# How to ask your therapist for your diagnosis?



## justmes

I am just curious how as a client, one "asks" their therapist for a diagnosis? My therapist hasn't been forthcomming with such information, but I am considering allowing billing to go through my insurance and would like to know what the treatment rationale is...I know that it is my right to know etc. but I guess my real question is what if I don't agree with her assessment? 
Am I the only one who has kept their insurance company out of the equation? Or, am I the only one who doesn't have a clue "what" they are being treated for?


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## Daniel

*Re: diagnosis what?*

Have you asked your therapist already?  

When I first saw a psychologist, it took a number of sessions before he was able to arrive at a definitive diagnosis.


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## Retired

*Re: diagnosis what?*



> how as a client, one "asks" their therapist for a diagnosis?



What is preventing you from just asking, "What is my diagnosis, Doc?"

There is nothing mysterious or secretive about a patient or client's diagnosis.  To some people it's unimportant to know, but for others it might be, for various reasons.  In my opinion, your therapist should comply with your request, which is logical and reasonable.


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## David Baxter PhD

Be aware that in many jurisdictions the act of diagnosis is considered a "reserved" or "protected" one. For example, in Ontario, only licensed psychologists and medical practitioners have the legal authority to "convey a diagnosis". 

If similar legislation applies in your are, it may be that your therapist is not legally able to give you a diagnosis.

Such legislation, by the way, is for the protection of the client or patient, to ensure that anyone transmitting a diagnosis, for example to an insurance company, has the necessary training and experience to do so.


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## adaptive1

Here is how wacky I am, when I first started trying to figure out what was going on with me, I had this definite need to have a diagnosis, when I got it, it still didnt satisfy me, is just fueled my anxiety and I wanted proof somehow of what was wrong with me, even though that isn't possible. I felt like I had every mental disorder that there ever was.  I worried about it. However, eventually I cared less and less to put a name to it and was able to accept that for the most part, it was anxiety fuelling this.  That doesnt mean I dont fall into the traps of anxiety, because I often find myself doubting my thoughts and what they mean,  But I do find now I spend more time looking for solutions and I am able to use methods I have learned to manage my anxiety. Lucky for me this forum is able to give me reminders when I need them.


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## justmes

No, I haven't asked. I didn't ask today either...One of the reasons that I haven't asked is because I'm trying really hard not to "do it myself" (I'm a mental health professional...new to this side of the office). I don't know, it's as if I would be OK with PTSD, but not with a panic disorder or something along those lines, not that I want either, but I also really value my privacy and if I go through insurance privacy somewhat goes out the window and I kind of think I should know what diagnosis she is putting through for treatment justification. I am concerned that my insurance will not continue to pay for my medical treatment if I process claims for mental health anything...even though prior to said medical treatment I didn't have any (major, huge, traumatic) issues in the mind department. This is a valid concern as the insurance company has attempted to invalidate my insurance after I wound up in the ER with sudden onset cardiac issues (I'm female and young and those were their justifications for trying to not pay and trying to cancel my coverage).  There is no jurisdictional issue with my therapist providing me with her assessment and/or diagnosis, I just really haven't asked...and now I think it's kind of weird to want to know now.


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## Daniel

> I don't know, it's as if I would be OK with PTSD, but not with a panic disorder or something along those lines





> and now I think it's kind of weird to want to know now.



Have you considered that maybe your concerns about the insurance company, however valid they may be, or your reluctance to talk to your therapist about this may relate to something else like internalized stigma about mental illness or be symptomatic of the very issues that brought you to therapy, like maybe anxiety?

In any case, you may find it reassuring to discuss such concerns with your therapist.


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## Marcel

justmes said:


> I am concerned that my insurance will not continue to pay for my medical treatment if I process claims for mental health anything...even though prior to said medical treatment I didn't have any (major, huge, traumatic) issues in the mind department. This is a valid concern as the insurance company has attempted to invalidate my insurance after I wound up in the ER with sudden onset cardiac issues (I'm female and young and those were their justifications for trying to not pay and trying to cancel my coverage).


 
Perhaps I shouldn?t comment, however I think your concerns about the insurance company are valid.

I had some mental health issues for which I was treated/made claims under my employer?s health insurance. Eventually I ceased treatment and by that time, some of the issues had already been resolved . 

Fast forward five years when I changed jobs and had to fill out insurance application papers with my new employer (same insurance company) and list the previous treatment I had received. The insurance company wanted written statements from the previous medical professionals (psychiatrist and general practioner) who had issued me medication. Both had switched jobs and left the city and every attempt to find them/get remaining staff at the clinics to provide me with the information requested met with a dead end. The insurance company, because they were not supplied with statements from the previous medical professionals (despite my having contacted them and having explained the situation and the reason both they and I had received no responses back from the clinics in connection with the information requests) denied my coverage for any kind of disability insurance (short or long term) in connection with any kind of mental health issue whatsoever. And the (I am sure ?form?) letter they issued to me was incredibly demeaning. 

Every time I have any sort of change to my employment status now, the insurance company sends me information requests about any mental health treatment being received. And I feel completely humiliated every time I have to fill out these questionnaires knowing I am not going to get any coverage anyway ? it has already been denied. When they follow up with their request for further treatment information (including the past again), I just tell them it is not available as per the attached and resubmit to them the original correspondence, including a photocopy of their derogatory letter where it told me I would never be eligible for any kind of mental health disability coverage. Why bother to keep asking me?

I don?t even claim the medication under the drug plan anymore because I don?t want to have to answer to them about my mental status and needing medication.

So just my two cents about insurance companies and being labeled.


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## justmes

I have actually considered the stigma of mental illness which is originally the reason why I did not process anything through my insurance. I'm actually more open now to the idea that there are times in life where everyone can use some help. And even though that is what I've always taught my students when I'm teaching therapeutic interventions, I never really, truly believed that I would ever be in that position. Well, here I am, and I have gone through that thinking process to see where I am coming from. 

My first experience with therapy which lasted about 3 weeks I was diagnosed with "acute traumatic stress" about six months later and after a repeat of that trauma "surprise" the symptoms came back.  I've never had any panic or major anxiety prior to this time, and really only have issues with having flashbacks, nightmares, and other related symptoms but that is it, so it's probably a safe bet that my therapist's response would be PTSD.  I think that it's important to continue treatment at this time (still having intense flashbacks etc) but cannot really afford to continue paying for each session out of pocket after having to take a year off of work.  

I don't know, however, if I am willing to chance it with the insurance. I already no longer have a 401K after having to cash it out to pay the portion of the medical bills that my insurance did not cover, but now am entering a new policy year and have the opportunity to put treatment through insurance, just still not sure that it is a great idea, regardless of diagnosis.


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## justmes

I finally asked. It took me a month from the time I started to think about asking to actually ask. PTSD. Not surprising. 
I was talking to a friend and said that I was wrestling with asking my therapist for my diagnosis and also telling my primary physician about my treatment, being all holistic mind body and stuff...and she looked at me and said "you don't think he'd be surprised by that do you?" and I kind of realized that it's ok to acknowledge a mental health issue, and it's ok to be ok with it.


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## David Baxter PhD

So how do you feel about it all now?


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