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Recommended Providers on webpage

a place for info and and ideas and brainstorming as this community resource develops. this can be a temporary subforum until the network is up and running

Recommended Providers on webpage

Postby kaizoku » Sep 09, 2007 10:09 am

I'm trying to read the recommended providers page
here - http://theicarusproject.net/resources/r ... -directory
but it only displays the guidelines and cuts off after:
"PROVIDERS

Full Spectrum Progressive Mental Health

http://www.fullspectrum.c

S "

Is it working for others? Maybe it's just my crappy dial-up? In any case, I'd like to read it.
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Postby sandpiper » Sep 09, 2007 10:59 am

Hi Kaizoku,

I could never get this to come up either. I posted something quite awhile back about it, but no one ever responded. I surmise that the recommended providers page is still in the works and not yet available. If someone knows differently, please say!

Thanks !

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Postby scatter » Sep 11, 2007 7:21 am

oh man, yeah, that's one of those really good ideas me and ashley had that never found a person to actually coordinate it. sorry for the false advertising.

if anyone feels like stepping up i'm sure it would be much appreciated!
"Bipolar I with Psychotic Features", but somehow that just doesn't seem to capture the essence of the whole dilemma.
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Postby sandpiper » Sep 11, 2007 9:26 am

scatter wrote:if anyone feels like stepping up i'm sure it would be much appreciated!


Wow! Maybe this is something I could do. What would it entail? I don't know if I have the needed skills, but I do want to figure out something I could contribute to this community... so maybe?

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Postby scatter » Sep 11, 2007 10:04 am

hey sandpiper -- you definitely have the skills to do this if you want to take it on. here's what occurs to me:
the different pieces --
- soliciting contacts. i would just start posting on the forums asking folks if a. they're interested in creating a local provider network in their community
b. they know someone (or are someone) who should be on the provider list.

- we give you the ability to edit that section of the drupal site and you can start off with a simple list. i think that would also give you the ability to edit a bunch of other stuff too so we'd just have to trust you but that sure doesn't strike me as a problem. and then we'd link the provider section to the front page blog with a blurb that you write.

-maybe we could just start off with the thread and if a bunch of people are talking about it and/or are interested in it we could make it a subforum. always best to find others to work on something like this with you for when you don't feel like always being the bottomliner.

what do you think?

also, i still love this text but does anyone think it needs to be updated or edited?

Recommended Health Provider Guidelines & Directory

Know a health care practitioner -- mainstream, alternative, or otherwise -- who shares the Icarus perspective on experiences labeled mental illness? Add them to our list of Recommended Providers.

Here is a list of guidelines for what qualifies them for including in the directory; email supportATtheicarusproject.net with the details and we will include them on the list.

Icarus Project Recommended Provider Guidelines

About The Icarus Project
The Icarus Project is a grassroots support network formed in 2002 by and for people labeled with bipolar disorder and other "mental illnesses" who understand our experiencs outside th mainstream medical model. We operate a beloved and strikingly creative community website with several thousand dedicated users, publish and distribute alternative literature on community-based mental health support, conduct workshops and outreach on these topics in diverse communities, and work with a network of local support and activism groups around the country.

Our membership is comprised primarily of people who have been diagnosed bipolar but also includes people with other mental health struggles and/or psychiatric labels. We are determined to take charge of our own mental health and have empowered relationships with healthcare providers. Many of our members use traditional treatments like psychiatric medications and therapy as part of managing our care, and many of our members use alternative treatments like nutrition, acupuncture, and spiritual practice as adjuncts to or replacements for conventional therapies. We do not judge people's choices and we respect each person's decision to define their experience in the way that works best for them.

Personal experience has made us acutely aware of the enormous and sometimes tragic potential for damage and dysfunction that comes with the kinds of extreme emotions and thought patterns that our culture labels as "mental illness." Nonetheless, we see a level of sensitivity, creativity, and thirst for life among so many people labeled with these conditions that we believe treating us as 'broken' or disorded is a a mistake. We propose a more nuanced and hopeful understanding of "mental illness" that recognizes the gifts and positive aspect of our experience while also being realistic about the dangers we face. If we don't learn to take care of ourselves we can cause tremendous suffering, but if we find ways to heal and understand ourselves, both as individuals and as communities, we have the potential to change the world.

