The facility I am visiting now provides therapy and psychiatry at the same time. They specialize in anxiety, depression and substance abuse. When I was doing the intake info over the phone, I was able to get in without outright lying. They asked me what I was going to be going there for. I said it was several things. She asked, “Do you have anxiety? Or depression?” I answered, “That’s part of it.”
Then I saw the therapist two times, and the second time she wrote me a referral to the psychiatrist. She also said she wouldn’t be there the next week. I said that was fine. Then she scheduled me three weeks out. When I called to get the psychiatrist appointment set up, the earliest they had available was 2 weeks out. And I realized my therapist set it up so that she wouldn’t see me again until after I’d been to the psychiatrist.
But it’s the best I can do. There are no therapists who list things like “residual schizophrenia” under what they specialize in. I don’t think any therapists (at least not around here) are really trained to handle anything beyond depression, anxiety and mild dysfunctions. You might find the occasional needle in the haystack who is bold enough to take on something like specializing in BPD, but that’s about as far as it goes. And psychiatrists don’t have time to also play therapist here, as there is a shortage of pdocs so they give everyone just 15 minutes and are still overflowing with patients.
I think almost the only way it works is to tackle psychosis like symptoms, and then go to therapy. You also need a therapist who actually has a passion for understanding and helping people, which can be hard to find ironically and sadly. But I think the way it’s usually set up is stupid then because if you only get 15 mins with a pdoc and you have any issues communicating at all, your pdoc is basically just stabbing around in the dark. If your therapist also cooperates with your pdoc, then they can vouch for you and help with communication and everything.
That is why I weaseled my way into this facility for therapy, despite it being focused on anxiety/depression and substance abuse. I want a therapist and pdoc working together.