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Old 11-07-18, 08:34 AM
yentzee yentzee is offline
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What are the steps of a behavioural therapy ?

Hi,
I am 41 and was diagnosed about 18 months ago. I am on medication since then. Unfortunately it is nearly impossible to find a therapist with experience in treating adults with adhd in Germany.
I found someone who claims to to be experienced and I have a good feeling but then my insurance refuses to pay as the necessary qualifications are missing (just a dr and not specialized in psychotherapy or psychiatry).
Now I am completely insecure in what is right and what is wrong. There is literally nobody who can be asked when it comes to this topic. Is there like a rough guide on how a behavioural therapy should work / what "steps" are included etc.
Just so I can check if thi gs are going the right way.
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Old 11-07-18, 09:14 AM
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Re: What are the steps of a behavioural therapy ?

Just come here and talk to us. You'll identify the issues and work out which ones are adhd and which are not. If you get stuck on an issue then seek extra help but in the meantime coming here us free.
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Old 11-08-18, 02:42 PM
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Re: What are the steps of a behavioural therapy ?

I think its hard for anyone to find an adhd specific therapist. I think a solid family or addictions even therapist might be good. If you are able to see their degrees (or what the letters after their names mean) you will get a better idea of what will be good for you.
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Old 11-08-18, 08:48 PM
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Re: What are the steps of a behavioural therapy ?

If Germany requires a psychiatrist who specializes in adult ADHD, that would be hard. Is it okay to just find one who specializes in general ADHD (required because of the meds, I assume)? Are there any where you live that meet that requirement? I've heard that Europe is harder for ADHD patients than it is here, stricter on which meds can be prescribed.
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Old 11-10-18, 09:55 AM
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Re: What are the steps of a behavioural therapy ?

Quote:
Originally Posted by yentzee View Post
Hi,
I am 41 and was diagnosed about 18 months ago. I am on medication since then. Unfortunately it is nearly impossible to find a therapist with experience in treating adults with adhd in Germany.
I found someone who claims to to be experienced and I have a good feeling but then my insurance refuses to pay as the necessary qualifications are missing (just a dr and not specialized in psychotherapy or psychiatry).
Now I am completely insecure in what is right and what is wrong. There is literally nobody who can be asked when it comes to this topic. Is there like a rough guide on how a behavioural therapy should work / what "steps" are included etc.
Just so I can check if thi gs are going the right way.

Grüsse aus der Schweiz :-)


I would consider to visit a doctor in a clinic, thats what i do, theyre at least half way specialized. Maybe thats a start here https://www.uke.de/ or somewhere in your local mental hospital.
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Old 11-12-18, 07:31 AM
yentzee yentzee is offline
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Re: What are the steps of a behavioural therapy ?

Thanks for your answers. Actually I live about 500 meters from the UKE but the also just offer first diagnosis.
Unfortunately nearly all psychiatrists just diagnose and prescribe but do not offer any therapy.
I am diagnosed already and getting medication as well but I think that just taking the meds is not going to sort out issues that exists due to reactions from the people around me reacting not the way I expected due to me behaving differently than most other people.
Anyway, I am having a person who specializes in ADHD but is "just" a Doctor without any official specialisation in psychiatry which is the reason I have to pay the therapy myself.
My impression is that she is very highly skilled in the subject of adhd but then I am not a psychiatris or therapist and can't really tell if that what we are talking about etc is the "proper" way of doing therapy for people with adhd which is the reason for me asking about a rough guiline how a therapy would look like etc.
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Old 11-12-18, 09:26 AM
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Re: What are the steps of a behavioural therapy ?

I don't know what it is like in Germany, but in the UK the diagnosis process is separate from therapy. This is because, to diagnose you either have to be a psychiatrist, which means being a medical Dr _ Psych specialisation, or a Clinical psychologist. Both of these are high grade qualifications, meaning and hourly rate of £100+.

Given that counselling is a long term process, particularly with ADHD, it's more cost effective to go for a psychotherapist/counsellor specialising in ADHD, who would cost £30-£60/hour.