The Icarus Project Recommended Provider Directory
One of the most demoralizing and discouraging parts of seeking help is encountering health providers, both mainstream and alternative, who are only able to view mental health struggles in terms of the dehumanizing paradigm of disease and dysfunction, and who are not open to any alternative ways of understanding or treating these problems. The Icarus Project is therefore compiling a directory of health care providers recommended by our members as open to, or even inspired by, our approach to conditions labeled as mental illness. This directory will be used to help current and future members locate compatible providers in their area, and will become a source of referrals and guidance.

The directory is based on recommendations by people involved with the Icarus Project but does not reflect any official endorsement or approval - only that people have personal experience with these providers and can affirm theat they resonate with and are compatible with our vision and approach.

To add a provider to the list, please email details to supportATtheicarusproject.net.

Recommended providers should reflect respect the following basic principles:

1.Don't impose diagnostic labels. While psychiatric labels like "bipolar disorder" and "schizophrenia" can sometimes be useful in for some people, these labels can also be misleading and even harmful. Some of us feel that these labels can get in the way of our healing. Recommended providers should respect the choice of clients to define our experience any way we choose, and should not impose pathological diagnostic categories on clients.

2.Accept alternatives to medication. We recognize that psychiatric drugs and psychotherapy can be useful forms of treatment for many people, but we do not believe they are the only possible forms of treatment. In addition, we believe that the potential for serious negative effects and trade-offs in quality of life must be honestly investigated each time medication is considered. Pharmaceutical companies have not given honest information about their products, and sometimes psychiatric drugs can make people worse. Recommended providers must ensure that clients have accurate information about psychiatric drug risks and the potential effectiveness of alternatives. Providers should be open to using medication in decreased dosages, exploring alternative therapies, supporting clients who choose to reduce or go off medications, and finding other creative ways to address our problems.

3.Collaborate with us as equal partners in care. We want to be involved in figuring out ways to take charge of our mental health and improve our lives. We want to be included in all decision-making about our treatment as much as possible. We ask to be respectd as competent, intelligent individuals who should be well-informed about all aspects of our treatment. We do not consider ourselves passive "consumers" of mental health and treated as markets with problems to b bought and sold. We are individual human beings struggling to make sense of our experiences.

4.Don't impose mainstream values on us. We expect respect for our alternative cultures or unusual gender/sexual/racial/class identities. We are not interested in working with providers who automatically consider our cultural, lifestyle, or identity choices to part of our mental health 'symptoms,' or who feel a need to get us more in line with mainstream values. We should not be judged if we don't fit into the career and work standards of the mainstream; instead, our uniqueness and creativity should be supported as intrinsic to who we are.

5.Provide low-income access to your services. We strongly believe that mental health care should be accessible to as many people as possible, and we find it problematic that the American health care system is a for-profit enterprise that leaves many without options. Recommended providers should offer sliding scales, public assistance, barter, pro-bono (free) services to at least a portion of their clients to promote greater access to services.

If you want to recommend a provider, fill send the following info to supportATtheicarusproject.net.

Your Name ________________________________ Your Email_____________________________
Provider's Name:_____________________________________________________________________
Field (Psychiatry, Acupuncture, Clinical Ecology, etc.): _______________________________________
Description of practice: ____________________________________________________
____________________________________________________________________________
Provider Phone: _________________ Provider Email/website: _______________________
Location / Address: ___________________________________City__________________________
Does the provider fulfill all of the principles listed above? ____________
Does the provider offer low-income access (sliding scale, free/barter, public insurance)? ___

"Bipolar I with Psychotic Features", but somehow that just doesn't seem to capture the essence of the whole dilemma.
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Postby sandpiper » Sep 11, 2007 7:26 pm

scatter wrote:


maybe we could just start off with the thread and if a bunch of people are talking about it and/or are interested in it we could make it a subforum. always best to find others to work on something like this with you for when you don't feel like always being the bottomliner.

what do you think?



I think I could do this. and I like the idea of breaking it into the above steps. Yep, my brain can handle these nice snack-sized bits! I will be away from the computer for several days, so I'll get started when I get back. Thanks scatter. yay!

