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Ask Dr. Z Your Own Question

Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5416
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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whats wrong with my daughter, she is 17.5 years old and she

Customer Question

what's wrong with my daughter, she is 17.5 years old and she want to go out and have sex with a 15 year old girl that lives 100 miles away, they met on the internet.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

DoctorZ :

Hello I believe I can help you with your concern

DoctorZ :

I am sorry that your daughter is expressing this type of behavior and that it distresses you

DoctorZ :

May I ask has your daughter ever expressed this type of behavior before?

Customer:

no

Customer:

she just met this girl online doing cosplay (like girls dressed up like guys)

Customer:

they seen each other 3 times

Customer:

within the last 9 months, they chat online everyday

DoctorZ :

So they have had a long term online relationship for the most part

Customer:

we explained to her that she is going to jail if this continues, I even pulled up some cases that minors (lesbians) have sex together and the older ended in jail, Yes, online mostly

Customer:

my husband was crying talking to her, begging her to seek help, and she said this is a easy way to find a relationship and she don't want to seek help

DoctorZ :

Yes going to jail or having any type of conviction is not something she should want

DoctorZ :

Is your daughter willing to continue the relationship without any physical activity until the girl is 18?

Customer:

not sure, the 15 year old girl is sexually very active, and she wrote her a love letter telling my daughter that she want to be on top, etc... all those garbage.

Customer:

We live in CA and my daughter is actually going to NY in a week to college, I truly think she have some metal issues, but we tried seeking help here in CA and they said lesbians are normal

DoctorZ :

So it was a very sexually explicit letter. One thing is that the more you and your husband are against it, the more your daughter will try to pursue it. One of the downfalls of a rebellious nature as a teenager

Customer:

yes, we know. That's why tonight I blew up and told her dad to drive her and drop her off so she can move in with her and live happily ever after

Customer:

They live in the Ghettos

DoctorZ :

In California, there is actually a proposed law that forbids mental health professionals from practicing what is called gay conversion therapy, although this law is on appeal in the courts.

Customer:

and we live in a upper middle class neighborhood

Customer:

Good thing is she is going to NY, but it's difficult to seek this kind of therapy in college

DoctorZ :

I think your daughter is being dominated emotionally by someone younger and more immature than her, that is a sign of poor self-esteem and self-conscious issues.

Customer:

unless I am there physically and take her to therapy

Customer:

totally agreed. The girl is actually very uneducated but street smart like a 20 year old

DoctorZ :

Gay conversion therapy is falling out of favor, so it would be hard to find it in NY. It can also increase levels of depression in patients, which can be severe.

Customer:

Lesbianism is OK, but not with a minor, that's sickening.

DoctorZ :

I think if you treat the depression and low self-esteem, then your daughter will not make such poor decisions that can have horrible consequences for her (e.g. jail)

Customer:

how ?

DoctorZ :

Well therapy strictly for her depression can be something she can discuss. A good mode of therapy is called Cognitive Behavioral Therapy (CBT) that actually changes her negative thought process to be more positive and this will effect her behavior and lessen any symptoms of low self-esteem.

DoctorZ :

But she would have to go to therapy for it to be effective.

DoctorZ :

A therapist will also explain as a neutral third party of the consequences of having sex with a minor too.

Customer:

she said she is afraid of guys

Customer:

that's why she wants to go out with girls

Customer:

and she picked a girl that's younger, shorter, weaker than her

DoctorZ :

So she may not actually be a lesbian, she may just feel more comfortable with girls, especially the younger one because she will not feel as intimidated.

DoctorZ :

Therapy will help her gain confidence and be more independent

Customer:

she talked about running away last month, we stopped her and told her to bring her home, but my husband explained to her that no touchy, no smooch in this house, and end up - they were sleeping cuddling in the middle of the living room

DoctorZ :

Well the good news is that she is going out to college in NY and this relationship will most likely fizzle fast, but it will further her depression and low self-esteem

Customer:

It could been burnt out from high school and she turned to this internet chat thing for entertainment and ended up falling in love with this girl. Do most schools have school psychologist ?

DoctorZ :

All colleges have school psychologists and they usually have good counseling centers with multiple therapists to help your daughter. And the symptoms your daughter is expressing of low self-esteem and intimidation of the other sex is common that they see frequently

Customer:

I am not sure how much time you can devote to our chat, but there is a place where she post her stuff and in it there are alot of "hint" you might see

Customer:

http://felicia-vargas.deviantart.com/gallery/

Customer:

Instead of studying, she spend a good proportion of her time drawing

DoctorZ :

Sure, no I can stay on for as long as you need me. Give me a minute to read these chats.

Customer:

thanks

DoctorZ :

Well I do have to say your daughter is very talented with her drawings and poems.

