My psychologist exam no clear answer.

[bigbeauty78 27]

Did you go to a psychologist referred by your surgeon? I ask because I was able to go to any psychologist I wanted' date=' but my surgeon's office worked with someone who knew the requirements, what was needed for clearance, etc. I chose to go with that doctor and I had no problems. He mainly focussed on making sure I understood the surgery risks and that I had realistic expectations. Sometimes these doctors don't really know what they are doing unless they have experience with WLS evaluations. If you decide to get a second opinion, check if your surgeon's office recommends someone. Otherwise, I would look online in your area and make some calls to ask specifically if they have experience with WLS evaluations.

I don't think it is fair for her to not clear you for surgery, even if she recommends therapy/medication. I take anitdepressants and I go to therapy, but that doesn't mean that I didn't qualify for surgery.[/quote']

Yes this was someone the doctors office referred me to. I believe its just away that they can make more money.

[bigbeauty78 27]

I have decided to use another office for my counseling services. I'll meet with him in 2 weeks.

[cindymg 629]

The psychologist that my surgeon uses doesn't accept my insurance (annoying). So I called my insurance company and they found me someone who does Bariatric surgery evaluations. He was basically evaluating if I understood what I was getting into, if I could manage the post op dietary requirements, and if I was doing this for myself and not to please someone else.

He didn't insist on more counseling, but I am leaving the option open. So far I am doing okay, but if I feel the need to talk to someone, I will go back.

Good luck on your journey. It's going to be amazing!

[TheOldMeAgain 128]

If anyone feels your pain it is I. Something similar happened to me. I tried the seek counseling as a condition for surgery approval. Nope didn't work. When I went to see the psychologist I was referred to she told me that getting therapy is not something I can check off my list so I can get surgery. Guess she had me pegged, lol. Lucky for me she won't be my therapist. I'm being handed off to someone else that hasn't got her license yet. It could be a good thing. After a few sessions with her where I let her know each time how much talking is helping me, I'll ask if she can speak with the psychiatrist that did my psych evaluation. Let him know how far I've come and I'm doing well. Being that I'm just a name he won't remember and the therapist I worked with for wks knows me better he should be more willing to go ahead and approve me. If he doesn't I will call his supervisor n demand a reevaluation from a psychologist/psychiatrist who doesn't have a bias against WLS. I guess some psychologists/doctors/counselors are determined patients get counseling for any perceived issue. It's ridiculous and shouldn't prevent or delay surgery because of it. A life without problems doesn't exist. Good luck with your therapy.

[TwinsMama 483]

I'm being handed off to someone else that hasn't got her license yet.

Wait...what?!?! How can the person who is not licensed be a therapist. In my state we'd call that an internist and they would have to have supervised sessions. Will a licensed therapist be in the sessions too?

I know everyone has to learn (one of my best friends is a licensed therapist so I know the process) but that seems like a bit of a stretch considering you are being "referred" by another therapist.

I'm so sorry your approval process has you jumping through all these hoops.

[TheOldMeAgain 128]

Wait...what?!?! How can the person who is not licensed be a therapist. In my state we'd call that an internist and they would have to have supervised sessions. Will a licensed therapist be in the sessions too?

I know everyone has to learn (one of my best friends is a licensed therapist so I know the process) but that seems like a bit of a stretch considering you are being "referred" by another therapist.

I'm so sorry your approval process has you jumping through all these hoops.

Actually I don't know how it goes. The psychiatrist that did my exam referred me to a psychologist who interview/consulted with me. I didn't know until toward the end the psychologist would only the supervisor of the woman that I will be getting therapy from. I get to meet the therapist tomorrow. She's the one who told she was in the process of getting her license. From what I researched on the Internet you don't have to have a degree or be license to provide professional counseling. Well at least mine is under the supervision of a psychologist. I could complain but at this point I want to get it over with. Also this is all done in-house at the VA Medical Center. I'm sure it's another way for the government to cut costs by hiring counselors in the process of getting a degree.

[chinamama 104]

In my state ( and I think many of them) when you graduate with your masters in counseling you become a Licensed Professional Counseling intern (LPCI). I can see clients with pretty much no restriction, as long as it is within my scope of practice, I can charge whatever I want, (I'm 90 an hour) however I can not be reimbursed by most insurances (but we all know they will figure out how to get out of paying). There are a couple of insurances who will pay, but not most. I am supervised for 2400 hrs twice a month until I am fully licensed,in fact I'm headed there today. There is not someone in the room with me, though once and a while I do video tape, but it is focused on me, and not the client.

FYI social-workers etc go thru the same process.

[TheOldMeAgain 128]

In my state ( and I think many of them) when you graduate with your masters in counseling you become a Licensed Professional Counseling intern (LPCI). I can see clients with pretty much no restriction' date=' as long as it is within my scope of practice, I can charge whatever I want, (I'm 90 an hour) however I can not be reimbursed by most insurances (but we all know they will figure out how to get out of paying). There are a couple of insurances who will pay, but not most. I am supervised for 2400 hrs twice a month until I am fully licensed,in fact I'm headed there today. There is not someone in the room with me, though once and a while I do video tape, but it is focused on me, and not the client.

