finding quality therapy/counseling

[StephanieCD]

I went in for intake at a neuropsycologist to discuss things like anxiety/adult add/depression, etc and I was very brave. I told myself that it was best for the process if I be honest about CD up front. Well, I did it! I told her up front. I mentioned that it contributes to the anxiety and so on and asked if it was her "cup of tea" (I inadvertently let a little femme mannerism go at the phrase) - she was obviously uncomfortable but professional in telling me it was more of a therapy situation verses her specialty, brain function.

This brings me to my question: how do I find a therapist that I can talk to that might have this as a cup of tea they've tried? Maybe someone who specializes in this sort of thing? Or what? And then - how do I get it under my insuarance!!? lol

But really though, some of you happen to work in the field (interested in studying for it, myself) and I'm hoping some of you might have done the therapy road before - any pointers? I've told a shrink or two before and they handled it well but all they did was spout information I'd read before they did... since they probably went out and read up on it after I told them. I'd love to find some real "help"?

[SultrySara]

I'm right there with you sister, I would love to have someone to talk to about this that is actually understanding and comfortable w/ it. and of course handling it under insurance would be a godsend.

[KewTnCurvy GG]

Well, I'm your woman to discuss this with. First of all let me explain, there are many, MANY different disciplines that comprise mental health and who are practioners identified collectively as psychotherapists. That said, a brief overview:

Psychiatrists:
These are physicians. They went to medical school and instead of choosing pediatrics, oncology or cardiology, they became psychiatrists. There training is primarily a medical model (the obvious I know). They are the only ones (with rare exceptions) that can prescribe medication, hospitalize ppl, perform ECT and perform what is politely now called "psychiatric surgery" (yes, this is, simply variations on a lobotomy, it still happens but is QUITE rare in the states). What psychiatrists are not well trained at (AND THIS IS MY STRONG PERSONAL AND PROFESSIONAL BIAS) is psychotherapy. Yea, yea, they learn all the theories and all. However, most of their programs do not require them to have therapy themselves (and almost all other disciplines do) and give them minimum exposure to doing therapy.

Psychologists:
These folks have either a master's degree or Ph.D, Psy.D. or doctorate. Now, you may ask what are the differences. The degree for independent clinical practice in psychology is considered a Ph.D., Psy.D. or doctorate (which I will explain these differences later). Therefore, anyone with a master's typically has to have supervision by either a physician or doctoral level psychologist. This is not true for all states but most. The differences in the doctoral degrees is roughly as follows. Ph.D.'s are heavily weighted towards research and like all doctoral candidates must conduct, defend (against a faculty committee) and publish original research--meaning, it has to be something never before studied. Whereas, the Psy.D. candidates are weighted towards the clinical end of things. They get more courses and direct exposure to psychotherapy. The doctoral degree in psychology is really a general term to refer to the two former specialties. Now beyond the degree is what area of practice they are in; they can specialize in a variety of areas such as neuropsychology, cognitive, adolescent, etc.

There are also a variety of master's trained clinicians from areas such as Pastoral Counseling, LMFT's (Licensed Marital and Family Therapists), Counseling Education and a few others that I can't think of at the moment. Again, they may have master's level education or a doctoral degree. And they can specialize in a variety of areas within their discipline, such as men's issues, substance abuse, 'co-dependency', sexual abuse, gender issues, gay and lesbian issues and the list goes on.