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Postby Inel » Sep 11, 2007 8:34 pm

this makes me very happy! thanks sandpiper for stepping up!!! this was one of my first stops in icarusland and although there were not resources available, i printed out that list of what the provider needed to accept as a guideline for my own personal provider search. i'm so happy that after my first year here 5 psychiatrists, 4 therapists...in my second year here, i now have a really really really amazing therapeutic alliance with my support people. i'd love to recommend my trad and alt folks.

my acupuncturist told me she cried after reading the icarus postcard i left in a stack in their office. we talked and she asked if i'd kindly keep them stocked and offered to work out some kind of flexibility when icarus folks came to town...so people could get "tune ups" without all the pesky "intake" junk they are required to do.

my only feedback on the written stuff is that the clinic where my "primary care" is provided is so philosophically down with it all, but still has to code stuff with diagnostic labels...but they all know how much i personally hate the word bipolar so they always catch themselves around me and pardon themselves and use words that work for me, although my file is full of the systems loaded language.

again, again, again...thanks sandpiper for stepping up and into this unknown task. sascha and ashley, thanks for holding the space for this to eventually happen. the world is ready!
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Postby Amy » Sep 11, 2007 11:05 pm

I have a lot of feedback on this document, but not the time to really sit down and give it justice tonight. I'll try to come back to it within the week to really give a thorough response. I like most of it, a lot, and was thinking how much I'd like to give a directory like this out to people and how much I would like to have one and how I'd like to see if my therapist would agree to be on such a thing! There are a few issues I see, like saying we can become dangerous...not really relevant...anyone can. and that we be "partners" with our providers and be notified whenever possible...not self-determining enough. We are not equal partners...we pay them or trade with them for a service that they are supposed to render and we either accept their advice or work or don't. We should not be partners, we should be in control, it is a capitalist transaction, unfortunately that the world's healing has come to that, but in so being, really requires we be in control, even while giving them total respect if they deserve it (and leaving if they don't). It's person-centered AND person-controlled, only except with those items we agree that they can decide for us on if we want them to (an advanced directive, etc.) And they should be willing to grant us easy and cheap access to copies of our records, no questions asked.

ok, more, perhaps, later,

gotta go to bed
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Postby sandpiper » Sep 20, 2007 5:11 pm

scatter wrote:also, i still love this text [Recommended Health Provider Guidelines & Directory] but does anyone think it needs to be updated or edited?


I am trying to sift through all the posts and find the ones relevant to this discussion.

In this post http://theicarusproject.net/forums/viewtopic.php?t=9642 Divi had some suggestions about updating and editing the Recommended Health Provider Guidelines and Directory:


divi wrote:Other than that, here are some things i consider important. Please add to the list:
- openly queer-positive
- sliding scale fees
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Postby Amy » Sep 20, 2007 7:52 pm

first, thanks Sandpiper so much for doing this!


ok, a few suggestions:

1) take out the dangerous part. irrelevant, as I said, we have the same chances as the general population according to the 1998 McArthur Foundation study to become violent...3% People have yet to realize anger is not a mental illness, neither is being an asshole. so just a big X

2) Under the collaboration part (which is fine with me), take out the "as much as possible" part and instead put something like, "unless we have directed you to do otherwise in an advanced directive or signed contract". Also in that same section take out "notified whenever possible"...it's always possible if they're against forced treatment...

3) Put in a line that the providers must be against forced treatment. I don't know how anyone can be person-centered and be for it, but we have to make this painfully clear because, honestly, a lot of therapists haven't even thought about it long enough to see the connection between person-centeredness and choice, even in dire situations.

4) Put in a critera that they must allow cheap and easy access to our records at all times, in all situations, if we request them.

those are my thoughts.

rock on, Sandpiper-
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not anti-Rx

Postby div3bulldog » Nov 26, 2007 5:22 pm

OK... so I'm new here. And I may be figuratively shooting myself in the foot with this first post, but this is the issue that I signed up to the forums to address:

Yes, I believe that our (American) health care system is a mess, especially with regard to mental health.

Yes, I believe that people should have more control over their own treatment. Emphatically, yes! While a doctor may understand the biological science, who knows me better than me?

That said, I've taken many different Rx meds. Some have worked, some haven't. I feel like a lot of what I find on this site is anti-Rx, and it would be great if we could say, "This may work for me, but this other type of treatment may be best for you."

After reading the latest version of the provider agreement, I think it's a huge step backward from the previous one.


1. While psychiatric labels like "bipolar disorder" and "schizophrenia" can be useful in categorizing and understanding our struggles in relationship to other people and to the available medical literature, we do not see clinical diagnosis as an end in itself nor as a complete understanding of our experiences.