DoctorZ :

I am reading the poem about her first time seeing a therapist

Customer:

thanks, XXXXX XXXXX certainly have some problems. We hate to see her going down this path..... the first time she saw the therapist, actually we have to meet her separately. In the first place, we think she is suffering from bipolar, she have a tendency to get very angry and would stabb thing like paper with a pen, she would draw an angry dog chewing on a person, etc. these pictures were drawn in a good mood

Customer:

Before we took her to the therapist, she said she will make the therapist miserable, she was playing games with everyone. Perhaps she want to be the center of attention trying to fight for that attention with her 6 year old brother

DoctorZ :

I think she is expressing symptoms of a disorder called Borderline Personality Disorder (BPD) here is a link describing it in more detail. But she is expressing mood changes, impassivity, and identity disturbances.

Customer:

One thing weird about her is, she can draw and listen in class at the same time, like multitasking. The psychologist we took her to and the psychiatrist don't seem to think she had problem. They said medicine won't help her

Customer:

that sounds like her

DoctorZ :

BPD is often mistake for Bipolar disorder, but Bipolar is typically longer periods of depression (months) and a short period of mania (5 days to 2 weeks). Your daughter's mood disturbances are going from depression, angry, to anxiety in a rapid fashion that is more associated with BPD

Customer:

you are right

DoctorZ :

Medication will help her, but the best type of therapy for this disorder is actually called Dialectical Behavioral Therapy (DBT). Here is a link of DBT self-help techniques, but usually DBT with a trained therapist is more beneficial.

DoctorZ :

The best medications for her symptoms would be a SSRI, SNRI, or a mood stabilizer.

Customer:

where are you practicing at ?

DoctorZ :

I practice in California, but my specialty is more with forensic evaluations for the state of California.

Customer:

where are you at in CA ?

Customer:

can you see patients ?

DoctorZ :

In Santa Clara, but I mostly do evaluations for the courts throughout Northern California

Customer:

can you see patients on the side ?

DoctorZ :

Unfortunately I do not see patients on a volunteer basis, most of my patients are ordered by the court to see me

DoctorZ :

Also this website does not allow the experts to share personal information either, so I would not be able to give you a phone number or address of my practice unfortunately

Customer:

any chance we can pay you on the side for a counel ? I think you can help my daughter out.

Customer:

can you call us ? XXX-XXX-XXXX

Customer:

we can pay you cash on the side

Customer:

we just need a short term help, or maybe if you know someone who can help

DoctorZ :

I am actually not allowed to call customers either, this is one of the website rules and I cannot ethically take cash on the side. But I can recommend a therapist in your area if you like

DoctorZ :

What city do you live in and I can search for therapists in your area

Customer:

san mateo

Customer:

that's too bad

Customer:

can we see you and then pay this website ?

DoctorZ :

Well like I said my practice is usually focused on forensic patients, individuals who have committed crimes, so all of my patients are ordered by the court to see me

DoctorZ :

This therapist is really good and in your area, I met her a few time and I found her very competent

DoctorZ :

This one is really good as well

DoctorZ :

I am also picking female therapists because I think your daughter will feel more comfortable with a female therapist as you mentioned she may be intimidated by males

Customer:

so what should we do in the meantime before we can get professional help ? Should we limit or take away her access on computer access, phones, texting, etc.. ?

Customer:

and lately she had been really in her own world playing video games, etc

Customer:

ignoring everyone in this house

DoctorZ :

Playing video games and in her own world is a form of isolation, also related to BPD

Customer:

so how successful are treatment with therapist and what's the timeline like ?

Customer:

so how should we treat her in the meantime ?

DoctorZ :

In the meantime before she can get professional help, try to make a compromise with her that she can still talk to this girl, but she cannot engage in any physical sexual activity because of the strong possibilities of legal action against her. If she does not agree to this, then you can take away her computer, phone, etc...

DoctorZ :

Well that DBT self help link should help you with some techniques to talk to her about in the mean time

DoctorZ :

DBT is very successful, but it does take an extended period of time for benefits to be seen because this disorder is ingrained in her personality, but it is a manageable disorder with this treatment

Customer:

but the psychologists cannot prescribe meds

DoctorZ :

No not in this state, they cannot prescribe medications. But her general physician or a psychiatrist can prescribe those medications that I mentioned earlier.

Customer:

are the meds pretty bad, meaning meds like prozac or ridadin ?

DoctorZ :

Prozac is a SSRI, but I would recommend Zoloft, Paxil, or Effexor for her to start with. Those medications usually have tolerable side effects and only very rare side effects that most likely will not occur in your daughter if she takes these medications

Customer:

have you seen cases like this in real life before, like this one, that actually end up one of the minor going to jail ?

Customer:

WOW, you are real good, so are you actually a psychologist or a psychiatrist ?

DoctorZ :

I have heard of cases like this, but actually California is more lenient regarding this. Now if you daughter was 18 and the other girl was still 15, then she could be prosecuted

Customer:

Can I have my daughter chat with you for a short while ?

