Question:
What type of Psych Evaluation is needed for clearance?

I'm preparing for WLS and need to have a psych eval clearance. I went to a psychiatrist yesterday and she said she normally likes to meet with clients at least 8 times before giving clearance. A friend said she went once for 90 minutes and received clearance. Is this possible and what do you suggest?    — franks310 (posted on July 4, 2008)


July 4, 2008
My surgeon requires at least one session with a PSYCHOLOGIST (although I don't really know the difference between psychiatrists and psychologists). I spent about 30-45 minutes speaking with him about life in general and how surgery is a life style change and not a quick fix. After our talk, he had me take two different "tests" that are used to help determine someones state of mind and personality traits/disorders.
   — JodieBlonde

July 4, 2008
See another psychiatrist just ONCE. Paying for a total of two visits is better than eight!
   — Toni Todd

July 4, 2008
One eval should be enough. I only had one visit, and the doc sent a fax to my surgeon. I bet you'll have extra fees to pay for 8 visits, so I'd try to find another psychaitrist eval that can be done in one visit. DAVE
   — Dave Chambers

July 4, 2008
Eight?! Sounds like a lucrative set-up for somebody. My surgeon only required one, and he's ranked as the best in the nation for WLS. My appointment took about 90 minutes, and frankly, the first 30 minutes were gone before the psychologist realized he was reading the wrong person's file! I still passed. I think they're just trying to determine if: a) you're doing the surgery because YOU want to, not because somebody else is pressuring you; b) that you're not suicidal and will be able to deal with the abrupt change in behavior and possible spots of depression that sometimes follows WLS; and c) you're committed to the program to make it work. I'd go somewhere else if I were you as eight appointments is unnecessary for the surgery, unless you really could benefit from the help in its own right.
   — suezahn4me

July 4, 2008
I only had to do one visit. I had 8 approved follow ups if I needed them after the surgery but only one before. I would find another psychiatrist. Good luck.
   — Kelly W.

July 4, 2008
Frank - In January I started to prepare for WLS and had 1 psych eval. I filled out an extensive evaluation before my first appointment. I would suggest checking with your surgeon to see if they have a list of therapist they can recommend. That is where I found my therapist. She did my psych eval and I now see her on regular basis. Best of luck!
   — MOM2ADAM

July 4, 2008
i waited longer in the psyche doctors office to see him than i did actually talking to him. It depends on the doctor but if it was me, i would check out another doctor. There really is no reason that you need to go 8 times unless that is what your insurance wants.
   — jan0859

July 4, 2008
I did my eval last week. It wasn't that bad. We talked for about 30 minutes, then I took a 300 question test. It was easy just silly questions like have you ever thought about suicide. I would answer no. Then about 10 questions later they would ask have you decided what your gonna write in your suicide letter.(well no, since I've never considered suicide. They are trying to slip you up. But it was a breeze.
   — pugsley101

July 4, 2008
I when once for 4 hours, took a test and then discussed the results or the things they found out about me. They suggested that I focus on the support groups, and they sent the report to my doctor. I paid $500.00 for that visit. That was the only one until I went back for depression following surgery. They chaged $125.00 that time to my insurance and I paid $40.00 and they gave me a perscription for 1/2 lexapro a day for 6 months. Hope this helps, best of success to you.
   — William (Bill) wmil

July 4, 2008
Neither my PCP nor my surgeon required a psych eval. for which i was very thankful. Every doc is different. You may want to challenge the need for this eval. laura
   — waterlover

July 4, 2008
The person u went to is a scam everyone i went once maybe twice but 8 they just want your money go elsewhere .
   — phatkatz

July 4, 2008
What matters is what your insurance company requires, and I doubt it's 8. Check with them, sounds like a money-making scheme to me... I had to go only once, for about 20 minutes.
   — Gina S.

July 4, 2008
One appointment for about 1/2 hour and answer all the question with much honesty. It will make your recovery go along much better. Best of luck in your healthier life.
   — usfour

July 4, 2008
Both my mom and I only went once and that was to two different providers and year apart. I would call around and get someone else. Good luck.
   — hannahsmom1014

July 4, 2008
I agree with everyone who says you need to find a different psychologist. Just make sure that you know what is required by your insurance AND your surgeon, because they might have different requirements. My surgeon and my insurance only required one session, and my insurance paid for half of it. The psychologist I saw recommended additional pre- and post-op counseling for me, but cleared me for surgery. I have since begun to see a therapist on my own, but moreso to deal with other issues in my life. And it just so happens that my therapist does WLS evaluations! Odd but happy coincidence! So if issues should arise regarding my surgery and the subsequent changes in my life, I have a therapist who already knows how to deal with it. That is very comforting to me.
   — lauren_marie

July 4, 2008
I only went twice, First time to do the 300 question elevation and the next time to talk with the Dr.. I would Run if i were you....Just wants more money I am sure..
   — Hlfpint40

July 4, 2008
I went once for 15 minutes and was cleared I think the psyc is taking you through the cleaners
   — humper

July 4, 2008
That is just over kill.No wonder our ins co will not pay.
   — stanwalker

July 4, 2008
I had one visit for 90 minutes before surgery. Eight visits seems kind of much and expensive too! Best of luck
   — Lynnmon

