View Full Version : For Diagnosis


healthwiz
03-17-03, 04:39 AM
PS... for diagnosis:

If you seek diagnosis, go to a doctorate level psychologist, I recommend a PsyD Clinical Psychologist, which is more clinically oriented than a PhD Clinical Psychologist in general, to have testing done. I do not recommend using masters level therapists until people are very good shoppers for therapists and know what they need.

My daughter was tested by a PhD level School Psychologist, which I highly recommend, and which is a specialty area. Her testing was extremely thorough in the diagnostics of the learning disability, and included a breakdown of the suspected learning disability patterns, which lead us to very accurate assistance in the follow up. I do not believe a Psyd testing battery would have been as thorough as a PhD School psychologist testing battery at diagnosing learning disabilities, the one designed to find learning disabilities, and the other designed to find clinical pathology. I really believe it was the excellence of the school psychologist, which we found in private practice, that was responsible in part for our success with our daughter getting the services she needed. However, this type of psychologist is not typically in private practice for therapy sessions, but is primarly doing testing. Expect it to be expensive, about $900 and our insurance only reimbursed about 350.00. Its worth the money though, as it really opens the door to proper treatment. I think the PsyD Clinical Psychologist would have diagnosed the ADD as well, but would have given a much more general diagnosis with out as specific a definition of the nature of the disability and there fore the treatment plan would have been more generic.

If you need counseling, therapy sessions, then I recommend the PsyD Clinical Psychologist. The PhD Clinical Psychologist was trained in a more research oriented environement while the PsyD was trained in a more patient oriented environment.

Another good choice for therapy is often an EDD in mental health counseling.

In general, I'm not that fond of masters level therapists, but I must admit there are some good ones out there with masters degrees, and some bad ones out there with doctoral degrees. Nothing in life is ever black and white.

The exception to the masters degree rule us this: I highly recommend any counselor who is a psychodramatist, masters degree level or doctoral level, for therapy sessions, individual or group. However, compare experience between psychodramatists if you have a choice between two or more. Go with the one you feel best about, but look at experience, because it counts.

It is suggested that people actually have a single appointment with three of their top picks for therapists before choosing, and select the one that you feel most comfortable with and you believe can help you the most.

Good luck in selecting a therapist

Jon

Tara
03-19-03, 03:00 PM
Personally I say get the diagnosis by who ever you can find to diagnose you especially if you are an ADDult since there are so many professionls who don't "get" adult AD/HD. Then once you have the diagnosis make sure you have it documented and have a copy of the diagnosis for yourself.

AD/HD itself isn't actually diagnosed through a set of tests. It's diagnosed through signs and symptoms like most other conditions in the DSM-IV. Many professionals will use checks lists similar to help diagnose.

If your insurance will pay for it or you can afford I too reccomend having a full battery of testing done. Many people with AD/HD also have other Learning Differences.

I think the 1st step is the diagnosis then you can decided what type of treatment/ management plan you are going to try.and whom you are going use to help you with it.

healthwiz
07-26-03, 09:49 PM
Just a note, to those wondering why I emphasize the doctoral level diagnostics and testing. The testing done by Doctoral level school psychologist, is actually very precise testing. Its more helpful than a general diagnosis. It helped us determine exactly what treatments we would seek for our daughter, what results we could measure for in the future, it gave us a baseline set of measurements, it showed us the disparity between IQ and performance, broken down into many subcatagories of intelligence and performance. It showed us whether or not to order a Central Auditory Processing Test. It also determined whether or not our daughter had a motor skills deficiency. It showed that our daughters hand writing was slow and under developed.. There was a plethora of information that this testing yielded, which we can always go back to, to determine where we are getting progress and where we are staying still or going backwards. I also feel that ADD symptoms can be similar in some cases to other syndromes/illnesses/etc, and there is concern that people are being over diagnosed or wrongly diagnosed. Thus, my emphasis on the doctoral level practitioner and the most extensive testing available. We spent a good amount of money for the tests, about $900.00, but we don't regret it, considering how much we were able to learn about our daughter from those tests. It pointed out all potential learning disabilities, not just ADD. It explained alot!!

Unfortunatley, such a thorough set of tests do not exist for adults, to my knowledge, which really is a disservice to adults.


Jon

mctavish23
05-16-04, 09:19 PM
I dont disagree with you in principal. One of the reasons we moved to Minnesota 20yrs ago was because it was the last and only state in the nation where I could be licensed as a psychologist with a Master's degree.So, for the last 19yrs that is what Ive been doing...lol. The door has since been closed and MA's were grandfathered in.
My belief( and my experience ) is that good therapists are born more than educated; in that you can't teach empathy and common sense. As far as evals go, it really is a crap shoot since there's no set criteria for testing for ADHD.When it comes to writing reports that is also as individual as the writer. The key I think is to not only know and understand the disorder(am talking ADHD here) but also be adept at writing for your target audience. That is especially true if you are doing neuropsych evals.

My respectful suggestion is to check out not only the credentials of the evaluator( and I'd go for a PhD in most cases (outside of Minnesota of course).Look for the psychometrist who has the most experience with ADHD(irrespective of degree) and then pay attention at the feedback session, as to whether they explain things in a way that you can understand.

Last but not least, don't be afraid to ask for a second opinion or in the case of a spec ed eval, an independent psych eval if you believe that is called for.