DoctorZ :

I am actually a psychologist, I know a lot about medications because I have a post graduate degree in Psychopharmacology and can prescribe medications in New Mexico

DoctorZ :

Yes she can chat with me on her that is fine with me

Customer:

thanks for your help, she is here now, I will let you talk to her.

DoctorZ :

No problem, I am always happy to help

DoctorZ :

Hello there

Customer:

hi, I'm carol

Customer:

so you've been talking to my parents about my... problems?

DoctorZ :

Hi Carol, well yes I have been talking to your parents, but why dont you tell me your viewpoint on what is going on

Customer:

uhm, what would you like to know?

DoctorZ :

Well why dont you tell me about your relationship

Customer:

well... we met at an anime convention around late october last year, and we've been chatting since... probably december...

Customer:

I'm not sure what my parents have told you but from what I heard they're blowing it a bit out of proportion...

DoctorZ :

Nothing wrong with chatting and these days a lot of relationships start online

DoctorZ :

Well they have told me that the other girl is 15 years old and they are concerned about the legal recourse with this.

Customer:

I understand their concerns, and I've examined the laws...

Customer:

I'm not sure how to put this, but I don't think their concerns have any real... grounding I guess?

Customer:

I mean, I'm still 17 and not technically an adult...

DoctorZ :

That is true, and I mentioned that to them, but what happens when you are 18.

Customer:

I understand that at 18 our relationship will be illegal, and I'm... not fine with that but I can deal with it for a few years if it lasts that long...

DoctorZ :

So you are okay with putting the brakes on the relationship at 18?

Customer:

it seems like I have no other choice...

DoctorZ :

That is a very responsible decision. So can you tell me about this girl, why are you attracted to her?

DoctorZ :

Why is she special to you?

Customer:

well off the top of my head... she's very selfless and acts very kindly towards others without expecting much in return, despite what my mom thinks... and that's one of the things that drew me to her in the first place...

DoctorZ :

Those are good qualities to have in a partner. Can you understand why your mom is concerned though?

Customer:

yes, she supposedly wants me to be have a stable family in the future and to be happy, but I think that would be possible no matter my orientation or the partner I choose...

DoctorZ :

Well she actually told me that she does not care if you are a lesbian or not, she is mostly concerned with the younger than you part and the possibility of getting arrested at 18.

Customer:

... no offense but I think my mom is lying... from what she's screamed at me she cares an awful lot... although she does seem to be extremely concerned with the age difference as well

DoctorZ :

That is a possibility, but it seems like you both understand about the age difference and how that can cause problems for you when you turn 18, is that something you can both agree on?

Customer:

I thought we had already agreed on it

Customer:

well, nonverbally that is

DoctorZ :

That is good. So you parents really want you to go to therapy, but you seem against it, may I ask why?

Customer:

... I don't feel like it would help me any more than I can help myself, no offense intended...

Customer:

I've already developed coping mechanisms and talking things out with my friends has helped a lot

DoctorZ :

Well I cannot force you into therapy and neither can your parents, you have to choose therapy. I do think that therapy will benefit you and help you develop other coping mechanisms and sometimes it is nice talking to a neutral party about any issues that you may have.

DoctorZ :

Your parents did mention that you sometimes have mood swings ranging from depression to anger, do you believe that to be true?

Customer:

... sometimes I feel depressed, but it's not depression if that makes sense...

DoctorZ :

I am not saying it is depression necessarily, but depressive symptoms

Customer:

ah alright, and yes sometimes I do get very angry, but I always end up lashing out at my parents, and not my friends which is probably why they think I'm constantly angry...

DoctorZ :

Sometimes we lash out at family through indirectly because they are considered safe targets that will still love us no matter what we do or say

Customer:

that makes sense...

Customer:

wow I've read through your chat with mom and she really did blow some things out of proportion...

DoctorZ :

Well your mom is concerned and sometimes things can be blown out of proportion

DoctorZ :

That is what fear does and your mom is concerned about you

DoctorZ :

Do you think it is possible that your mother blew things out proportion because you do not open up and talk about any issues you may be having?

Customer:

I understand, but it is rather insulting when she acts as though I have no ability to make judgement and makes my girlfriend out to be some promiscuous sex crazed whore when she is anything but

Customer:

and possibly, but I prefer not to talk to her because she usually blows up and starts yelling at me...

Customer:

my dad's the go to guy for talking and I don't talk to him often either...

DoctorZ :

It sounds like you both may have benefited from family therapy to help your communication because it seems like when you open up to your mom she blows things out of proportion which frustrates you so you choose not open up to your mom and this further causes her to blow other things out of proportion because she does not understand what you are thinking, since you will not tell her...it is kind of a vicious circle.

Customer:

that sounds fairly accurate...

DoctorZ :

So I think both of you would better communicate if your compromised a bit. You could open up more to her and she would have to promise to listen and try to understand, so that she does not blow things out of proportion. It is something you both can talk about before you leave for college in NY and see how it works out talking when you are both long distance.

