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jcl76
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Default Jan 23, 2020 at 04:43 PM
  #1
Hi I was hoping to get some feedback and how to approach treatment for a 19 year old male teen and the best options to find the right Dr and treatment.

This is my GF's son and they have really not found good care from providers. Here is a script see you in 30 days. Oh here are some good therapist BUT not real collaborative plan and compassion. Well I took charge of doing the legwork since I was diagnosed with BPD long time ago and understand the challenges with find the right care. Fortunately I found it long after the fact though.

So my question is.

What are good things to look for and ask for in a provider?

Any success stories of things that work better than others?

A- he is on Lexapro and Abilify which in my opinion seems a little off.
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Default Jan 23, 2020 at 06:35 PM
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Hi jcl76. I'm sorry to read that your friend's son is not getting the care all you feel he deserves and needs. Unfortunately, there are, indeed, some so-so to even lousy doctors and therapists out there. Sometimes being forward with the providers about expectations can help, but when it doesn't, a replacement may be necessary. I lucked out pretty quickly finding my psychiatrist, that I like. In contrast, it took me several therapists to find a good fit. Then they retired. I found another good fit, and they moved far away. Some tips for things I look for when searching for a new therapist (which can apply to psychiatrists, too) is:

1. Know what I didn't like about the previous one, and what I wished they'd had offered.

2. Research possible providers and look for good recommendations and perhaps things the doctor/therapist has written on a website describing their specialties and approach. Google their names and see what comes up. There are plenty of rating sites out there, but note that they aren't perfectly reliable. Sometimes only angry people review providers, while there are mostly happy clients/patients that don't. Google reviews are about the best, if there are any for the provider. That's because Google often sends the visitor the review request vs. the reviewer seeking out the chance to review. Psychology Today is especially helpful in finding therapists. If the therapist is listed, they must write something and list their specialties. If they sound like a freak, they probably are a freak.

3. If one's insurance allows, I find it good to trial more than one doctor or therapist to see which is the better fit. They don't always like that, but you don't have to tell them. Ask lots of questions, including about their experience with bipolar disorder, willingness to cooperate with other providers, amount of time they give for med checks. What type of therapeutic approach do they use and is it appropriate for bipolar disorder? If not, can they recommend a colleague that might be a better fit? The interview goes both ways. It's not just the provider interviewing the patient/client.

4. Your friend's son is very young, but he and his mother will learn a bit more over time what works best for him and the personality types of providers they like. It can take time, unfortunately.

Not sure if any of this has been helpful.
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Default Jan 23, 2020 at 08:50 PM
  #3
I am so sorry you are dealing with such a difficult situation.

Sometimes, major medical centers, especially medical schools, have actual bipolar clinics or doctors whose practice is mostly bipolar patients. Not sure where you are located, but that might be something for you to look into. If you have a medical school within driving distance, you might call the Psychiatry Department and ask if there is a faculty member specializing in bipolar disorder. If there is, they should be able to refer you to that person right away.

In my experience, finding a doctor you are comfortable with is critical. It could be worth a bit of a drive to be sure he is getting the best care.

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Default Jan 24, 2020 at 07:40 AM
  #4
If you are unsatisfied with the psyche doc prescribing meds, get a second opinion. What does your partner say?

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Default Jan 24, 2020 at 08:14 AM
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BirdDancer gave some excellent advice on how to find a good doctor. On top of that, you can reach out to friends and family for good advice. You can also ask your doctor (or your gf's doctor) for recommendations on good psychiatrists.

Definitely look into reviews like BirdDancer said. Also make sure you understand why someone hates an office (if they say they hate it). I've found that some people are utterly ridiculous when they leave reviews, though. For example, they'll rate a provider poorly because the front desk staff sucks, but it's not the provider's fault the front desk staff sucks! So you really, really have to look into what people are saying. Plus, you have to remember that people who are seeking out help typically have psych problems themselves and may have a warped thought process when they're writing their review. I'm not trying to be mean when I say this, but sometimes people are psychotic or they have some kind of personality disorder and then they leave a very negative review. Or, some people think that the psych office is going to cure all their problems when that's not 100% possible. But then there are people who do have a genuine concern about a psych office and have genuinely received poor treatment, so try not to discount every review.

FWIW, though... I don't think any psych place is going to be perfect. Most have crappy front desk staff -- at least around here, anyway. I try to ignore the front desk staff and look for a provider based on years of experience and what kinds of experience they have. I can cope with a poor front desk staff if the provider is excellent. But of course, everyone has different levels of tolerance and may not be able to accept poor front desk staff.

But yeah... I look at: (1.) years of experience, (2.) areas of specialty, (3.) where they have worked, and (4.) type/level of education.
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Default Jan 24, 2020 at 11:19 AM
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Quote:
Originally Posted by bluebicycle View Post
Definitely look into reviews like BirdDancer said. Also make sure you understand why someone hates an office (if they say they hate it). I've found that some people are utterly ridiculous when they leave reviews, though. For example, they'll rate a provider poorly because the front desk staff sucks, but it's not the provider's fault the front desk staff sucks! So you really, really have to look into what people are saying. Plus, you have to remember that people who are seeking out help typically have psych problems themselves and may have a warped thought process when they're writing their review. I'm not trying to be mean when I say this, but sometimes people are psychotic or they have some kind of personality disorder and then they leave a very negative review. Or, some people think that the psych office is going to cure all their problems when that's not 100% possible. But then there are people who do have a genuine concern about a psych office and have genuinely received poor treatment, so try not to discount every review.
This point you made, bluebicycle, is such an important one when it comes to reviews. I've seen totally off-base irrational reviews from clearly unwell patients. That's sad to see because people may avoid even considering the doctor. In one case, it was plainly clear that the same very unwell ranting patient posted 10 bad reviews on the same review site for a particular doctor (mine). On the same day. According to that website, they only allow one post per month from the same person. If that's true, that person (in their frenzy) likely created 10 separate email accounts just for the purpose of writing the multiple reviews.
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Default Jan 24, 2020 at 04:21 PM
  #7
Excellent advice here. I'll add that I have been on Lexapro and an antipsychotic together...for some people the combination is okay, others not so.

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