<p>My D had medical issues last spring and had to see a doctor off-campus. We discovered that health services offered transportation to and from doctor's offices and the hospital, as long as the van was booked in advance. Maybe your D could check into it. Obviously, the distance has to be within reason and medically necessary (which mental health care is). Just a thought.</p>
<p>Health Services at my daughter's LAC provided vouchers for cabs if the student had an off campus doctor's appointment. The school paid for the cab, my daughter just had to request a voucher in advance. Once when she had to get an Rx filled, I had her ask the cab driver if he would mind stopping at the CVS and waiting while she had it filled. The driver was happy to do so for her as she usually had the same driver.</p>
<p>Check with the health center and see what might be available. They might also have names of therapist in the community.</p>
<p>I agree with bookworm on this one. Any competent therapist should be able to formulate a diagnosis after a session or 2 at most (and would have to have a working diagnosis if they were submitting bills to your dau's insurance co.) And it seems unusual that your dau has established such a strong attachment after just a few sessions. And, if her issues aren't that "big", why is she being seen by this therapist 2x/week? (the threapist wil probably say to get in as much work as possible before your dau goes to school. that is not necessarily appropriate). It sounds to me like the dependency is being fostered by the threapist. Any competent professional (and I am guessing this is a masters level therapist, not a doctoral level professional) would encourage short-term therapy/stabilization and transition to care in your daus college town (whether it be in the school counseling center or with a private therapist). Email and or telephone "therapy" is typically not appropriate, and cant usually be billed to insurance, so this doesn't pass the smell test to me. There is significant risk at not having a person see your dau face to face. That is the best and, IMO the most appropriate treatment modality/approach. A treating Dr. can't see what your dau looks like, what her non-verbal body language is, whether she can show appropriate affect, facial expression, if here eyes aere bloodshot, if she is eating, sleeping, etc etc. Your dau should be encouraged, not discouraged from seeing someone in her school envt. I strongly suspect this "therapist" is the one putting the idea in your daus head that professionals in the school counseling center are "a joke" . They are often grad students in training or licensed professionals, and very good. I am sorry to say this, but I am wholly unimpressed with your "therapist". He/she is fostering inappropriate dependency and isn't looking out for your daus best interests. Get her to a better trained professional .</p>
<p>I completely concur with Jym. Phone or email therapy? Short term therapy, but twice a week? These are red flags to me.</p>
<p>Good luck.</p>
<p>My D almost died this summer from a surgery complication...TWICE. Consequently, she was in pieces. A month ago I called the psychologist who was headed out of town for vacation. When she did meet with her she immediately diagnosed her with PTSS (post traumatic....) ( I did take her into a psychiatrist in the interim and that was good because he diagnosed her issues and talked to the psychologist so when she returned they had a plan.)</p>
<p>The good news....just a couple of sessions and she was much improved and now after two weeks she is doing great and ready to return to college.</p>
<p>My point: alot can happen in a short time. She SHOULD stay in touch with a professional where she goes to school....she will be okay. You also could let the campus psychologist know so they can check in with her and continue a few sessions.</p>
<p>Most college students get depressed. She will have lots of company.</p>
<p>Also, when your D comes home from breaks she can check in with her psychologist at home. ALso there is a book she should read that was suggested by numerous people when my D went through a depression...called Feeling Good. She said it was the best book she ever read.</p>
<p>Small technicality, Atlmom, but the OP sounds like her dau sees a Masters level therapist (maybe a social worker, LPC or LMFT), not a Doctoral trained (Ph.D.) Psychologist (we need to hear from the OP to get this clarified). I am sorry if I am offending anyone here, but there is a large difference between the training of Masters and Doctoral level mental health professionals, and as allmusic, mimk6, bookworm and others have said, the approach and some of the recommendations made by this thrapist don't sound like the best, IMO. To the OP- I would encourage your dau to get to a good, qualified, competent Ph.D. psychologist in your dau's college town. As mimk6 said
[quote]
face to face therapy is better than telephone and/or e-mail therapy and phone therapy is usually more productive when there is already a well established relationship. However, phone therapy with a therapist your kid likes is far better than no therapy at all.
[/quote]
Hopefully this "therapist" is looking out for your daus best interests, not his/her own.</p>
<p>** Addendum-
Atlmom- Glad your dau got the help she needed for her PTSD</p>
<p>Most people with unspecified mental health needs (that is, not obvious depression or delusions or manic behavior or whatever) get referred to master's level therapists, not psychologists or psychiatrists. I get the impression that the original doctor did not take the OP's concerns seriously (hence the comment about being over-involved) and therefore recommended someone who s/he thought would help mother and daughter work things out. We, of course, cannot possibly know how serious the situation is. She may need a psychologist, or she might only need someone to talk to so she can clarify her own goals and desires.</p>
<p>For me, the red flag in all this is the daughter bursting into tears during what was described as a seemingly innocuous first few minutes in front of a therapist. This suggests to me that something specific may have happened, something the daughter does not want the mother to know about. I'm not a therapist, so take this with an enormous grain of salt, but my personal experience with clinically depressed people has been that they lack affect in situations such as that. It's only when prodded, when the wounds are opened, that they demonstrate that kind of sudden emotion. (The wounds may have indeed been opened in that short conversation, but it wasn't described as such.) I think something is going on that isn't depression per se, although depression may be a result of it, hence the "may be depressed" comment. </p>
<p>We can speculate all day (hey! it's College Confidential!) without helping the OP. What's most important, as many others have said above, is getting the OP's daughter the help she needs while she's away at college. Yes, she can call her current therapist in an emergency, but she really needs someone who can meet with her face-to-face. The two therapists can communicate and work together.</p>
<p>Mom,
Just curious- on what are you basing this opinion?