Customer:

that would be nice, especially since I can express myself better through writing than through talking...

DoctorZ :

Yeah and I think it can help you both improve the relationship, so when you come back for vacation you may have a more comfortable time talking with your mom and her with you.

Customer:

that really would be nice, especially since I was considering never coming home and staying at friends' houses during vacations to avoid her...

DoctorZ :

That would not be good for your relationship and your mother does care about you a lot, she just may not go about it the best way, but she does love you a lot and wants you to succeed in life.

Customer:

that's what everyone keeps telling me...

DoctorZ :

Well I would encourage your to try this compromise and not do anything impulsively

DoctorZ :

By the way this is what therapy is, it is just discussing and trying to come up with solutions to issues.

Customer:

we already tried a form of that compromise tonight and that was a bit of a disaster, but I'll give it another go...

Customer:

it's really different from the last therapy sessions I have...

Customer:

I actually want to become a psychologist when I grow up so this is very interesting for me

DoctorZ :

A good therapist is supposed to make the individual feel comfortable and just there to help that person with anything.

DoctorZ :

I think being a psychologist is a good profession and I am sure you would learn a lot from it.

Customer:

well then thank you for being a good therapist

DoctorZ :

Anytime, that is why I am here to help

Customer:

I like to talk to people about their problems and to try and figure out their root causes... I try to help my friends out a lot this way...

DoctorZ :

Well then when you get to college you can volunteer at the counseling center and learn how this profession works, you may find it very enlightening

Customer:

that's a wonderful idea, thanks for the suggestion!

DoctorZ :

No problem. Is there anything else you wanted to discuss with me?

Customer:

uhm, not that I can think of off the top of my head...

Customer:

would you like to talk with my mom again, or maybe my dad?

DoctorZ :

Well I will tell you what, now that you know about this website, if you ever needed someone to talk to in the future you can always contact me here. I am usually online most days.

DoctorZ :

You can put your mom back on if you like

Customer:

ah alright, thank you so much!

DoctorZ :

Anytime, and good luck starting college.

Customer:

I'm going to put my dad on now, my mom is currently indisposed...

Customer:

if that's alright with you

DoctorZ :

Sure no problem, that works for me

Customer:

Hi Dr, this is mom again

Customer:

dad wants me to type he said he is too slow

DoctorZ :

No worries, that is fine with me

Customer:

so what do u think ?

Customer:

prognosis ? and where should we go from here ?

DoctorZ :

I talked with your daughter and she seems like she understands the law pretty well and is willing to put the brakes on the relationship when she turns 18 as that is the law in California, but she seemed reluctant to do that but she knows that it is the law

DoctorZ :

I think your daughter would be more open to therapy after talking with me and getting a different perspective on what therapy is like, she also mentioned that she would like to study psychology in school and this can help her as well

DoctorZ :

One thing that I asked for her to do is to listen to your concerns more and to open up more with you as parents, but you have to agree to listen to her and as she says not to blow things out of proportion because that just pushes her away

DoctorZ :

Talking with her online I cannot come up with a diagnosis, but she agrees that she has some angry outbursts and depressive symptoms, so she may eventually seek help for that and I encouraged her to do so

Customer:

but i highly doubt that she will just put the brakes on when she turn 18, if she can't do it now, what makes us think she is logical enough to put the brakes on when she turn 18.

Customer:

So do you still think she have BPD ?

DoctorZ :

I cannot determine that from just talking with her online. I see those traits there from what you are telling me, but to be 100 percent sure I cannot say unless I did a full evaluation in person, but I do feel she would benefit from therapy

Customer:

What about holidays ? Do you think instead of flying her back to CA that we should go visit her in NY instead, say Thanksgiving, christmas ?

Customer:

meaning keeping her away from this girl

DoctorZ :

You are right she may not put the brakes on the relationship when she turns 18, but she knows the law and lets give her that choice to make. You have explained the law to the best of your ability for her, so she knows the consequences

Customer:

Do you have recommendation on who will be able to treat her in upstate NY, clinton, NY to be exact ?

DoctorZ :

I do not thinking keeping them away from each other will really stop them, since it seems like their relationship grew online, so physical connection is not a necessity for them

Customer:

wow

Customer:

like virtual reality

Customer:

scary

DoctorZ :

Well I recommended the counseling center of her college should provide her with enough therapeutic services to help her

Customer:

yeah, at least that's a good start

DoctorZ :

It is kind of like virtual reality, but I actually meant that your daughter feels she has a more emotional connection with her and that is why physical closeness is not necessary for her to express her feelings for this girl

DoctorZ :

I think your daughter is very open to therapy, but let her get there on her own. I also mentioned that she can always use this website to contact me to talk to as well

Customer:

from when we talked to her earlier, she would consider marry her, that's scary. I don't want to see my daughter marry someone from a different walk of life and end up nowhere.

Customer:

How do we contact you in the future ?

