Borderline Personality Support Group

I wish I had known all of what I know, when I signed up for Kaiser at work. First of all, I was in the ER for an emergency psych visit and it took about two months to get an appointment with mental health. Who doesn't have a system to make sure emergency patients see a counselor within a week of their ER visit? The woman who they assigned me to was awful. She acted like a teacher, more than a counselor. She kept trying to shove DBT down my throat. I told her that I'm really not comfortable with group therapy and sharing really personal info with a group of untrained strangers. I finally agreed to go to the CBT/DBT group to get her to shut up about it. It didn't help and hearing other's stories and trauma just wasn't helpful and made me feel worse. I kept getting worse while I saw my first therapist. She kept acting like I wasn't using my skills enough. She spent at least half of every therapy talking about what she wanted (see the teacher association). So, I got maybe 10 minutes to discuss what I needed at each session. She did me one favor by saying that I seemed more borderline than bipolar. I had never been diagnosed as borderline before. But, then she was like well they're treated the same and so don't worry about it. It seems to me like there is stuff that is different between the two. For example, borderlines are way more likely to need all of the components of traditional dbt (including 24/7 access to someone who knows them at their therapy place). Given that clinical guidelines recommend weekly therapy for borderline treatment for at least a year, I'm surprised she never recommended transferring me to a contract provider who can provide weekly therapy. I wouldn't even know that Kaiser offers that option, if it weren't for other patients. Nobody at Kaiser ever informed me of that.

Right before switching to my second therapist, I ended up in IOP. My IOP counselor was the worst counselor in the IOP group. Thus, I didn't take advantage of the opportunity to have daily counseling. When I expressed concerns about not getting weekly therapy and how difficult it was to the Case Manager, she said she couldn't do anything about it. This is when I had an axis I and axis II diagnosis! The IOP therapist said to just focus on my axis i diagnosis and that Kaiser probably doesn't even cover my axis II diagnosis. Nobody in this situation said hey wait a second, we have a borderline/bipolar who is getting progressively worse and Kaiser's group therapy and individual therapy don't seem to be helping. In all fairness, I was starting with a new therapist right after DBT and the appointment was already booked, so I guess it could have been reasonable to chalk some of that up to me getting worse because of a bad therapist match and assume that I'd start to get better with a new therapist.

Finally, I switched to a second therapist who was my group leader. She was very nice and different than the first therapist. She was very positive, which I appreciated. But I think, she felt that by always encouraging me to think positively and give me hopeful advice, that I'd eventually end up in a positive place. The other issue was that I could only see her about once a month. I just don't think she could really realize how bad off I was. Even after I attempted suicide, she didn't really talk about suicide for more than a session and didn't frequently ask if I was having suicidal thoughts. I feel like she worried too much about upsetting clients. I wish she had been like you're not doing well, you need a higher level of care. Maybe I could have gone to Kaiser's mental hospital without having to first attempt suicide. I came into her office every time telling her that I felt hopeless and like nothing was getting better. The other issue was that she was too much of an active listening type of therapist. I personally need someone who is more engaged, instead of the nod mmm hmm style that just encourages you to talk about whatever is on your mind.

Even when I went to Kaiser's inpatient mental health hospital, I was told that weekly therapy wasn't an option on Kaiser. This is after a borderline patient attempts suicide and while medical guidelines specifically indicate that weekly therapy is necessary for recovery! My therapist kept pushing me to join group bc I stopped going to my last group after it wasn't helping. I told her that group therapy just wasn't enough help in between once a month individual sessions and that it just wasn't a helpful setting of care for me. She still kept pushing me to pick a group. Nobody at Brookside ever once offered to look into seeing if they could contact someone higher up at Kaiser about my situation to get me more frequent therapy. When a patient has already been going to group and individual therapy, how is it going to help them to tell them to simply continue doing the same thing? Isn't the definition of insanity doing the same thing over and over and hoping for different results? And why didn't anyone here take the steps to contact whoever authorizes sending patients to contract therapist? Why wasn't I told this was an option at the hospital?

The only reason that I know that Kaiser does sometimes refer patients to off campus therapists is because I know someone who that happened to. While I'm glad she got the care she needed, she doesn't have an axis or axis ii disorder and was able to get weekly therapy on Kaiser's dime. Yet, I ask for that multiple times and am told that's not an option even though my insurance plan has full mental health parity and is willing to pay for weekly therapy. Well, I finally go to Kaiser's website and e-mail my entire chain of problematic events to every chief executive on Kaiser's website. I get contacted the next day and told this request is fast tracked. The request is approved. I'm going to a place that offers full DBT and 24/7 access to clinic staff. Kaiser has guaranteed they'll pay for at least 6 months. However, if I had been on Blue Cross, I could have been referred this program over a year ago and had much less suffering. It is unacceptable for Kaiser to advertise that they offer comprehensive mental health services, when weekly therapy is only actually available to IOP patients and hospital patients. Nobody should have to be forced inpatient, when weekly therapy is available for much cheaper in the community. This is beginning to sound like the warehousing of mental health patients before mental hospitals were forced to free a lot of their patients and provide care in the least restrictive setting.

Wow, that sounds like the worst case scenario for BPD treatment! I'm sorry you had to go through so much, but I'm glad you continued to push and assert yourself to get the care you not only need, but deserve. Good for you!

I feel as if I need to go to someone about this. This just cannot be acceptable.

You have already done what I would have suggested, which is email the people highest up with a complaint. The only other thing I could suggest would be contacting the better business bureau and reporting them as a company not providing the services they claim to provide. It could be more of a case of the employees not doing their job, and not specifically the company though.

Post edited by: peaches261, at: 04/09/2012 06:38 PM

The therapists want to provide more frequent therapy, but can't because they're so overloaded with patients. The providers there have no control over their caseload. BBB says that they don't deal with insurance disputes. They said that the state insurance division handles this stuff.

The providers are scared to speak out because of fear of losing their jobs.

Oh gosh (. So glad you FINALLY are getting some appropriate care. There are ironies in most insurance plans. Some will pay for extended inpatient but not IOP. Mine covers IP but at an OP level, most covered agencies can only see clients every other week. The lack of intermediate levels of care is appalling and no doubt ultimately very costly. Awesome job for being proactive in your right to services!!