Working in the field of mental health for the past 18 years, I find the most common question I encounter from clients is how to find a good psychiatrist. While there are many, I have discovered that some psychiatrists demonstrate a specialty and knowledge base that may exceed those who practice in a more general area of psychiatry. For example, I specialize in the treatment of anxiety disorders and related conditions. I have found that one of the best ways to find a doctor who is skilled and trained in the area of anxiety is by word of mouth. Therefore, I encourage people to consider others whom they may know that have similar conditions and to ask them about their doctor, and whether they are pleased with them. If they have had good results, often times that is a good indicator. Additionally, there are many websites that offer referral lists of doctors who specialize. In my field, I refer clients to The Obsessive Compulsive Foundation (http://www.ocfoundation.org) as an excellent referral source, as well as the Anxiety Disorder Association of America (http://www.adaa.org/). If you do not go through a referral base, there are other means through which you can find a psychiatrist. You can contact your insurance company and ask them for a list, or simply look in your local phone book to see if there are any doctors who indicate a specialization or particular focus based on your needs.
Prior to your first appointment, I recommend that you make some notes about what you would like to share with your doctor. A list of your symptoms will be helpful, as well as how those symptoms have impacted your life. This will help to make the most use of your time with your doctor and ensure that you have covered the issues that have led you to seek help.
Upon meeting with your MD/psychiatrist, feel free to ask them about their training and experience in treating the symptoms which you are looking to treat. This is a reasonable question to ask any professional that you are seeking to establish a relationship. Because you will be sharing very personal feelings, it is important that you feel safe, comfortable, and understood. If you do not feel comfortable, continue to search for one that you do feel good about. This is a very important decision and worth taking the time to establish the right fit.
Next, begin with the symptoms that are most distressing and have the most significant impact in your life. Discuss how those symptoms are affecting your relationships, educational endeavors, employment, and general functioning in life. Share any interruption in sleep, appetite, energy level, etc. This will help your psychiatrist to have a thorough understanding of the difficulty you are experiencing. It is also important that you share with your doctor any current or past medications you have been prescribed, as well as who prescribed them. Along these lines, let them know whether you have seen any therapists to treat your symptoms and the outcome.
Your doctor will then share what medications are recommended, if any, as well as how often you should be seen, and provide you with any adjunctive resources. Your doctor will discuss with you any side effects the medications recommended may have, and how the medication(s) prescribed will help to specifically address your symptoms.
Prior to making your final decision, you may want to consider the some of the following questions:
1. How much experience do you have in treating (identify your condition, e.g. OCD, Social Anxiety, Body Dysmorphic Disorder, etc)?
2. What is your treatment approach?
3. How long do you think I will need to see you?
4. How do you measure progress?
5. How often would I need to come and see you and how long does each session last?
6. Would you want to get information from other family members as well?
7. How much do you charge, and do you have a sliding scale if I can't afford your regular fees?
8. Do you accept health insurance and if so, which ones?
Once you have obtained all of the information recommended above, you should be able to make a confident decision. If you are still not sure, it is always okay to take the time to think about your visit to the doctor and consult with others about your experience.
Tips When Thinking About Insurance
Many people feel very confused about what their insurance will and will not cover when seeking a therapist or treatment services. The following tips may be helpful to consider prior to contacting a treatment provider or talking with your insurance carrier.
First, if you are looking for a therapist to treat an anxiety condition, I highly recommend that you seek a therapist who specializes in this area. “Clinical anxiety” or anxiety reaching a point that is requiring therapy services, is far different than anxiety that we experience on a day to day basis, that otherwise, we would not tend to seek treatment. As such, the higher levels of anxiety do require a protocol that many therapists are not familiar with.
The treatment protocol that has been scientifically researched and supported for anxiety is Cognitive Behavior Therapy (CBT) and Exposure and Ritual Prevention (ERP). It is important that when contacting your insurance company that you indicate that you are looking for someone who specializes in this area. Next, if they give you a list of providers, contact them and ask them the following questions:
1) Do you specialize in treating anxiety disorders with CBT and ERP? If they don’t know those acronyms, that is not a good sign. If they say, “Yes”, then,
2) Ask them how many people on their caseload currently suffers from an anxiety disorder? If they say, “None, but I have treated a few in the past,” this also is not a good sign.
3) If you find someone who specializes, then great! You should be on the right path. If not then,
4) Contact your insurance company and let them know that the names they gave you (and be specific with names, dates you spoke with them, and their response) were not specialists. Note: Some therapists will not call back or are not taking on new clients. Give the insurance company this information should that be the case.
5) At this point, if you are living in California, inform the insurance company of THE PARITY LAW. This is key to getting the benefits you are entitled to.
The Parity Law, which applies to California policies, was established in 2000. In a nutshell, this law recognizes that certain diagnoses are chemically/medically based, rather than psychological based. Some of these diagnoses include Obsessive Compulsive Disorder, Panic Disorder, Major Depression, Attention Deficit Disorder, and several others. As such, because these conditions cannot be treated on a short-term basis and require specific treatment protocols, they are entitled to specialized treatment services. Therefore, if the insurance company does not have anyone “in network” to provide these treatment services, by law, they are required to go “out-of-network.” Sometimes when you call the insurance company and reach the call center, you will need to educate them on this law. While unfortunate, reality. It is also important to not take “no” for an answer and advocate for yourself. Remember, this law entitles you to these treatment services. If you need assistance with this process, please contact Dr. Robin Zasio, Psy.D., Director of The Anxiety Treatment Center and Cognitive Behavior Therapy Center at 916.366.0647.