Customer:

hello you are back

DoctorZ :

Well in the future you can always go to this website and before your question you can say DoctorZ to make sure that the question is only intended for me to answer. Or you can go to my profile page and ask a question there too.

DoctorZ :

http://www.justanswer.com/mental-health/expert-doctorz/

Customer:

So do you think meds will help her ?

DoctorZ :

Well your daughter is also very young and the odds that she will marry this girl are not high, so I would not worry about that. That is too far in the future for you to worry about

DoctorZ :

Therapy will have a more lasting impact for her and will help her develop techniques to help her manage any symptoms. Medications can be used to for a more short term relief of symptoms. But I would recommend just encouraging therapy for your daughter at this point because she is still somewhat reluctant.

Customer:

so what's the difference between CBT, DBT and BPD ?

DoctorZ :

Well CBT and DBT are very similar, but DBT adds an element to help with emotion regulation and mindfullness that would benefit your daughter. So I think DBT would be more beneficial for your daughter at this point.

Customer:

and will the school psychologist counsel her on sexual orientation, or you think if they can take care of her other problems like BPD/DBT/CBT, is there any cure for sexual orientation, because we truly believe she is not born lesbian, she was converted into a lesbian, and when we accuse her of hanging with the lesbians, she denies that those are lesbians.

Customer:

in New York

Customer:

and how long does it take a person to go through a DBT therapy, and does it involve using SSRI ? And if New York don't counsel on sexual orientation, then it's not a full therapy.

DoctorZ :

I would not push the lesbian issue with your daughter and this can push her away farther from you and from any treatment. If she is not meant to be a lesbian and this is just a phase in her life, then the therapy will help her find her identity, which will include sexual orientation.

Customer:

Does Texas have more flexibility on sexual orientation counselling ?

DoctorZ :

DBT therapy can take as long as the individual still feels they are benefiting from the therapy. I have seen results in 3 months and I have seen patients take for years and still getting benefit out of it

Customer:

what's the approx. cure rate on DBT ?

DoctorZ :

So far I only know of California that has passed a law banning gay conversion therapy, but that law is on appeal. So Texas may be open to sexual orientation counseling, but I do not think this path will benefit your daughter and may push her father from you and possibly worsening and depressive feelings that she has

Customer:

so you think sending her to NY school is the best option for us ?

DoctorZ :

Well there is no cure for BPD, only successful management. I think 12 months of DBT is usually sufficient to see positive results that will last for a long time

DoctorZ :

I think if it is a good school with a quality education, then yes I think that will be a good option for her

Customer:

do you recommend ssri with her ?

Customer:

and how many days per week these DBT therapy session take and how many hours ?

DoctorZ :

I think I would start with therapy and see if she gets any benefits from that before starting with medication

DoctorZ :

Usually once a week for a 50-60 minute session is sufficient

Customer:

so what exactly does DBT treat and CBT treat ? Should I go and talk to the school psychologist about her to get to started or what should we do ?

DoctorZ :

DBT is more specialized for individuals with BPD, but can be used to treat disorder like PTSD, Bipolar Disorder, trauma, and depression as well. CBT has been used to treat Depression, Anxiety, Personality Disorders, Schizophrenia, Bipolar Disorder, Delusional Disorder, and Addictions. No I do not believe that you have to contact the counseling center at the school before hand but just encourage your daughter that therapy is always an option for her if she wants it

Customer:

but she is not going to go to therapy unless we drag her in there.

DoctorZ :

If you drag her in there she will just be resistant to therapy and not cooperate.

DoctorZ :

And the school cannot force her to go to therapy either

Customer:

did she sound like she is willing to try when you talked to her ?

DoctorZ :

Yes she did seem very open to it, but let her get there on her own. If he seeks out therapy on her own it will be more effective for her

DoctorZ :

*she

Customer:

what about phone/texting/computer in her dorm room ? I am planning to not take her PC to dorm, she can always use the PCs in the library, they have tonns of it there, and if it's not convenient for her to use the PC in the middle of the night doing chats then she will not do it, she is more of a "convenient" type of person

DoctorZ :

Well wont she need a computer to help her with her studies?

Customer:

she can always use her phone for internet access, but not easy to type on the tiny little screen. I am trying to make this more discouraging.

Customer:

the school is known to have tonns of computer all over campus

Customer:

she is going to take chem, calculus, german, art and psychology so I don't think she will need the computer much

Customer:

One question for you, do you need a very good graduating GPA to get into PhD program in psyc ?

DoctorZ :

Well that is up to both of you to talk about, I think this will hurt your relationship with her and she can always buy a cheap laptop somewhere

Customer:

she don't have money and no credit card

DoctorZ :

It depends on the PhD program. You have to have at least a 3.0 for most of them though

Customer:

I think she might like what you do......

DoctorZ :

She says she wants to be a psychologist and she seemed excited when I mentioned that she should volunteer at the counseling center.