Now, for the piece de resistance! CLINCAL SOCIAL WORKERS:
I am, of course, very biased here as this is what my major and degree are in. Clinical Social work requires a master's degree and in social work, the master's degree is the terminal degree for clinical practice. The doctoral degree is for teaching and research. In fact, I knew of a professor of mine who had a Master's Degree in Theology, a Master's Degree in Childhood Develpment and a Doctorate in Social Work--yet, she was not able to practice clinically or teach clinical courses. She had to go back to school right along side moi to get her master's in social work. Sooo, the moral is that mastered degreed social workers can be clinicians. Now they must be licensed, registered or certified as such by the state they work in. For instance, I have an MSW (master's in social work) and I am a LCSW (Licensed Clinical Social Worker). Essentailly an MSW requires a bachelor's degree and a 60 hour master's program. The 60 hour program is much more than required for other master's degrees. Any other program, regardless of discipline, only requires around 40 hours on average. Some are only 35 and others may be 45, but around 40 is sufficient for most master's programs. Social Work, also, has two practicums or internships, where one must practice as a clinician, in a supervised setting for a minimum of 20 hours per week for two years. Additionally, I feel there is a stronger push than in most professions to receive psychotherapy and to get as much exposure to therapy as possible. You may ask why is this important? Well, everyone has 'baggage', no one grew up in a perfect family; therefore a clinician practicing without having gone through therapy IS (not a maybe here kids) going to bring there stuff in the door with them. It's inevitable. So, regardless of which discipline one were to choose, my strong bias is that you pick someone who has gone through their own therapy! Period! Now, don't get me wrong here, I'm sure one coudl find a psychiatry program weighted towards therapy and a social work program that is not. So, please always, regardless of the clinicians degree ask about this. Yes it is okay to ask, where did you get your degree, what kind of training did you receive, have you been to therapy, what is your theoretical orientation? Any clinician worth their salt, should freely and willingly discuss all of this with you. If they are not willing--LEAVE! Do not go back. End of lecture on that and back to our training. Now, unique to social work are the concepts of social justice, self-determination, and cultural competence and social diversity (please see: http://www.socialworksearch.com/html/nasw.shtml, for an explanation of these terms). Other professions, psychiatry, psychology and the like do not have these. They may have some variation on these but definitely social work is POSITED (see: http://www.m-w.com/cgi-bin/dictionary?book=Dictionary&va=posit&x=0&y=0)
on these concepts. This means that it is our ethical duty to work towards these concepts and strive to ensure we 'practice what we preach'. Now check out the code of ethics for psychiatrists and psychologists; you will see quite a difference: psychiatry: http://www.psych.org/psych_pract/ethics/ppaethics.cfm and psychology:
http://www.apa.org/ethics/code2002.html. I think you will see a difference and in my view quite a difference. Now, having said all that. Who do you pick and why? Good question, glad you asked!

Choosing a good psychotherapist should not be dictated by their degree. Meaning don't think the more schooling they have the better they must be--wrong assumption. Also, don't think that one profession is one up on the other. I believe there are good clinicians in all disciplines, that said we also know I have some bias. There are good, bad and mediocre practitioners in all disciplines and level of training. Decide first how you're going to pay. If you need your insurance to pay, then that may in part or fully dictate your decision. If your insurance only covers certain disciplines then you may have to choose that type of clinician. However, also be aware of this; in the pecking order of fees social workers and other master's level clinicians tend to be the most economical. For instance, I would charge $100 per hour; whereas, a psychiatrist would charge around $200. So, if you need your dollar to stretch more keep this in mind. Also, master's level clinicians and social workers being amongst them (and the majority really) are required to make their services available and within reach of all persons (again, part of our code of ethics and committment to social justice). So you will generally find that social work clinicians most flexible. Another thing that should factor into your decision is what I mentioned before about their training, experience in therapy and willingness to talk of these things with you.

PLEASE STAY TUNED, I'M STILL COMPOSING MY RESPONSE. THERE IS MORE TO COME!

[StephanieCD]

Oh Dear! Kew, I must admit you inspired my question and I posted to all rather than boldly PMing you but, now, I'm very glad I asked the question in a public setting! Bring the noise you cute little GG ;) I'm really very interested and I'm sure the information could help us all!

[StephanieCD]

Try this:

A listing of Gender Specialists (http://www.drbecky.com/therapists.html)both US and International


What a remarkably useful link!! I found like 5 within driving distance within 2 minutes! Thank you Julie! You're quite the useful gal yourself! :)

And, wow, Kew! Um... you are doing the community a great service - I suggest your post be separated and made sticky or at least added to a useful threads list!

[KewTnCurvy GG]

What a remarkably useful link!! I found like 5 within driving distance within 2 minutes! Thank you Julie! You're quite the useful gal yourself! :)

And, wow, Kew! Um... you are doing the community a great service - I suggest your post be separated and made sticky or at least added to a useful threads list!

