Don’t forget we moved!
https://brandmu.day/
Predators and Roleplaying Communities
-
@GF I appreciate the care! And not to derail the thread, but psychology is one of the few disciplines that have lay people butting in to say that they’re “basically therapists because they’re good listeners” or they can diagnose people because they have a copy of the DSM. I’m all but dissertation in my PhD (not to say that makes me an expert, but probably more knowledgeable than the Facebook aunt) and still would be unlikely to accurately diagnose and prescribe correct therapies to people I don’t know since it always depends on the individual. Also, the purpose I usually see in diagnosis is appeasing our insurance overlords who will say whether a patient will be able to be treated or not. Some people really like getting their diagnosis as it presents a quick explanation of symptomatology (“ah, so that’s why I’ve felt that way”) or can bring them some sense of togetherness (e.g., support groups for people with certain personality disorder diagnoses), but I think it’s more helpful when therapists follow the patient’s lead rather than stick by a prescribed treatment method. Whew, rant over!
they/them
-
@somasatori said in Predators and Roleplaying Communities:
I’m all but dissertation in my PhD
So you’re also seeing a trauma therapist, right?
He/Him. Opinions and views are solely my own unless specifically stated otherwise.
BE AN ADULT -
@Pavel said in Predators and Roleplaying Communities:
@somasatori said in Predators and Roleplaying Communities:
I’m all but dissertation in my PhD
So you’re also seeing a trauma therapist, right?
Seeing someone who specializes in trauma while still having to meet with my advisor, so not a ton of progress on that front.
-
Not to derail but where the fuck does everyone even get therapists, I had one through my insurance but she was so overbooked she was only available every 6 weeks or so and then I kept having to reschedule due to work until finally I just fell off completely and I STILL don’t have a replacement. Mental health is HARD.
I had an experience with an emotionally abusive person in MU** rp who used to threaten to kill herself at me when I was high school age. It’s been so long, though, that I don’t even remember how I separated myself. I think I just eventually drifted off that game and stopped interacting with her but not in any concrete, on purpose way.
let it be a challenge to you
-
@sao Well, I was looking at a two years’ wait until I ended up finding one with only two months but in the other end of my country. Five hours of driving, thirty minutes of therapy, what’s not to love?
-
@sao said in Predators and Roleplaying Communities:
Not to derail but where the fuck does everyone even get therapists,
Literally asked this question to my psychiatrist when he kept asking if I was in therapy yet during med checks, but also no one in his practice was taking patients. Like, I know I need therapy, dude, but HOW DO?!
The only reason I got to him was because they had a new psychologist willing to do my ADHD assessment. And now I’m not medicated because the adderall shortages made me realize it wasn’t quite right for me anyway, but he won’t try anything else, apparently, so I don’t even talk to him anymore, either.
Never mind that the whole system seems to be actively set up to be as inaccessible as possible. Don’t forget to make all these phone calls and set up more appointments and follow up with us because we will literally never follow up with you, person who has no short term memory and chronically dissociates rather than using the phone.
I’m fine.
-
What bothers me is almost all therapists I can find are out of network. Like, they take no insurance at all. WHY?!
$200 for an initial consultation, $150 for every follow up appointment, probably just paying straight out of pocket with no hope of insurance covering anything because they’d like me to use someone “in network” who doesn’t do in-office hours and isn’t a good fit. Sigh.
-
@Floof I relate hard. My psych billed $500 for a noshow and I was paying out of pocket, no insurance. They waived the fee one time but then I no-showed again because I was off my meds. It took me an entire year to actually try and make another appointment, and then it took me two months to fill out the forms and send them back in. I’m on my second day of meds right now after 14 months+ of no meds. TOTAL DERAIL BUT ARRRRR it is ludicrous that this condition that is literally the ‘bad at phone calls and calendaring’ condition requires so much phone calls and calendaring in order to even get treatment and STAY treatment.
-
@DrQuinn So a lot of this is because insurance is a headache to deal with as a therapist. Often insurance will require you to provide them with your progress notes as well as your intake summary. Some private practice folks I know who work with the bigger firms will also have a required “case consultation” with them (bogus term since case consultation is intended to be between mental health workers or physicians) where an underwriter will evaluate whether therapy is progressing properly. Insurance companies also pay less, from a materialistic perspective. As Marxist as I am, I still have $250,000 of student debt and that’s about the average these days.
Additionally, most outpatient therapists don’t use instruments to track progress. In inpatient (and at my current intensive outpatient place) we use various metrics – typically the GAD-7, PHQ-9 or BDI, and PCL-5 – to evaluate for anxiety, depression, or trauma symptoms respectively on a weekly basis. The return rate in inpatient and IOP is pretty low, probably natively around 40% at the VA, and we get about a 60-ish% return rate where I am now, so it’s a lot of hounding people “did you fill out the weekly form? Don’t forget to fill out the form” because it’s often a requirement by insurance companies.
In California, we have the mental health parity act, which is generally a good thing as it prevents therapists (or “coaches” in the worst case scenario) from practicing non-evidence based treatment. However, it also allows insurance companies to say “you’re going to use CBT for this patient.” Even if you’re working with, say, a person who has bipolar disorder and borderline personality disorder and would better serve them by using DBT or (maybe) acceptance and commitment therapy, the insurance companies know that CBT has a wife body of literature showing it to be effective insofar as it becomes a shotgun approach to treatment. CBT is effective for many things; CBT is also very ineffective for many things. CBT has an added benefit for the money people of having between 12-16 sessions for clinically significant change (with specific illnesses).