Customer:

she is an over achiever at school, perhaps AP Biology burn her out and she turned to the wrong people. I told her to join clubs at school perhaps something fun like cooking and outing club where she can find other students that interests her.

Customer:

she graduated high school in 3 years

DoctorZ :

That is impressive, I am sure she will do well in college

Customer:

Her IQ is high, but EQ is lacking. She started off with separation anxiety when she was 3 going off to preschool and we had a psychologist helped her then.

Customer:

Last year, we went to Kaiser and as you saw on her poem that's a diaster.

DoctorZ :

I understand, the school counseling center will have more specialists that can probably relate to her better. I have not heard many good things from Kaiser therapists.

Customer:

agreed. Even their regular docs are not that good. My dad went to see his doc for severe back pain and they said it's just part of getting old. He went to Hong Kong, got MRI and found out that there is a growth inside, so he had it removed and now he is all better.

DoctorZ :

That is good that your father is better now

Customer:

OK, I better let you go, THANK YOU so much for your help, I think this is very helpful, I don't know how we can thank you enough. You are definitely a good therapist ! 10 star rating !!

DoctorZ :

Thank you very much, I am happy that I was able to help you and your daughter

DoctorZ :

If you have any other questions or concerns please feel free to contact me at anytime.

Customer:

Have a good evening, and we will definitely get a hold of you if we have any more questions.

DoctorZ :

Good luck and I wish your entire family the best

Customer:

Thanks again !!

DoctorZ :

Good night and have a great weekend

Customer:

Thank you and you too.

DoctorZ :

Oh and also when you finish rating me, this chat should be sent as a link to your email so you can always use it for future reference

Customer:

Thanks and have a great weekend.

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5416
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Dr. Z,


I found this therapist in New York, she is willing to travel to see my daughter at school, do you need someone with a PhD to counsel or someone with the training will the fine ?


Here is her info:


http://therapists.psychologytoday.com/rms/prof_detail.php?profid=155504&sid=1375659006.8138_28343&city=Rome&county=Oneida&state=NY&tr=ResultsName&trow=3&ttot=9

Expert:  Dr. Z replied 1 year ago.
No you do not need a doctorate to treat your daughter. I looked at the therapist's info, she has plenty of experience and has a specialty in DBT, I think she will work well with Carol. Good luck and I wish you all the best.
Customer: replied 1 year ago.

That's great, the therapist sounds very nice, and she had 2 kids 50 year olds, in trouble with the law before and one had mental illness so she said she fully understood the pain as a parent .......


And she said she got the training from the lady that invented DBT.


So does all the therapist on www.psychologytoday.com get verified before they can advertise ?


 

Expert:  Dr. Z replied 1 year ago.
All therapists on psychologytoday usually have a license verification to practice in their respective states, but the services that they advertise are usually not verified by anyone independent on that website. Still most therapists know what they can and cannot do, and it is unethical for them to advertise for services that they cannot perform adequately. If they do misrepresent themselves on advertisements then this is an ethical violation and they can be given a sanction, suspension, or even removal of their license to practice. So most therapists will not misrepresent themselves on the website.
Customer: replied 1 year ago.

I think BPD includes lack of self confidence, low self esteem, depressions and anxiety, does the symptom include issues with self-identity, meaning lack of sexual orientation ?


So why would an arrogant kid (she always say she is so smart, etc.) also have BPD ? That's kid of like bipolar as well.

Expert:  Dr. Z replied 1 year ago.
Bipolar Disorder typically has periods where the individual would feel depression for several months and then a period of mania or hypomania for 5 days to 2 weeks. Your daughter's reported symptoms fluctuate more frequently which is why I suggested BPD. Now there is a very rare form of Bipolar called Mixed State where the fluctuations can occur more rapidly, but so far I have not seen a patient with this type of Bipolar and it is extremely extremely rare. So yes individuals can display a form of arrogance because the individual is overcompensating from their low self-esteem.

BPD has identity disturbances where they do not feel comfortable with who they are and their self-image is unstable. Now identity disturbances can include sexual orientation or not, it depends on the individual. Therapy will help her manage these symptoms of BPD and her identity will be more stable then.
Customer: replied 1 year ago.

And from reading, there is a new form of treatment, Mentalization Behavioral Therapy (MBT), according to psyc today, this sparks a lot of studies, what's the difference between MBCT (mindfulness based treatment) and MBT or are they the same thing ? I only saw therapist with MBCT training and not MBT.


And how is MBT differ from DBT or is that similar ?


Thank you

Expert:  Dr. Z replied 1 year ago.
MBCT is a cognitive behavioral therapy that is better at treating individuals with Major Depressive Disorder. DBT uses core principles of MBCT in it's technique and uses other principles to better treat other disorders, including BPD.

MBT is a psychodynamic theory that is supposed to help treat individuals with BPD. Psychodynamic techniques do poorly in treating individuals with BPD as studies have shown, so that is why I do not recommend MBT for your daughter.
Customer: replied 1 year ago.

