What to expect from your psych eval

I was wondering if anyone can tell me what to expect from the psych evaluation? Why do some get approved and others need more counseling?

It all depends on you and what the Pysch gets from you. Before I seen the Psych there was I hate to say test,,,(forget what it is called over 500 questions) and showed I had a wee bit of anexity disorder and showed mild depression! I said being overweight cant move who wouldnt be depressed,,But didnt stop me from getting his ok,for the surgery. Its to show Dr's and insurace companies you are really ready for the surgery, Trust me its a life changing and they want to make sure your ready.

The purpose of the psychological consultation (IMHO) is to ensure that there is no severe psychological issue that would compromise your chances for success on the program, and to ensure you'll have adequate personalized support as you begin your post-operative life. This psychological service is an important and required portion of many weight loss surgery programs.

HI! I can tell you what *I* look for in a psych eval. I happen to be a psych nurse practitioner who does them (several hundred now)..(also a 6 yr postop wlser!) I see people 1-1 1/2 hrs...BUT your mileage may vary as with anything. I have heard of the 15 min eval where a provider says yup you are ok, and others *****quire the MMPI psychological testing and yet others who use a standard 3 session etc. No right or wrong I suppose. For me the proper use of psychology postop is a key in long-term success. Those who embrace this part of the journey may do better and IMHO maintain if they work on any preexisting issues ESPECIALLY emotional eating!

This is what I look at based on my experience and review of the literature.
Possible Exclusion Criteria:
1. Current drug & alcohol dependence/abuse (needs to be in remission 1 year).
2. Untreated and/or unstable mental illnesses: Depression, Bipolar disorder, Anxiety disorder, severe personality disorders or Thought disorders, need to be in treatment with minimal symptoms.
3. A history of near lethal or repetitive suicide attempts may require further evaluation.
4. Current eating disorders: anorexia, bulimia, severe compulsive/binge eating with no ability to control intake. (*If a history may necessitate further eval and intervention)
5. Noncompliance issues & concerns (unwillingness to diet, exercise, or follow treatment recommendations).
6. Inability to give informed consent for treatment.
7. Inability to make lifestyle changes (ex. financially, psychosocially).
8. Unwillingness to follow post-surgical care.
9. Unrealistic surgical expectations, ambivalence about surgery or impulsiveness in decision-making regarding surgery.
10. Inadequate family supports or family hostility toward surgery. *does not disqualify but the need to explore this and develop coping strategies is imperative.
11. Presence of unresolved severe situational stress that may interfere with patient's success/compliance: current divorce, job stress, financial issues or family issues. May require some work and time to be best prepared.

I also discuss:
diet history, eating issues & insight into...Knowledge of surgery, risks, complications, outcomes..lifestyle needed for f/up etc! 2 OH links to see:

http://www.obesityhelp.com/morbidobesity/information/wlsjourney/your+psychiatrist.php
http://www.obesityhelp.com/morbidobesity/information/wlsjourney/getting+authorization.php


More counseling is something I feel everyone can utilize, we all can do personal growth work..the more you do preop chances are the smoother the journey!

My psych eval lasted over an hour. The psychologist was very rude and condescending. He would say things such as, " How hard is it to peel a banana?" or '"Why don't you just stay on weigh****chers forever?"
I found it best to keep my answers with him short and sweet due to his nature.

He has had problems with many other patients in my area. He has even gone so far as to hang up on them. One patient's mom went in to pick up her evalu for her due to her being physically unable to walk that far. He accused her mom of lying to try to get her report and yelling at her even after she had called ahead to explain the situation.

I'm sure there are many qualified people conducting these evals. Unfortuantely this one is not!

We can only share our individual experiences and mention that YOUR MILEAGE MAY VARY. Thank you for your experience even if it was not what I would envision as helpful. Reality is not always that sadly.

Thank you so much for the info. I was asking because I've had issues with "stress eating" or "emotional eating" in the past and probably still now. But now I recognize my triggers and confront them instead of "swallowing" them. I have lost 36 lbs since May and still going.

I have a counselor who has helped me realize how my abusive past relationship and childhood has shaped my thinking and my eating.  I know I was building an unhealthy wall around me for protection, and I didn't even think about it until I was 100 lbs over weight.

But I have come far in this journey. I am in college for environmentalism and I want to be healthy, not only for my husband and kids, but to do the dream career I always wanted.

I am ready for this surgery, but I'm just concerned that because of my emotional connection with food in the past would effect my "okay" for this surgery. I cant say that I'm completely cured of this disease, but I know how to handle those stressful days better. I can be the first to admit that i am an (food) addict and have been for many years and I'm sick and tired of being sick and tired.

Sounds like you are in a good place and have done much work. As you stte there is always work to be done. Those with childhood trauma can have a more difficult time emotionally (per literature) and well in my anecdotal experience, but it id not a reason to postpone only to stay connected in treatment!

They will typically ask you the same question in different way too see if you are consistent with your answers, they also want to know what are your triggers for food and eating if you are honest and have a firm grip on your situation you should be fine, if you still have unresolved issues you might need some additional visits

My Psych eval first consisted of answering a bunch of questions...it was pretty obvious some of the questions to see if you were crazy.    I recall a question "Do you hear voices  when you are alone?"  LOL...

After that the psychiatrist asked me a bunch of questions like why i wanted the surgery what i can expect from it etc.  Just be honest and you have nothing to worry about