July 5, 2008
Frank, I would discuss this with your psych person you spoke to, and tell them that you would be glad to visit with them 8 times, but want your clearance now unless they have reason to suspect that you might not get their support. If there is valid reason for the delay, then just submit to it, and deal with the issues that trouble them, but if you have support and doing what you are supposed to, etc., then challenge their process as unreasonible compared to others, and let them know you will "jump through their hoops" to prove you are stable and ready for the surgery, but want your clearance now so you can move on to the other issues you have to clear before surgery. Then, keep your word, go to every visit, and get some real help perhaps to use as you face the surgery. Counseling is a vital aspect of wls. Many people skip support group and skip support, and they fail miserably after surgery. Grab all the support you can get, and listen closely, it helps. Take care. Patricia P.
   — Patricia P

July 5, 2008
Hey Frank Are you using one you selected or are you using the one suggested by the surgeon. Most surgeons have a list that they do business with and it's usually a one time visit and you take a psych-evaluation test. My visit was once for almost 2 hours. I believe I spent 45-60 minutes with her and then she had me complete 2 psych evaluation tests.
   — the7thdean

July 5, 2008
Here is a question that came in the same posting as yours. ===== *Subject: Can't quit eating* I am on the 6 month diet that my insurance requires. I can't quit eating. Its like I know in a few months I will never get to eat again and I am freaking out, I just eat and eat, what can I do. I'm suppose to go back to Dr. next week and I ain't lost a pound. ===== How would YOU like to be in THAT fix AFTER surgery? The purpose of a psych evaluation is to determine whether you will have a high (or low) probability of success with weight loss AFTER surgery. In my humble opinion, an adequate evaluation can NOT be made with just one or two trips to a psychologist or psychiatrist. What is the point of going through the expense, risk, and pain of major surgery if you have a high probability of getting back into the "Can't quit eating" state even before your scars have fully healed? Believe me, THIS HAPPENS! All you have to do is read the sad stories of people who post to this OH site. My advice to you is that the time and money you will spend for eight visits to a competent, impartial psychologist is well worth the price.
   — [Deactivated Member]

July 5, 2008
Here is a question from someone else who posted in the same message that contained your question: ===== Subject: I don't know where to start. I had RNY 6 years ago. I had lost about 110 lbs and have since gained back about 65 lbs. My surgeon no longer deals with this surgery. Should I try to get a revision? ===== Do YOU want to find yourself in thay AFTER surgery? The purpose of the psych evaluation is to determine the probability of long term success AFTER surgery. Please do NOT opt for the 1-visit psych evaluation. In my opinion, it's worse than worthless and it's a SHAM!
   — [Deactivated Member]

July 5, 2008
Melissa had 1 required visit with the Psychologist and that was it. The idea of eight visits to a psychiatrist is very quesionale, but may be wat your doctor requires, check with the first 8 visits can be very very costly. As fo clarification on the Psychologist vs. Psychiatrist issue. Best of luck
   — Ira Sansolo

July 6, 2008
What I've learned from talking to other WL patients and my own experience, is there is about as much diversity with psych evals as there is with the pre-op diets. It seems no two surgeons or no two psychologists are the same on what they recomend. There is no correct answer. If your doctor has someone else he will approve for you to see, then you may go that route. Maybe you'll be cleared after the first visit.
   — corky1057

July 7, 2008
8 visits PRIOR to surgery and/or approval? I agree that we do need to focus on the emotional aspects of obesity and have to do the emotional work every day for the rest of our lives. One of the many reasons I became a Certified Bariatric Life Coach and a Certified Life Coach. Seeing someone in the psych department or a life coach is not a bad thing to do in the long run, but you really should only need 1 visit for the approval. Mine took about 15 minutes, my surgeon wanted to know 2 things from the psyciatrist- (1) do I have an actual eating disorder? (2) do I have any psychiatric diseases? I actually saw an LMHC. One visit really is the norm, NOT the exception. Good luck to you, Dawn Vickers, RN, BLC, CLC
   — DawnVic

July 7, 2008
I sas my psych two weeks ago. I sat with him for an hour talking about many different things then I was sent to another room to take an 800 true/false question test. Last Monday I went back for the results of my test. I was told that I passed, and although I didnt need any further counseling, I did need to have my anti-depressant jacked up some. He also told me that he will back my surgery 150%. Are you a depressed person to begin with? If so, I could see having to go more than once. I was real scared that I would have to go more prior to surgery, but was told only to increase my meds and if I needed to speak with someone, I could do so at any time either prior to or after surgery. It surely wont hurt you. I have a lot of anxiety and fear over this surgery, because I absolutely need it, not just because I am a few pounds overweight. So talking to someone would do me a great amount of good if I need it. I was offered it, but not a mandatory thing. Your doc maybe feels that you need more counseling. Could that be the case? Dont know if any of this helps you out or not, it is only my perspective of what I just went through during the last two weeks of my appointments. Best of luck to you! :)
   — bicngillette

July 8, 2008
At the Bariatric Center (a Center of Excellence) that I went thru, the pysch evaluation is part of the entire process, and they have a pysch on staff. There was only one very short appointment with him - and no co-pay. If you aren't having your surgery thru a Center of Excellence, I would find one nearby and switch to that.
   — Monte57




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