Will a psychologist/psychiatrist that's trained on DBT be more effective than a social worked who is trained on the same technique, or you think they are equally effective ?


 


Carol stayed up until 3am watching you tube last night, when school start, how do we limit her on her internet exposure when we are not around ?


 


It looked like none of her school psychologists mentioned training on DBT. So is it only the professionals who mention DBT technique knows how to treat with this technique ?

Expert:  Dr. Z replied 1 year ago.
A master's level therapist can be effective in treating with DBT. A psychologist just goes through extra schooling to get their doctorate and may be more effective with DBT therapy and may not be, it really depends on the individual therapist. I think the therapist that you chose has plenty of experience in this area and should be very effective in treating your daughter.

Teenagers frequently stay up late and play on the internet, even while going to college. She will learn that she cannot keep up that behavior if she has an early morning class and she will pace herself appropriately, but it will be a learning experience. College in itself is a learning experience because you are on your own for the first time. Successful college students successfully adapt to college life and can balance their studies and free time well. But it will take some time for your daughter to learn that balance, but she has to on her own if she wants to be a successful adult. Now if she cannot maintain this balance while at school and her grades start to fall, then there should be a remediation plan, but at this point give her a chance to adapt on her own, she sounds like she is a successful student, so I am sure she will do fine.

School psychologists typically do not always advertise DBT, but most have some experience with DBT as it is very effective for college students.
Customer: replied 1 year ago.

I just checked the credentials of the school psychologist, one dr has a PhD in clinical psy and another in PhD in counseling psyc.


Both are guys though. I think she might be more comfortable talking to a lady, and the dr. in clinical psyc is also a professor at the school, which may not be a good thing for her especially if she want to get a degree in psyc.


 


Bob Kazin, Ph.D.
Ohio State University (Counseling Psychology)

Areas of interest: men's issues, alcohol and other drug prevention and education, 'typical' situational and developmental challenges of college students, sexual identity concerns, family issues.





David Walden, Ph.D. (He also teaches)
Fielding Graduate University (Clinical Psychology)

Areas of interest: romantic relationships, childhood sexual abuse, identity issues, LGBTQ and gender identity concerns, becoming comfortable with emotions, concerns related to marginalization, oppression, and racial identity, and existential issues.


 


 


** Dr. Z,


So what undergrad education requirements you will need for grad school, say if she wants to get a PhD in clinical psyc ?


Her school's psyc program only have 9 courses and that's a BA degree in psyc, that seemed a little not enough knowledge for getting into a grad program.


Will she still need chem, physics and biology like premeds ?


 


Thanks




Expert:  Dr. Z replied 1 year ago.
Having a Bachelor's degree in psychology is not always mandatory to getting into grad school for psychology, some students have bachelor's degree in sociology or other areas. Every grad school is different and most do not require prerequisite in chemistry, physics, or biology. Most want at least some classes in psychology and basic statistics. Now some individuals go from a Bachelors degree to a Master's program then to a Doctorate and some go from Bachelor's degree to a Doctorate program. There is really no difference with these paths, except if you get a separate Master's degree you usually have more experience and do better in the doctoral program and usually have a better pick of internships, which are very competitive and are required for completion of a doctorate in psychology.

The two psychologists that you linked to most likely have a lot of experience, but I am sure they do a lot more supervising as well. Many new therapists that need hours for their license are probably under their supervision that provide most of the therapy for the entire student body, that is typically what happens at a college counseling center. And most likely there will be a number of female therapists there for her to choose from if she chooses to seek therapy there, but the private therapist you mentioned looks really good.
Customer: replied 1 year ago.

Thanks Dr. Z, I will rate you when I come back from dinner, so please reply to this and I can rate to finish when I am back.


Thanks so much and have a nice week !

Expert:  Dr. Z replied 1 year ago.
No worries, take your time and thank you for rating me positively. I am happy that I was able to help you. Have a great dinner.
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5416
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and other Mental Health Specialists are ready to help you
Customer: replied 9 months ago.

Dr Z,


Are you online ?

Expert:  Dr. Z replied 9 months ago.
Hello yes, I am online. How can I help you?
Customer: replied 9 months ago.

we just came back from 2 days session with McLean and you were right about Carol having BPD. Still have one more day of psyc testing on monday


the dr prescribed IC sertraline HCL 50mg for treating her depression, what do you think ?

Expert:  Dr. Z replied 9 months ago.
Sertraline is a SSRI antidepressant that is standard first line treatment for BPD and she is not on a high dose, so that is good start her off on a low dose of the medication. So hopefully this antidepressant will be effective for her, but it will take a few weeks for it too accumulate in her system and reach the maximum benefits of this medication. Hopefully she is doing the DBT therapy as well too?
Customer: replied 9 months ago.