Behavioural Therapy.... which in the UK means CBT, is given in 6-10 sessions. In my view is is highly unlikely that this low number of sessions will result in significant change.

Good CBT can be effective, however research indicates that the type of therapy is less significant in the outcome than the relationship with the therapist. My personal view is that ADHD therapy is most effective when the therapist is integrative and specialises in ADHD and similar AS type clients.

In short.... if you're looking for a diagnosis your insurance is probaby right, you need someone with a Dr qualification... if you're looking for therapy, it's better to look for someone who understands ADHD and you get on with.... and forget the insurance..... in my view good therapy delivered well is worth paying for....... plus you are in control of the process is you pay.
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Old 11-12-18, 11:30 AM
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Re: What are the steps of a behavioural therapy ?

You do not need a doctor for therapy. You need a psychologist, counselor or therapist. Docs handle the meds.

Quote:
Originally Posted by yentzee View Post
Thanks for your answers. Actually I live about 500 meters from the UKE but the also just offer first diagnosis.
Unfortunately nearly all psychiatrists just diagnose and prescribe but do not offer any therapy.
I am diagnosed already and getting medication as well but I think that just taking the meds is not going to sort out issues that exists due to reactions from the people around me reacting not the way I expected due to me behaving differently than most other people.
Anyway, I am having a person who specializes in ADHD but is "just" a Doctor without any official specialisation in psychiatry which is the reason I have to pay the therapy myself.
My impression is that she is very highly skilled in the subject of adhd but then I am not a psychiatris or therapist and can't really tell if that what we are talking about etc is the "proper" way of doing therapy for people with adhd which is the reason for me asking about a rough guiline how a therapy would look like etc.
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Old 11-12-18, 04:19 PM
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Re: What are the steps of a behavioural therapy ?

Quote:
Originally Posted by kilted_scotsman View Post
I don't know what it is like in Germany, but in the UK the diagnosis process is separate from therapy. This is because, to diagnose you either have to be a psychiatrist, which means being a medical Dr _ Psych specialisation, or a Clinical psychologist. Both of these are high grade qualifications, meaning and hourly rate of £100+.

Same in switzerland. My diagnosis was made in a mental hospital, apart from further therapy. If I were you, I would call the UKE or a near psychiatric clinic or visit their homepage and check if they do diagnosis on this. Ive received a 5 pages long diagnosis.


Quote:
Originally Posted by sarahsweets View Post
You do not need a doctor for therapy. You need a psychologist, counselor or therapist. Docs handle the meds.

Sarah's also right in this. I want to add here that the diagnosis only can be given by a psychiatric (doctor) and not a psychologist. Its the law in switzerland and im pretty sure that it is too in germany.
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Old 12-11-18, 09:00 PM
Drogheda98 Drogheda98 is offline
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Re: What are the steps of a behavioural therapy ?

the steps. well everyone is different however, this is what I know.

the process. that is, saying to yourself "what do you want, what are you doing, how is it working for me" outloud or slightly under your breath.

the "what do you want" is super ego formation, and the entire process is to get to trust yourself again. the what do you want part of the process is usually just "to drive over there,to walk over there to go over to my friends house etc...." there is no ego in the first step.

the second step "what are you doing" is the behavior engagement, or where the ego falls. such as "what do you want, to wright something on the boards, what are you doing, I'm writing something on the boards"

the third step, the "how is it working for you" is at first "it's working" after repeating the process over and over you will start to notice patterns, as the process gains traction behavior change and self trust in pretty much everything becomes possible.

as is, you do the process for the behaviors you want to incorporate into your life, you don't do the process for behaviors you want to get rid of. the more you do the process for any behavior the more automatic that behavior comes (cause you are trusting yourself more and more in those behaviors)

the best thing, is piece of mind. when the process starts to gain traction between the first and second step, the distance between the 2nd and third step will free your mind up from rumination because the "it's working" becomes the the dopamine hit you are working towards. the first and the second step could be moments apart, however the third step (when you say it's working) could be hours away.

aside from that, identifying projections of insecurity, how to be secure with self, how to be more of the person you want to be instead of who others think you should be.
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