That was an excellent post. Thanks.

mctavish23
05-16-04, 10:01 PM
As far as testing adults goes, Russell Barkley has some good insights on this. He favors age referencing the symptoms ,as opposed to using the 6 of 9 criteria for kids.He also points out how the normative sample used in developing the criteria had as the oldest person, a 16yo. Therefore, age referencing makes sense.He also stresses the need to corroborate info with as many people who know the adult as possible.In addition, he also said that the person themselves may actually underreport the symptoms because they are used to them and have compensated for them over the years.Please check Barkley's site for more info on this.

Take care.
mctavish23

mctavish23
05-18-04, 08:31 PM
This post brought to mind an issue that was discussed recently at the Minnesota Psycholgical Association's Annual Convention. It was presented by the chair of the Minn Board of Psychology, who is also a licensed psychologist and a classmate of my boss at the Univ of North Dakota's Doctoral Clin Psych program.

The discussion was about the use of the word "competent" in terms of the expectation that the practitioner will practice in a "competent" manner. I won't go into the details because it is a complicated subject for which there just isnt enough time ( or space). In a nutshell, it came down to the difference between knowing and doing. This is really the jist of all such discussions. I would therefore encourage you as the consumer(s) to check out the mental health provider you are thinking about working with and dont be afraid to ask questions.

Russell Barkley encourages parents to become what he calls "executive parents". This means that the child is the corporation and you, as the parent(s) are the CEO(s). Therefore, the school, the doctors and the therapists are more like your consultants. Good luck and thanks again for this post.

healthwiz
08-27-04, 03:00 AM
Russell Barkley encourages parents to become what he calls "executive parents". This means that the child is the corporation and you, as the parent(s) are the CEO(s). Therefore, the school, the doctors and the therapists are more like your consultants. Good luck and thanks again for this post.

Perfect. I love it. That is the way we have been functioning, but hearing it in these words is wondeful reinforcement to do it even more. Without being very proactive parents, my kids would not get what they need from their schools or their doctors. I have too many examples to mention. Parents have to get in the game, roll up their sleeves, and do whats best for their kids, irrespective of the feelings they may ruffle at the school. In the end the kids going to only get the benefits if someone advocates for them, and that often means going against the grain by definition, or why would they need an advocate?

Jon

mctavish23
08-29-04, 09:13 AM
Sam Goldstein (and another author who I can never remember (my apologies) also make some excellent suggestions in their book Raising Resilient Children.

exeter
09-11-04, 02:50 AM
Hmm, I was diagnosed by a PsyD who specializes in psychological evaluations of all sorts (she doesn't have a counseling practice at all, just evaluations). I'm glad she was receptive to the idea of adult ADD. I'd have never started testing with her if she wasn't, of course. :)

As far as picking a therapist goes, I think that finding someone you like is a lot more important than whatever alphabet soup of letters behind his or her name. Again, you'll want to make sure that the therapist believes in adult ADD, if you are an adult, and it's reasonable to ask whether the therapist has experience treating ADD/adult ADD.

The main thing is, you probably won't get very far with a therapist you don't like, regardless of how qualified he or she is.

healthwiz
09-12-04, 04:34 AM
Hmm, I was diagnosed by a PsyD who specializes in psychological evaluations of all sorts (she doesn't have a counseling practice at all, just evaluations). I'm glad she was receptive to the idea of adult ADD. I'd have never started testing with her if she wasn't, of course. :)

As far as picking a therapist goes, I think that finding someone you like is a lot more important than whatever alphabet soup of letters behind his or her name. Again, you'll want to make sure that the therapist believes in adult ADD, if you are an adult, and it's reasonable to ask whether the therapist has experience treating ADD/adult ADD.

The main thing is, you probably won't get very far with a therapist you don't like, regardless of how qualified he or she is.

It's very important to like your therapist. It's essential to be able to build a trust with your therapist. It is important to trust your gut instinct too, to help you pick the right therapist. However, bear in mind that people pleasers, therapists who pander to gaining the love of their clients, may not be doing much impressive work with those clients, despite any amount of charm they possess. How much training does it take to be sympathetic? A guy off the street can be sympathetic and charming. That said, the repore you develop with a therapist may ultimately determine how much courage you have to go into issues you would rather not talk about. How much comfort you have with your therapist will make a huge difference at that point. I suggest limiting your choices to the most qualified, and then choose the most likeable from that group.

To qualify all these comments, I want to say I know someone seeing a "yes" person therapist. It's comforting for the client, but is it effective? I don't think so, but it sure does keep the client coming back each week. So it's some aggravating personal experience bias driving my opinion that you also have to beware of the "yes" therapist.

Other than that, of course you better like your therapist!!

:) Jonathan

paulbf
09-12-04, 12:37 PM
I have a real hard time placing too much trust in any doc or therapist; I'm picky & I don't like when they have an agenda like they know better & I'd better be a good student & do what they say. I saw one guy who was very empathetic but he kept pushing the whole catharsis guilt thing on me. And I didn't really trust his qualifications or level of experience. The lady I'm seeing now is a psychologist so at least she's plenty smart & knows about all different approaches. She's got her agenda too but she'll listen to me when I say I want to go another direction, she's real eager to pleas in that regard but that's the only way to work with difficult me unless the person is really some kind of remarkable genius that I can respect deeply (which I doubt I could afford if they were that good). So she gives me homework assignments & she researches things I ask about & is able to help answer questions, has a pretty broad range of techniques she's willing to apply & it's helpful.

mctavish23
10-11-04, 09:16 AM
Sounds like she's flexible in her approach. Cognitive-behavioral therapy is big on "homework," which is another reason I personally like it.It makes it more of a "team " effort in terms of working together. Just remember that in this day and age "eclectic" can be a VERY broad term.Good luck.:)