The social worker that she had been working with for the past few months swore that she don't have BPD, however Carol said she felt she have BPD, or at least possessed 5 or more symptoms of BPD.

Anyways, we are moving to NJ and hopefully will be able to take her to a psychiatrist at least once a month to monitor her progress with the drug

The psychologist we met at McLean was pretty impressed with your diagnosis, she said she normally don't recommend an expert online, but she said she was impressed with your diagnosis.

Dr. Aguirre said he think Carol's prognosis is good, she should be symptom free if she gets on meds and do DBT for a year

But now the question is, who can administer this DBT program near Hamilton and truly belief that DBT works for Carol ?

Expert:  Dr. Z replied 9 months ago.
Well like I said I am very familiar with diagnostic criteria as a psychologist and I recognize the symptoms, that is why I thought BPD. I am glad that it was confirmed at McLean and that she is getting the right treatment. I would ask the treatment team for referrals near Hamilton that can provide DBT therapy for your daughter as they must know of someone near there hopefully. DBT was designed specifically for BPD originally and has been adapted over time to treat other disorders, but it is still considered the best therapeutic treatment for BPD at this time. I cannot say with 100 percent certainty that it will work for your daughter, but I think it is the best chance for Carol with this treatment protocol of DBT and Sertraline (Zoloft).
Customer: replied 9 months ago.

The problem is they don't know anyone there.


So does she need to work with the same person throughout the year, or can we work with one person near Hamilton during school year and in summer work with someone else locally in NJ ?

Expert:  Dr. Z replied 9 months ago.
Yeah I remembered we looked and did not find many people that specialized in DBT treatment near her college as well, which was unfortunate, so I was hopeful may be individuals from McLean would have access to therapists that are not listed possibly. Carol can see a therapist near Hamilton for the rest of the school year and then transfer to another therapist in summer near NJ, that is an option. I would only recommend that Carol sign a release to get the therapy notes delivered to her new therapist in NJ, so that there would a continuation of treatment and she would not have to start all over. In addition, Carol can also try Self-Help DBT treatment as well, which can be effective too.

http://www.amazon.com/Training-Treating-Borderline-Personality-Disorder/dp/0898620341/ref=sr_1_2?ie=UTF8&qid=1389399344&sr=8-2&keywords=dbt+workbook

http://www.amazon.com/Dialectical-Behavior-Therapy-Skills-Workbook/dp/1572245131/ref=sr_1_1?ie=UTF8&qid=1389399344&sr=8-1&keywords=dbt+workbook
Customer: replied 9 months ago.

Dr Aguirre actually suggested something like "distance support", like she can work with someone online or over the phone. What do you think ?


Maybe she can do the self help and also work with someone online ?


Do you know someone reputable that do DBT training support online ?

Expert:  Dr. Z replied 9 months ago.
That is not a bad idea, I do not know of anyone that provides DBT online or over the phone though because online therapy is very new still and also DBT is a very specialized therapy as well that requires extensive training. But I can look for her if you like, just give me till tonight to do a search and you can look as well, and if that does not work then I would be happy to provide DBT therapy through phone support as well as we can now offer additional services like that on this website.
Customer: replied 9 months ago.

That would be great if you don't mind taking on more task !


It's not easy to convince anyone that she needs help, even she tried to convince the social worker that she needs help.


She said she wants to live her life fully, not feeling sad everyday and don't even know why is very frustrating.


Dr. Aguirre understood how she felt, even the psychologist knew something is not right about her, but she is not convinced that meds will help her. I wanted to start her on meds right away since we are going to be with her for the next 10 days and so I can monitor her to make sure she is alright with the drug, and Dr A agreed.


So how can she reach you by phone or email and how do we pay you ?

Expert:  Dr. Z replied 9 months ago.
Well the system is still not perfect for additional services and we started this conversation before additional services was provided, but a button should show up for me and I can select it to provide for additional services and then afterwards I will give you my contact information to contact me and then we can set up an phone appointment with Carol to start the treatment next week at an hour that is convenient for both our schedules. So let me see if the additional service can be provided here, if not we may have to open a new chat. I will let you know. If it works though a screen will ask if you want to accept the additional service.
Expert:  Dr. Z replied 9 months ago.
It does not appear to be working, like I said the system is not perfect, so we may have to open a new chat where I can provide for the additional service for you
Customer: replied 9 months ago.

So how do I do that ? Seemed like when I start to ask a new question, they want me to talk to the other lady psychologist.


So unless I go back to our old chat session, I can't seem to find you.

Expert:  Dr. Z replied 9 months ago.
I believe that is just a glitch with the system software. If you go to this link directly and ask your question there and also put "For DoctorZ only" no one else should answer it, but me.

http://www.justanswer.com/mental-health/expert-doctorz/
Customer: replied 9 months ago.

Just tried, please see if you get it.

Expert:  Dr. Z replied 9 months ago.
Yep just got it, I will wait for you to reply in the chat so that I know you can see me

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