Taking the next step - initial evaluation on Monday

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another_1
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24 Jun 2011, 1:36 pm

So . . . just what the title says. One year and two weeks after I realized that Asperger's was a very real possible explanation for my, uh, "quirks," "oddities" and general weirdness, I've decided to take the next step - an initial evaluation with a counselor, with an expectation that it will lead to a referral to a specialist.

I was pleasantly surprised to find that the "clinician" from my insurance company was familiar with ASDs, so I didn't have to explain what AS is.She knew enough that, when she didn't have a counselor who listed ASDs as a specialty, she suggested one that works primarily with ADHD, because she knew that the two often go hand in hand.

My strategy for the session is pretty simple: provide so much data pointing to AS that a nonreferral would be absurd. :lol: I know that many on here argue against telling a shrink what diagnosis you feel fits, but if she even glances at my paperwork, she'll already know why I'm there.

I intend to print out and present the scores from all the tests I've taken in the past year - AQ, SQ, EQ, BAP, Aspie Quiz, faceblindness quiz, reading the mind in the eyes, my high sensitivity questionnaire results, the "new" quiz from Facebook - every stinking one of them resides in a file on my computer.

I also intend to print out a copy of the DSM IV criteria for 299.80, with a short paragraph after each section describing why I believe it fits me.

Further, I plan to print out copies of lists of AS traits, with a short description of why each trait (that fits me) applies to me. Knowing that I am the only available source for my history, I plan to give examples of how these traits manifested earlier in my life as opposed to now. I also will present a one or two page "report" highlighting my utter dearth of a social life in school.

I do NOT expect her to read all of this during the session. I plan to use it as notes during the session to ensure I don't forget something, and leave it with her in hopes that she will at least skim it later, before reaching her decision.

Does anyone have suggestions for other information I should include? Tests I may have not listed, particularly comprehensive lists of traits to reference, anything like that?

Oh, FWIW - I only just made the appointment, but I'm already getting nervous - I can almost feel my "traits" becoming more prominent, especially my stimming, which I usually suppress. :lol:



Last edited by another_1 on 24 Jun 2011, 11:01 pm, edited 1 time in total.

un-worthy
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24 Jun 2011, 2:15 pm

1) You could probably just ask for a referral and she would give you one. I don't think you'd have to convince her beforehand.
2) I think a lot of therapists would resent your efforts to convince them of your diagnosis. If I were you I would bring up the diagnosis, but not bring any paperwork or anything, that would just be weird*. Then again, if you want an Asperger's diagnosis weird might be the way to go.

*It would sound like you were trying to prove a point instead of just suggesting ideas



K-R-X
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24 Jun 2011, 2:21 pm

I just got this process finished myself. There really isn't anything wrong with bring along paperwork showing the reasons you want the tests. I ended up e-mailing details after the evaluation as I locked up during it and couldn't do much more than answer questioins.

Just don't act emotionaly about it and don't argue if they suggest you might have something else. Stick to your request for the AS testing and sound reasonible about it and you'll be fine.



wavefreak58
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24 Jun 2011, 2:59 pm

un-worthy wrote:
1) You could probably just ask for a referral and she would give you one. I don't think you'd have to convince her beforehand.
2) I think a lot of therapists would resent your efforts to convince them of your diagnosis. If I were you I would bring up the diagnosis, but not bring any paperwork or anything, that would just be weird*. Then again, if you want an Asperger's diagnosis weird might be the way to go.

*It would sound like you were trying to prove a point instead of just suggesting ideas


I respectfully disagree. Any competent therapist or clinician won't just hand out a referral for the asking. And any therapist that resents the efforts of a client isn't worth anything.

I would suggest coming prepared with as much material as possible but not try to overwhelm with facts. You don't want to "do battle", but you need to be consistent and persistent.


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un-worthy
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24 Jun 2011, 3:22 pm

^ mine have been more than willing ... does that mean they're incompetent?


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wavefreak58
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24 Jun 2011, 3:47 pm

un-worthy wrote:
^ mine have been more than willing ... does that mean they're incompetent?


Depends on how well they know your case. If you are a complete unknown, a competent practitioner will inquire about your symptoms and history before making a referral - if for no other reason than to ensure you are referred to the correct type of specialist.


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another_1
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24 Jun 2011, 9:39 pm

un-worthy wrote:
1) You could probably just ask for a referral and she would give you one. I don't think you'd have to convince her beforehand.
2) I think a lot of therapists would resent your efforts to convince them of your diagnosis. If I were you I would bring up the diagnosis, but not bring any paperwork or anything, that would just be weird*. Then again, if you want an Asperger's diagnosis weird might be the way to go.

*It would sound like you were trying to prove a point instead of just suggesting ideas


I think I disagree on both of the points you raise, but I do (really - not meaningless pro forma words!) appreciate you taking the time to put them forth.