Research backs up the use of CBT as well. Depression and anxiety are also the most common mental illnesses in the US (probably the West in general), and usually receive the lion’s share of attention by researchers, who will typically use CBT because it’s quick to implement and fairly easy to learn, which means we have a research corpus that includes so much research on the effectiveness of CBT and a lot of papers that have to reiterate that ACT, DBT, CPT, TLDP, AEDP, other alphabet soup acronyms, etc. are as effective if not moreso than CBT in specific situations and within cultures. I didn’t touch on culture, but that’s just another big blind spot in the field.
None of this is intended to be an excuse, but a remonstration of the American medical and mental health system. All of this sucks and we’re aware.
-
I was about to suggest we get back on topic, but really, is there a more on-topic discussion about predators than one that mentions health insurance companies and guidelines?
-
@sao I’ve been hearing good things about https://www.betterhelp.com/ if you wanna try peeking at that (if you haven’t).
-
I actually abandoned the therapy providers through my VERY good insurance because I NEEDED more than they could give. My anxiety, even medicated, was getting really bad. I finally signed up for BetterHelp and used a therapist for a few sessions and didnt click. Switched and used someone that fit me better for months. When summer came around I stalled out and canceled for a few months. The moment I started crying daily at school again I realized I needed it. For the last year I’ve met weekly/Bi-weekly with my therapist. 85% of the time I just talk, and other times she asks questions that make me think.
The flexibility to do video calls is a life saver. I can’t recommend it enough. (Also, it is more helpful now that I don’t have to take the time to drive or have the anxiety of being in-person either.)
And my pets can join me on the call. So if I’m feeling extra vulnerable I grab a kitty and snuggle it while we talk. Sometimes her dog jumps on camera. (Only allowed once I asked to see puppy and she saw how happy it made me). All around 100000% lovely.
Yes, I pay out of pocket, but it is worth it.
-
@icanbeyourmuse I poked at this, but i was pretty turned off by the fact that I filled out some preferences when I signed up and they matched me with a therapist that fit none of the preferences I’d set.
-
Before giving any data to BetterHelp, it’s important to know that they were recently fined something like 8 million dollars for selling patient data to companies like Facebook and SnapChat. They promised not to do it again… but they kinda promised not to do it when you sign up, so I’d take that with a whole shaker of salt.
-
Cost benefit is always important to weigh. For me the fact that I can have almost weekly therapy is worth all the data they can sell on me. Is it a great cost? Nah. But this is AMERICA where health care is almost always choosing the lesser of shitty options.
-
@sao Maybe it changed since you last tried (that sounds snarky in my head rreading it back but it isn’t meant to be). I don’t know how long it is since you did, obviously. Hopefully you can get what you need soon.
-
I have a lot of complaints about BetterHelp, but most of them are related to their contracting practices and wouldn’t offer much insight into how they work from a consumer perspective. One positive thing I will say about BetterHelp is that has been useful is that there are many places in the US – and Canada, I would presume – that have no access to mental health resources whatsoever. When I lived in Oklahoma, for example, most mental health resources were available in the two major cities (OKC and Tulsa) but those cities are within about an hour and a half drive of each other with many small towns beyond that range. There are other services that could help you if you have bad luck with BetterHelp though. ReGain is one of them, there’s no matching algorithm that I recall with that.
TalkSpace has you do a short assessment with someone who will match you with a therapist, so it’s a little more hands-on. They also will work with insurance. I can’t remember if BetterHelp works with insurance or not. TimelyCare is something my university offers to undergrads through post-docs, but I think they have an alumni program, so if you went to college and still have your .edu email address, you might be able to find some resources through your alma mater. A lot of therapy apps are doing work with corporations as well, which gets a little dicey in terms of what you might feel comfortable sharing (technically in industrial psychology the company is the client and the workers are child clients of the company).
Anyway, all that to say that there is a lot of help out there. Despite that it is hard to find someone, especially someone with whom you really connect. And sometimes if you do, it’s often prohibitively expensive. In any case, I hope you find someone!
they/them
-
@somasatori said in Predators and Roleplaying Communities:
technically in industrial psychology the company is the client and the workers are child clients of the company
The ethics organ in my brain (probably the amygdala) just squirmed at that…
He/Him. Opinions and views are solely my own unless specifically stated otherwise.
BE AN ADULT -
@Pavel said in Predators and Roleplaying Communities:
@somasatori said in Predators and Roleplaying Communities:
technically in industrial psychology the company is the client and the workers are child clients of the company
The ethics organ in my brain (probably the amygdala) just squirmed at that…
YEAH! I remember when I first learned that. Also, in forensic psychology the employer (prison or district) is the client, not the prisoner/parolee, so there is no ethical requirement to privacy for prisoners. It’s why I did a trauma emphasis instead of a forensic emphasis.
(Also I veered us wildly off topic, sorry about that!)
-
Thank you for sharing this, Cobalt. LAMush was the first World of Darkness game I ever played, and the first MUSH. I was 17 when I first signed in. There were bad things that happened there which I have heard about over the years, including the infamous meetup. I experienced a few borderline things myself in pages and scenes. I thought it was just how things were, like hazing or I was just new to the MU* scene, and since I was too young and didn’t want people to know I was too young I made the mistake of not speaking up.
I’ve often had an overly rosy view of that place which I may have shared with you on occasion later on other games, and now that I realize how oblivious I was, I feel awful. I’ve been out of the hobby a long time, but I’ve always liked roleplaying with you when we’ve come across each other over the years. So, I felt compelled to say thank you for your courage and screw LAMush. And thanks for making the scene a safer place.
