean when they have to report you???? Is she just trying to scare you? Isn’t it illegal to break confidentiality?

  6. I agree with Lisa– a diagnosis means nothing. I mean, calling you “borderline” or “depressed” or any other label doesn’t change how things are. It won’t change you– it’s just some letters scribbled on a paper.

    I hope you’re able to find a good, suitable DBT program. I’ve been to DBT groups before. It’s simple, but sometimes we need simplicity, you know?

    Wishing you well,
    NOS

  7. I really hope the whole DBT thing works out for you. I’ve been exposed to it a few times, both inpatient and outpatient, but am currently unable to find any groups in my area. Best wishes. *hugs*

  8. Hey. I just wanted to say that I just caught up on everything that’s been going on for you these past weeks. I’m really sorry, and I don’t understand why they need to “report you” — how is that relevant? Anyway, I hope things get better and that you find a DBT group.

  9. we use DBT therapy a lot at work.. only because I work with teenagers, and apprently their personalities share BPD traits as still growing, emotinal rollercoaster etc etc.

    It was specifially designed in America for people with BPD, but it is a CBT based therapy… just deals a lot with stress management and emotional mangement…

    Its all about being mindful and having a wise mind, so that when you are in a ‘hot’ moment, you able to seperate your rational thoughts from your impuslive thoughts.

    Maybe because you’re young, and gernally because it is a good therapy programme is the reasons you have been referred? Please dont assume you’ve been labelled with BPD just because of the therapy you have been referred for.

    *hugs*

  10. Dear BtF,

    I agree with some other readers here: you should know what they think is the problem with your mental health. I know you probably hate labels of this kind, but sometimes, even just temporarily, a label can help to feel that you’ve got the thing in one place and under scrutiny. It also shuts doubters up…

    Re the DBT: it might not be the answer you are looking for. BUT, give it a go, and commit to it fully until you no longer have any value from it. I think you need to question your beliefs about yourself as much as those you hold about others. But the main thing is to learn to rationalise how you feel when you are in a bad place. This is so that you can learn to deflate the desire to self-harm by removing the idea that you cannot assertively say to yourself or others what you want or feel.

    I really hope that you go and stick it out for at least a while. But you know what – if it isn’t for you, just ask for something else. they have to find the right treatment for you: that’s their job. You should push if you have to.

    Stay safe and know that we all love you very much.

    X Clarissa X

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