FYI social-workers etc go thru the same process.[/quote']

Thanks for the clarification. Today my counselor actually mention that with my permission, she will record a few of our sessions. That it was only used to review her work by her supervisor. Good luck with getting your license.

[ElaineB 207]

It seems weird to me that you are the paying customer, but have to kiss up to these people and try to convince them to allow you to make a personal medical decision. If you and your physician agree you need it, then I would have a real problem with someone trying to play games with me. I had a 40 minute session and that was it. If you aren't a danger to yourself or others, then how can they force you into therapy? Being a little nutty or dysfunctional is my right as an American:). If it were me, I am way too assertive to just simper around and try to talk them into it. I would go right to my primary care doctor (who knows me, was in agreement with me pursuing WLS, and manages my total health). I would tell him what was going on, say that I think this therapist is full of crap, and get him to call her himself. I can't imagine most therapists are going to tell a physician that has an ongoing relationship with you that, after one meeting, they are going to delay a medically necessary procedure. My PCP would put a stop to it. Unless of course I did have an eating disorder or that therapist could convince him I was a danger to myself. You need some back up here. Talk to your doctor that knows you and get their help. The surgeon is great, but he just does his thing. He can't really help, because, for all he knows, you really are a nut job who will binge and kill yourself 3 weeks later.

Good luck and don't be afraid to stand up for yourself. She's not God and she's not your mother.

[TheOldMeAgain 128]

It seems weird to me that you are the paying customer' date=' but have to kiss up to these people and try to convince them to allow you to make a personal medical decision. If you and your physician agree you need it, then I would have a real problem with someone trying to play games with me. I had a 40 minute session and that was it. If you aren't a danger to yourself or others, then how can they force you into therapy? Being a little nutty or dysfunctional is my right as an American:). If it were me, I am way too assertive to just simper around and try to talk them into it. I would go right to my primary care doctor (who knows me, was in agreement with me pursuing WLS, and manages my total health). I would tell him what was going on, say that I think this therapist is full of crap, and get him to call her himself. I can't imagine most therapists are going to tell a physician that has an ongoing relationship with you that, after one meeting, they are going to delay a medically necessary procedure. My PCP would put a stop to it. Unless of course I did have an eating disorder or that therapist could convince him I was a danger to myself. You need some back up here. Talk to your doctor that knows you and get their help. The surgeon is great, but he just does his thing. He can't really help, because, for all he knows, you really are a nut job who will binge and kill yourself 3 weeks later.

Good luck and don't be afraid to stand up for yourself. She's not God and she's not your mother.[/quote']

My PCP is against weight loss surgery. Told me all I needed to was the weight loss program. We didn't even discuss it. As soon as I mention it he shot it down. I was actually relieved I didn't need a referral from him because of his reaction when I first brought it up. It would be great if he believed in WLS even though he's not the personal type that would try to advocate for a patient sadly. In the military and government its hard to get a person to step outside his/her lane. Knowing my physician I bet he bow to whatever a colleague thinks based on their professional opinion. But to make sure and try another avenue I will ask anyway. Thanks for thinking of that option. I took it real hard at first. Now Im trying to make my peace with it. No matter their expert opinion no one knows a person like themselves. A few back out because they don't feel ready or need more counseling. A psychiatrist opinion shouldn't override the patient unless like you said they're a danger to themselves. I'm also a dysfunctional American who may be odd compared to their textbook normal person. Don't worry no one ever referred to me as a push over before.

[ElaineB 207]

Can you change PCP's? Even if you have to pay more to see someone out of network it seems like it would be better. A good relationship with a primary is the key to optimal health. Mine is honest, will do research on things if he doesn't know a lot about something and is someone who really listens to me. I found him when I moved back 2.5 years ago. However, I've always found one like this. I just occasionally had to kiss a few frogs first;). I say fire him!!.

[TheOldMeAgain 128]

Can you change PCP's? Even if you have to pay more to see someone out of network it seems like it would be better. A good relationship with a primary is the key to optimal health. Mine is honest' date=' will do research on things if he doesn't know a lot about something and is someone who really listens to me. I found him when I moved back 2.5 years ago. However, I've always found one like this. I just occasionally had to kiss a few frogs first;). I say fire him!!.[/quote']

I tell myself all the time I'm going to get a new PCP but don't because its cheaper to get health care to the VA and the connivence of having everything from checkups, X-rays, gynecologist etc all in the same building. But it can work against you too. I need to look into it because I really don't care for his service and dismiss all my health concerns to my weight even the issues I had prior to being fat. Most of my adult life I spent in the military where your told to suck it up and have little say in you personal choices if doctors that accepting whatever when it comes to medical care.

[bigbeauty78 27]

Im doing the happy dance! My ARNP is supporting me 100% and will write a medical necessary letter. My sleep AP test showed rem sleep AP. He didn't issue me a cpap machine. He did imply on his letter I lose weight and sleep on my side. Wondering if this is going to affect my co-morbid with Bmi of 36.

[TheOldMeAgain 128]

Im doing the happy dance! My ARNP is supporting me 100% and will write a medical necessary letter. My sleep AP test showed rem sleep AP. He didn't issue me a cpap machine. He did imply on his letter I lose weight and sleep on my side. Wondering if this is going to affect my co-morbid with Bmi of 36.

That's great your getting the help to get things moving as they should be and unhindered. Let us know when you get your surgery date.