1) You may be correct. However, she is supposed to act as kind of a grand jury - she doesn't have to give me a diagnosis, she just has to decide if there is enough evidence to justify a full evaluation.

2) While I expect her to make her own observations during the session, and to give considerable weight to what she observes. However, she IS going to ask, "Why do you think you might have Asperger's?" Knowing that I often have trouble explaining things in a manner which accurately makes my point clear to others, it seems prudent to have my answer to that question prepared, and on paper so I don't forget to mention details.

It is possible that she will be one of "those," needing to prove that she knows more than the patient possibly can. However, if she believes that the patient's input is irrelevant, I would be curious to know why she chose to become a counselor. From what I read here (and elsewhere), more people are refused a diagnosis for reasons which are not part of the diagnostic criteria (you're married, you made eye contact, you can drive, etc) than for supporting the position that they may have AS. To me, it makes sense to - discreetly - make sure that she knows what the diagnostic criteria are than to simply hope that she knows them already.

* Yes. Yes I am. I am attempting to prove - to someone who may know very little about Asperger's - that there are valid reasons for me to suspect it, and that those reasons are strong enough to justify going to the trouble (and expense, which my current insurance would fully cover, although coverage will end before I am able to complete a full evaluation) of seeing a specialist for a formal evaluation.



another_1
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24 Jun 2011, 9:50 pm

K-R-X wrote:
I just got this process finished myself. There really isn't anything wrong with bring along paperwork showing the reasons you want the tests. I ended up e-mailing details after the evaluation as I locked up during it and couldn't do much more than answer questioins.


The locking up is what I'm afraid will happen to me, too. I write better than I talk, sometimes - especially when the conversation is focused on what/how I feel/think.

K-R-X wrote:
Just don't act emotionaly about it and don't argue if they suggest you might have something else. Stick to your request for the AS testing and sound reasonible about it and you'll be fine.


Thanks. I intend to present it as: I know there are other things which can look similar to AS, but none of them seems to explain all of my quirks, the way AS does. I think there is enough evidence suggesting AS that it's worthwhile to have an expert in ASDs evaluate me.



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28 Jun 2011, 11:37 pm

OK, that went well.

The therapist I saw has ADHD herself, and a 25 year old nephew with AS, so, while she works primarily with ADHD, she is quite familiar with AS.

I decided not to take in the detailed paperwork I planned to, and am glad that I didn't - she never even looked at the stuff I did take in, although she did ask what it was.

Very early in the session she commented that I seemed more social than most people with AS are, at which point I reminded her that I AM 50 years old. She kind of nodded and said something like, "And you've learned to compensate. OK."

She then asked the expected questions about how did I learn about AS and why did I think I might have it. I explained how I had remarked during a TV show that a certain character was "probably supposed to have Asperger's," and then decided that I shouldn't be using the term if I didn't know what it actually was, so I looked it up the next day - and found that it seemed a near perfect description of me. I told her that I think I fit the DSM diagnostic criteria today, and am certain that I met it when I was a kid - or would have, if the diagnosis had existed then.

We transitioned to discussing my employment history, primarily talking about why I left my last halfway decent job in December, 09. I had been hired to do tier 3 tech support, with very broad boundaries on what I could do to help the customer. The company, in their infinite wisdom, decide to send all those calls to another call center, and I (along with the rest of the Tier 3 team) was move to Tier 1 tech support, where we were prohibited from doing anything technical and required to use (fairly) high-pressure sales tactics on every customer we spoke with. I ended up leaving the company because I felt that what they wanted us to do was inappropriate, and I just couldn't do it.

After this, she asked numerous questions about my relationships, both my current one and my previous long-term (17 1/2 years) one. As some of this was quite personal, I would prefer not to go into detail about exactly what was asked or what my answers were. She was very interested in the sources of conflict in both relationships, and how we dealt with them.

Next, she focused (briefly) on my independent living skills. I told her, straight out, that I am unable to get along without some sort of support in place, and gave an overview of the ongoing disaster that unfolded the one time (only four years ago, for about a year) that I attempted to do so - house a wreck, yardwork undone, bills unpaid, appointments missed, etc.

She started to wrap up the session after this. She expressed a strong desire for me to bring in my boyfriend, if possible, at our next session.

She also showed me a little chart that she had filled out as part of her notes, asking me if I agreed with her rankings. On it, she used a 1 - 5 scale * to rank my current status in 5 areas - two of which I don't remember. :oops: For my social skills, she gave me a 2. For independent living skills, she gave me a 2. The next two sections were both marked as 3s, and the last - substance abuse - was a 5.

Last but not least, she told me that she was giving me a referral to be evaluated for both ADHD and for Asperger's.

So . . . nothing resolved, and I can't possibly get a formal evaluation done before my insurance runs out, but at least I know that a professional agrees that AS is, at least, worth considering.


*
1 =severely impaired:
2 = significantly impaired;
3 = moderately impaired;
4 = slightly impaired;
5 = no impairment