This is much better than "Don't impose diagnostic labels." The latter is a command. We're more likely to get stonewalled with sentences like that.

2. We recognize that psychiatric drugs and psychotherapy are useful forms of treatment for many people, but we do not believe they are the only possible forms of treatment. In addition, we believe that the potential for serious side-effects and trade-offs in quality of life must be honestly investigated each time medication is considered. We believe that openness to discussing using medication in decreased dosages, exploring alternative therapies, and finding other creative ways to address our problems is essential in any relationship with a provider.

I would've taken the bolded text out of the old version. It is a given that these things should be addressed. By specifying it, we're showing partiality for 'providers' who prefer alternative treatments over prescription meds.

This:

2.Accept alternatives to medication. We recognize that psychiatric drugs and psychotherapy can be useful forms of treatment for many people, but we do not believe they are the only possible forms of treatment. In addition, we believe that the potential for serious negative effects and trade-offs in quality of life must be honestly investigated each time medication is considered. Pharmaceutical companies have not given honest information about their products, and sometimes psychiatric drugs can make people worse. Recommended providers must ensure that clients have accurate information about psychiatric drug risks and the potential effectiveness of alternatives. Providers should be open to using medication in decreased dosages, exploring alternative therapies, supporting clients who choose to reduce or go off medications, and finding other creative ways to address our problems.

just intensifies the problem. Trust me, I'm not a fan of 'Big Pharm' and how they do business... but I don't think ANY doctor would sign the agreement after reading that text, except a hardcore D.O.


3.Collaborate with us as equal partners in care. We want to be involved in figuring out ways to take charge of our mental health and improve our lives. We want to be included in all decision-making about our treatment as much as possible. We ask to be respectd as competent, intelligent individuals who should be well-informed about all aspects of our treatment. We do not consider ourselves passive "consumers" of mental health and treated as markets with problems to b bought and sold. We are individual human beings struggling to make sense of our experiences.

Ok, this is better than the old one. A bit less hostile.


4. If we participate in alternative cultures or have unusual gender/sexual/racial/class identities with which you are unfamiliar, we expect unequivocal respect for these facts. We are not interested in working with providers who consider our cultural, lifestyle, or identity choices as part of our mental health problems and feel a need to get us more in line with the mainstream. Similarly, if we choose not to participate in the ideal of the 40 hour work week and instead choose unorthodox work schedules and housing choices that may permit us to engage in creative or socially conscious pursuits, we expect respect and will not accept judgmental attitudes towards these choices.

YES! This was written so well. And the key word is IF.

4.Don't impose mainstream values on us. We expect respect for our alternative cultures or unusual gender/sexual/racial/class identities. We are not interested in working with providers who automatically consider our cultural, lifestyle, or identity choices to part of our mental health 'symptoms,' or who feel a need to get us more in line with mainstream values. We should not be judged if we don't fit into the career and work standards of the mainstream; instead, our uniqueness and creativity should be supported as intrinsic to who we are.

Again, starting with a command. And the rest of it basically says, "Hey, by the way... we're all a bunch of freaks, deal with it!!!!!" We should not be pigeon-holing and isolating ourselves!! I'm not Mr. Joe American, but you might never know if you saw me walking down the street. I would hope that there are others here like me.

5. We strongly believe that mental health care should be accessible to as many people as possible, and we find it extremely problematic that the American health care system is a for-profit enterprise. To this end, whenever possible we strongly encourage participating providers to consider offering sliding scales or working with public assistance programs that will allow more people to have access to their services.

This one didn't change much in the second version, but I would not have written anything about bartering or pro bono for fear of scaring providers away. Also, I would've taken out the criticism of the health care system as a for-profit enterprise... not because I don't agree with it, but because the very people we're trying to recruit work now in that for-profit system.


I'm sorry if this post came off as disrespectful, but I believe that we need to work on changing society, not turning our backs on it. And it's been frustrating trying to find people that feel like I do... stuck in between the capitalist health care debacle and the alternative treatment crowd.


Peace,
BD
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Postby Inel » Nov 26, 2007 6:20 pm

Welcome BD! What a bold first post and vital voice you have. I'm happy you're here and are willing to share your critical opinion. I look forward to hearing more from you.

And thanks for pulling up this important thread. Your feedback about language could be useful in the dialog about the mission/vision statement thread as well.