Thanks sweety! Julie M. showed me up by her one line posty linky; however, I think (though I was verbose) the info I posted is important for ppl to know too. Thanks, Julie M., I'm going to save this linky meself. I eventually plan to work with TG folks:)

hugs
kew

[StephanieCD]

Thank you both so much.

And, Kew, you really should! Even see if you can put yourself on the list or something. An accepting gg is exactly what I would hope to find as opposed to a possibly biased post op ts offering specialized gender counseling... my apparent only option at the moment. Though she seems nice.

Kew, may I PM you?

[KewTnCurvy GG]

Hi and thanks! And of course, I'm always willing to help any of you grrls. So no problem, pm away:)

hugs
kew

[Sweet Susan]

I have had much experience in being analyzed. I have been to psychiatrists, psychologists, and sex-o-therapists. The guy that charged me the most bucks told me to get it out of my head, that I was simply going through a phase. Of course, I didn't tell him that I had spent my teen-youth years as a subserviant sex tool for the town pervert. The guy that took my insurance company to the cleaners told me it was okay. When he cracked the safe and found out about my lifelong secret, the aforementioned sex slave years, he thought I needed intense therapy. The woman that really helped me, set me free, gave me the strength to accept myself as the crossdressing, transvestite who may or may not have totally enjoyed being molested and it only matters if you want it to matter that I am, charged me a mere $75, told me to come back if I wanted, but not to let myself get too hung up on holding my urges down, she, and only she, has my undying gratitude. I say, go to a therapist if you feel a need. If not, spend the money on a new dress and a pair of shoes and a new wig and go out and have some fun.

[KewTnCurvy GG]

Well, Sweet Susan, I'm certainly saddened to hear what happened to you as a child, how absolutely horrible. And glad you found someone who helped you find your way. Whatever you may personally think of therapy it has it's place and role. It has saved me and helped make me who I am today. I wouldn't take any of it back.

hugs
kew

[Sweet Susan]

I have no problem with therapy. I recommend it, and I hope my little diatribe didn't come across as negative about therapy. Hell, I'd like some right now!

My childhood experience was what it was, and I'm really lucky that I came out of it as balanced as I feel I am. I could have easily gone down a very bad road, and I didn't. Also, I don't believe that it caused me to become a crossdresser, as I had that penchant before I was molested. If anything, I think my desires to be a crossdresser may have set me up to be molested, though I have no way of knowing that.

[Jerry]

I've only been to two psychologists. The first one I never told and got nothing out of it.

The second one was a "Texan" manly man. He asked if I wanted to stop, which I thought I did, so we spent a dozen sessions talking about how to change the behavior. If I "REALLY" wanted to stop the behavior (don't know if I could ever stop the "urges"), his methods were helping.

So here's my advice. Really ask yourself what you want.

Do you want to stop?
Do you want to accept yourself as a cross dresser?
Do you want to transition?
Are you trying to cope with family, SO, etc?

When you figure those type questions out, tell your "shrink" and they will likely help you. If you find your not getting the right support, move on to another therapist.

Sorry, but I don't think there is a "right" answer. Human sexuality a very "broad" gray spectrum and you need to understand your place in it.

Jerry

[KewTnCurvy GG]

Therapy isn't always about change though that can be the end product. We are all works in progress and, if we're wise enough, we learn something about ourselves, challenge ourselves and strive for the best. However, therapy can also help someone to grieve tragic losses and wrongs done us, when other means don't work and the paths seem unavailable. Sometimes therapy is just about acceptance, to help us make the inner and outer match up if you will. Sometimes that's about change and sometimes it's about standing still. Keep in mind you're talking to a therapy veteran. I've been on the other side of the couch for about 20 years and on this side (as a professional) for about 10+ years. More if you count some of my experience before grad school when I worked a lot with troubled youth (I was one meself). Anyhow, again, Sweet Susan, I am truly sorry for what was done to you. It breaks my heart when I hear stories like yours. But I've heard many and yet it always makes my heart sad and angry. Good for you, for overcoming whatever bullshit he heaped on you! I am happy for you to hear that.

Hugs, Big Hugs
kew