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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4421
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I recently fired an APRN who was my prescriber because 1) she

Resolved Question:

I recently fired an APRN who was my prescriber because 1) she had been bilking my insurance company, and the more I learn about it, the more I find it's bordering on fraud; 2) She threatened me that if I didn't go to a certain doctor for DBT (who wasn't on my insurance and was very expensive), she'd discharge me; and 3) She told me that I should stop paying my mortgage in order to pay for DBT. Her exact words were: "DBT over Mortgage! Get your priorities straight!"

I am in the middle of an ugly custody battle. She knows that. I asked for a copy of my medical records and she sent me a 5-page document riddled with errors, and ending with the final dx of Borderline Personality Disorder. She had NEVER mentioned this to me before. I asked for documentation or evidence that led her to that dx and she said, "I don't need evidence; it's my impression. That's all that counts."

Is this correct? She also says she keeps separate personal notes that she shares with no one. She will not tell me when she arrived at this dx. I have a feeling it's retaliatory because I fired her. I sent her a termination letter expressing that I thought her advice to go into foreclosure (she said, "It takes about a year before they actually take your house away. You can wait.") was irresponsible and would cause me more long-lasting problems in the long run.

Is she correct that she can keep personal notes that can't even be subpoenaed? Can she make this dx based only on her "impressions"? She refuses to tell me which criteria I meet. Thanks.
Submitted: 10 months ago.
Category: Mental Health
Expert:  Dr. Z replied 10 months ago.

Dr. Z. :

Hello I believe I can help you with your concern

Dr. Z. :

I am so sorry that you had this trouble with your APRN, I can imagine how this must have distressed you

Customer:

Yeah, in rather a big way!

Dr. Z. :

To diagnosis someone, a mental health professional should never rely just on "impressions," they should make the diagnosis based on the criteria of the diagnosis itself

Dr. Z. :

And these are the criteria for BPD

Dr. Z. :

Also it is very unethical for her not to go over the criteria with you and just plain wrong to tell you to mortgage your house to get therapy that can be expensive.

Customer:

Okay, so I looked up BPD and apparently I must meet 5 of the criteria. She said she's using DSM-5. Do you have those criteria?

Dr. Z. :

They are the same the criteria for the DSM-5. It did not change.

Customer:

Yeah, she actually said to STOP paying my mortgage!

Customer:

Oh, okay. No change in the criteria... thanks!

Customer:

Well then I have NO idea how she's coming to this dx.

Customer:

But it's going to damage me in Court.

Dr. Z. :

Let me look to be positive, but I worked on the personality disorder section for a DSM-5 committee and I remember there was no change

Customer:

Okay, thanks....

Dr. Z. :

While Dialectical Behavioral Treatment (DBT) is the best therapy modality for BPD. You can also use DBT self-help techniques for treatment if you cannot see a therapist.

Customer:

I have been told it's just plain good for everybody.

Customer:

But I can't afford the $300/week up front and wait 4-6 weeks for my insurance to reimburse me.

Customer:

I was laid off in April and am on Unemployment.

Dr. Z. :

I just compared the criteria from the DSM-5 manual to the link I gave and there are no differences at all

Dr. Z. :

This is why I can give you some books and websites where you can use DBT techniques

Customer:

Thank you so much. I am going to email her now and ask her to justify her dx.

Customer:

Yeah, that would be great!

Dr. Z. :

Sure give me a second to send you the links

Dr. Z. :

That website has a breadth of materials on DBT and it is free

Customer:

Great!

Dr. Z. :

The books also use step-by-step guides to teach you DBT

Customer:

Free is good for me right now!

Dr. Z. :

This is a lot cheaper than therapy for you

Customer:

Indeed!

Dr. Z. :

Is there anything else I can assist you with today?

Customer:

Thanks so much for your help!

Customer:

I'm all set!

Dr. Z. :

Anytime, I am always happy to help. I hope that everything works out well for you. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime

Customer:

Okay, I will! Thank you again!

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4421
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and 2 other Mental Health Specialists are ready to help you

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