I may not agree with everything you say, but I too am often found swimming in the gray. Thanks for taking the time and putting attention/intention into this. Welcome!
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Postby christin » Nov 27, 2007 3:14 pm

1.Don't impose diagnostic labels. While psychiatric labels like "bipolar disorder" and "schizophrenia" can sometimes be useful in for some people, these labels can also be misleading and even harmful. Some of us feel that these labels can get in the way of our healing. Recommended providers should respect the choice of clients to define our experience any way we choose, and should not impose pathological diagnostic categories on clients.


Maybe I'm reading this wrong but some practitioners need to diagnosis you with something to have insurance pick up the tab. I like the bottom part. Maybe something along the lines of:

Recommended providers should respect the choice of clients to define our experience any way we choose, and should not impose pathological diagnostic categories on clients except for insurance purposes.

As far as forced treatment goes I know it varies by state to state but in Minnesota anyway if a psych practitioner believes someone to be a serious danger to themselves or others they are required to report it or else they can lose their license. So that's kind of holding those type of practitioners in an impossible position.
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Postby Amy » Nov 27, 2007 5:08 pm

From what I understand, states do not license people, professional licensing boards do. I have no further intelligent contribution at this time in exact language around force for providers, but I think we should struggle with this a little. After all, they serve US. We pay THEM. If it comes down to approaching licensing boards, I'm all for it. I think we're missing the point when we begin playing to their needs and not ours. We pay THEM. They would not have a job or a license without US. Now, if we move away from the discussion on litigation and towards a discussion on telling someone who you have disarmed that you are going to off yourself and the ethics of that, then, yeah, that's not fair to them as a person. But in terms of their professional role, they wouldn't have one if we weren't around. This is the "consumer" empowerment piece that is constantly missing in dialogues at Icarus and has me so pissed off...not at anyone in particular, just in how warped the system has become. Working for people with developmental disabilities in self-advocacy, it was real clear...they hold the power because they decide who to pay for services. Where have we gone that we have become so afraid of stepping on practitioner's toes?

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Postby christin » Nov 27, 2007 6:08 pm

I have no problem with stepping on practitioners toes or otherwise. And obviously there are a lot of non-traditional practitioners that this would be a moot point in. Again, I'm not sure how this is set up in other states but in Minnesota the board of psychology is a state agency. Psychiatrists are physicians (obviously) and are licensed by the Minnesota Board of Medical Practice and it is that board that takes disciplinary actions against physicians and revokes licenses.
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Postby xenobia » Nov 27, 2007 8:10 pm

Opps. double post- sorry.
Last edited by xenobia on Nov 27, 2007 8:13 pm, edited 1 time in total.
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Postby xenobia » Nov 27, 2007 8:11 pm

Two points:
1), Money, or fees for therapeutic services
2) Legal obligations of providers to report suicidal/homicidal ideation.

5. We strongly believe that mental health care should be accessible to as many people as possible, and we find it extremely problematic that the American health care system is a for-profit enterprise. To this end, whenever possible we strongly encourage participating providers to consider offering sliding scales or working with public assistance programs that will allow more people to have access to their services.

Um, I actually think that # 5 is a bit wishy washy.
I think we are in a position to ask outright for participation in social justice, part of which is economic justice.

This is my version of #5:
We believe that health care, including mental health care, should be accessible to all.
We believe that health care should be a right, not a commodity. Often, people who are disabled are consigned to poverty, even if they are able to get public disability entitlements.
To this end, we ask that participating providers offer sliding scale fees, or work with Government sponsored health insurance.
As Government sponsored health insurance is often sorely lacking in its coverage, and is difficult and even costly for providers to manage and utilize, we ask that providers make one opening in their practice for people who cannot afford to pay anything, or whose insurance is impossible to utilize.



This is a form of active social justice, and you would be surprised at how many folks with clinical practices will respond.
I started a non-profit that provides healing and restorative services of all kinds, including psychiatry, somatics, and depth social supports/social services for homeless people. All of our services are free.
We put out a call to psychiatrists to work for free, and lo, after a year of searching, Dox stepped up.

Many "professionals" in the field are quite nutz themselves, and are often infuriated at the constraints of the health care system.
I suspect that there are quite a few who would work on a 0 to ? sliding scale, and those who would open at least one pro-bono slot for those with 0 income.