[quote]
Most people with unspecified mental health needs (that is, not obvious depression or delusions or manic behavior or whatever) get referred to master's level therapists, not psychologists or psychiatrists.
[/quote]
I don't think this is necessarily accurate
To clarify, many people with what we call "adjustment issues" get referred to Doctoral level providers all the time. I see plenty of patients who are dealing with adjustment issues, not necessarily severe mental health challenges.</p>
<p>If the OP's dau is at the large, well known U in NC, there is an excellent graduate Clinical Psych training program on campus, and I would espect that they have a clinic available to see clients. I would encourage your dau to look into this opportunity. Excellent, excellent resource right at her back door</p>
<p>Ph.D psychologists (I am one) have more years of formal education than those trained at the Masters level, but that doesn't always make them better therapists. An on-site therapst would be ideal, but a distant one she can relate to is a good start.</p>
<p>Depression can be a very serious thing. The best approach IMHO would be to have your daughter talk to her current therapist and work out a plan for when she returns to college be in phone sessions or a referral to a local college therapist.</p>
<p>I don't think it is appropriate, or even ethical, to manage psychiatric care from a distance. A teenager wouldn't know this, but a therapist should.</p>
<p>Allmusic-
I agree entirely. The risk factors in doing "phone therapy" are huge, especially with a client you hardly know (and can't even formulate a diagnosis for!). Sorry if I sound cynical, but I would not believe this is a recommended appproach in most cases. And btw, I am a Ph.D. psychologist too.</p>
<p>Just a couple of thoughts. I'd be really concerned if this was my daughter. If she wanted to go to school, at the very least I'd arrange for her to see a therapist on a regular basis in her college town. She could still email the other one, etc... but she needs someone close by to be there for her. </p>
<p>I also would be curious as to what was not "dangerous or illegal" and the first two things that come to mind are sexual orientation or sexual abuse. What ever it is, I would focus on letting my child know that they could tell me anything and that I would still be there and love them - no matter what. </p>
<p>Good luck and the best to your family.</p>
<p>Say what?</p>
<p>This is a forum and the poster asked for opinions, calmom. She did not frame the OP as a single question. She (rightly) expressed general concerns.</p>
<p>
[quote]
Any other parents experience a similar situation? My concern is what happens once she is away at college far from home on the east coast.
[/quote]
</p>
<p>A few posters are qualified to give professional opinions based on the many many similar experiences they have had. You a re qualified to give a legal opinion. They are perfectly qualified to suggest, based on similar experiences, that the description of the current therapist doesn't pass their 'smell' test.</p>
<p>Furthermore, I am perfectly qualified to suggest that the OP go with her 'mom gut'. If Mom is worried about serious depression, there is probably cause to worry. She should treat the diagnosis with gravity and address the matter until it is resolved with a 'no depression' or 'depression' diagnosis.</p>
<p>Personally, I would get a second opinion--preferably from a psychiatrist who can prescribe medication if need be.</p>
<p>Calmom,
I always enjoy your posts and find they have been some of the most helpful. In this particular case, professionals in the field of psychology/psychiatry offered their opinions to the OP. </p>
<p>The article you cited discusses the merits of phone therapy. Acoording to the APA Ethics Guide, it is not ethical to conduct therapy in this fashion.( Legally, one canot bill insurance companies.) There are exceptions, e.g. remote locations. The few exceptions mentioned do not apply to OP's dtr. Phone calls and e-mails are a supportive way to help with a transition.</p>
<p>Personally,it was alarming to read OP's first post about the current therapist not being able to make a diagnosis after weeks of treatment.</p>
<p>As an aside, I recently relocated from CA. I hired a CA lawyer thru referrals, and we communicate by phone and e-mail. What is acceptable in one profession does not apply to another.</p>
<p>I am not going to argue the ethics of clinical practice with you, Calmom, as you are clearly not familiar with the ethical code of psychologists. We in the field are allowed to share our professional concerns here, just as you are entitled to, once again, argue about whatever it is you like to argue about, Calmom. Suffice it to say that there are several of us with clinical training on this thread who have concerns with the described behavior of this therapist. It raises red flags to those of us with training in the field, and we are sharing our concerns with the OP. Go pick a fight with someone else, Calmom.</p>
<p>If people put their situations out on a public forum, they are open to a number of different opinions, including those from professionals.</p>
<p>The situation presented by the OP brings up some serious ethical dilemmas. There was nothing UNethical, and certainly not illegal, about pointing out the ethical issues apparent in the OP's question. Jym was absolutely and completely within bounds on this particular issue, and Calmom is not.</p>
<p>Thank you, cheers, bookworm and allmusic. Well said.</p>