Lots of family stress, depression, discouragement, loss of interest, feel like giving up. I wrote something that was very detailled, then lost it. It disappeared from the screen and I can’t seem to find it. Anyhow, I’ve been through lots of therapy from the time I was age 13, back in the dark day s of 1976 when analysis was the main way to go and there were hardly any antidepressants.

I need help. I probably need inpatient help, which I’ve had several times. There have been many problems for me with getting help from therapy. Mostlly I talk a lot, but stay in my head, not my heart.

Each time I have left the hospital I have been better. But that has always been temporary. Really temporary. I’m telling you, therapists really need to get their acts together!!!!!!!!! The follow through is almost non existent. At best it’s unhelpful. Sometimes it conflicts with the direction the hospital help seemed to take.

I cannot go through another inpatient experience, only to come back to the exact same circumstances and challenges I left. Do you really think that two weeks in a hospital can change someone and their life long patterns and cognitive processes, in order for them to suddenly be able to pick right up and handle the exact same problems, but this time effectively? Just who is the crazy one, if that is what therapists think, and they do seem to think so.

No effective, comprehensive follow through? No dice.

But I really, really need help (so does my family). We have insurance, but really no other money.

OK, so help me. What do I do??????

A: At best, two weeks in the hospital gives you a break to take a breather, to get some intensive individual and group therapy to perhaps jumpstart some new thinking and an opportunity to adjust medications. Followthrough is very, very important. But in the current state of things, you probably can’t expect other people to keep it organized for you.

What do you do? First, make sure your outpatient therapist is imformed of any hospitalization. (If you don’t think you’ll be on top of this, ask a family member to be sure to call.) Sign releases so everyone who is important in your care can talk to everyone else. Make sure the hospital knows who they should send a discharge summary to. That includes your psychiatrist, your primary care physician, and your therapist.

Best case is that the outpatient therapist and your outpatient psychiatrist will coordinate with the inpatient therapist before you leave the hospital so that everyone is on the same page. Work with them to create a reasonable discharge plan. If you have family members who are willing to be involved in your treatment, make sure there is a family meeting before you leave the hospital as well. You want your family to have the information they need to help you keep on track.

And — get out of your head when talking to the people who are trying to help you. Unless you are emotionally as well as intellectually honest, helpers are limited in what they can do. Participate actively in groups. Often fellow sufferers are better dectectors of avoidant behavior than even experienced therapists. Participate actively in your therapy. Please, please care enough about your care that you don’t expect your therapist be a mind-reader.

You’re absolutely right. You will of course come back to the exact same challenges and circumstances you left. Life is surprisingly constant unless we act to make significant changes. It’s up to you to reach out to the people who can help you and to get the support you need to make the external changes you need to make (change of housing? job? friends? etc.). It’s also up to you to make use of the help and support available to you.

I’m sorry that you have had such a tough time. As much as I might kind of wish there were a way to make change simpler, I also know that the struggle toward mental health and a reasonable life is often an important part of what makes a person stronger.

I wish you well.
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 22 Oct 2010

APA Reference
Hartwell-Walker, D. (2010). Therapists really need to get their acts together!. Psych Central. Retrieved on October 26, 2014, from http://psychcentral.com/ask-the-therapist/2010/10/22/therapists-really-need-to-get-their-acts-together/