Putting out a "call" to professionals who want to do something that for them, may be a little radical, is one way to screen the risk takers from the by-the-book-players.

Regarding the licensing and requirements of the state to report danger to self, others, etc:

All licensing boards are authorities of the State. The xyz State Licensing Board is the authority that licenses professionals of any degree- PhD, LCSW, MA, MFCC, etc.

Regarding the licensing and requirements of the state to report danger to self, others, etc:

I do not believe that there are laws that require the reporting of incidents to the State when “patients” threaten to kill themselves, but “professionals” are required to in some way, and certainly to chart this threat.
The standard phone greeting for many “professionals” is:
“You have reached to offices of Dr. Snerkidy P. Nimblestumble, clinical specialist in fixing you right up.
If you think you are having a life threatening emergency, hang up and dial 911.”
(In cities in the Bay Area, the fire department is the first responder, regardless of what the emergency is. How many times have I told a 911 dispatcher that my emergency is not on fire, that she has accidentally overdosed, and please to send an ambulance, not a fire truck thank you. It doesn’t work. The FD always shows up. It’s a union thing. )

This is their standard CYA. But, no where does it say that licenced folks must do this, or, that they must report threats or feelings of sucidality.

Ther is a law, started in California and now I believe it is in every state, that a clinician must report a credible threat made by their client about a specific individual, not only to the police, but to the intended victim.
This has caused no end of harm.
This is the Tarrisoff law in CA, named after the case that resulted in a civil suit and a new law.

I think we must state in our criteria for a radical mental health practitioner that we believe in the practice of depth harm reduction, and redefine what the parameters of this are in realtionship to therapy.

Part of this would include the therapists and client creating an advanced directive that makes it possible for both to be comfortable around these issues.
Many therapists understand that when people say “Im feeling so fucked up about this that it makes me feel like I
A) kill myself
B) Kill President Bush” that it is very very different that a client stating, “I’m goingto kill myself or I’m going to kill the President.”
The operative word in these statements is [b]feeling/b]

Someone who feels like killing themselves isn’t stating that they are going to do it, nor does stating that they feel like killing the president.

These are the things that can be negotiated with any good therapist.

OK, my 7 cents worth. And boyOboy, do I have more, but I’ll hold my fingers for now.
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Postby silverelf » Nov 27, 2007 8:51 pm

hi xenobia - thanks for all that - i think simply noting what sort of fee structure they offer in any directory is okay - eg; for those of us lucky to have health insurance i would hate to see a provider not listed if they were really down with a radical conception of mental wellbeing just because they didn't offer a sliding scale - on the other hand, i think we are quite right that we should advocate for sliding scale and pro-bono service provision -

i would rather see a broad directory that is informative, rather than a more narrow screening one. it is hard enough to find good service providers as it is, finding one that aligns on all principles might be downright impossible in some parts of the country, so if I am looking for a specific kind-of service provider better to find one that looks like they are good on a b and c and maybe not on x y and z rather than have to just take shots in the dark
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Postby silverelf » Nov 27, 2007 8:59 pm

also not even having the debate around the issue of reporting and involuntary treatment, i think there are many healers who would be willing to discuss the issue with clients up front in terms of personal boundaries and how they do or don't make decisions but would not ever have their name listed somewhere where it looked like they were stating outright that they wouldn't ever report sucidality/homicidality without client consent because it opens a giant can of worms if they would ever be sued in the future for malpractice.

if we want to fight the litigation issue and licensing/accreditation orgs, that's fine, but in my mind that's a totally different ballgame that a provider directory/network

and you are right that outside of licensing there are legal requirements in all (?) states regarding credible threat or child abuse.
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Postby Amy » Nov 27, 2007 9:05 pm

silverelf--

you are probably right on this one. though it would be cool if a whole lot of providers just said f you to the system and put their names down. I think you get enough people together, anything is possible. The issue is rallying them and I sure as hell don't have the energy to do that, so perhaps some language about following advanced directives and engaging in committed conversation if we are threatening suicide. X--I like your distinction between feeling suicidal and threatening it. That's even part of lethality assessments.

while licensing boards are state accredited, most groups, like psychologists and social workers, follow their ethics from national professional organizations which state licenses are often based on, so that's what I meant by going more upstream. Again, though, I don't have the energy for that one myself at this moment.

peace-
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