There are a number of things about the clinical practice at Gateway that are a little bit different. If you have seen another psychiatrist or psychotherapist it might be helpful to read this blog post to orient yourself to those differences and also to see if this is the right place for you to be receiving treatment.
We strive to make our treatment recommendations based on as much information as we can gather. This usually means asking our patients to complete a daily mood chart.
We may want to get together with you more often and for longer sessions than a previous psychiatrist might have wanted to. Again, we want to offer you our best recommendations and that often means gathering more information.
We will ask you to fill out a pre-visit form to make sure that we’re not missing anything important that has changed since our last session.
We will encourage you to make positive changes in your life – changing your sleep schedule, diet, exercise, etcetera.
And we ask you to be proactive in communicating with us about problems that you’re facing or issues that suggest the need for a change in treatment plan.
From time to time we will review our collaborative relationship and if we have concerns about how well we are working together we will want to talk to you and figure out how to improve your treatment. The effectiveness of our collaboration with someone is probably the main predictor of how someone will respond to treatment at Gateway.
We’ve worked with many people with seemingly “intractable” psychiatric problems and been extremely successful, but those have been people who’ve been willing to be active participants in their treatment. Elsewhere we have written about the curious phenomenon of people who seem to want to have the same kind of relationship with a psychiatrist or therapist as they might with a car mechanic: they want to drop off their brain and get it tuned up and then pick it up when the pharmacologist is done, without spending a lot of time or energy on the process of understanding what’s going on.
We certainly understand the wish to do that. Depression and mood symptoms can be very hard to face, but that wish needs to be resisted as it can be a big barrier to getting well.
If at any time we’re concerned that someone we are seeing is not improving because of problems in our collaborative relationship, we will certainly talk about this concern to try to solve it.
If after a number of attempts of trying to make things work better it still seems as though someone we are seeing is unlikely to benefit from treatment because of how they are working with us, we may suggest a referral to another psychiatrist or clinic.
We do this very occasionally and only after lots of discussion, but we do know that any relationship can get stuck in a negative pattern (including a relationship with a psychiatrist or therapist).
We have sometimes been pleasantly surprised when someone who is referred out gets back in touch to say “thank you” for doing that, allowing them to move ahead making effective change after a period of feeling stuck in treatment in our clinic.
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