Question:
What needs to be said at a psch evaluation?

My insurance requires me to get a psyh clearance. I went to a doctor today and denied clearance, because he felt I was a little depressed. Da! No kidding! He said i needed a few months of therapy with him and maybe he will clear me then. I was devastated. Sure I am depressed, I weigh 300lbs. I have another appointment with someone else and need to know the right words to say so I can pass this time. I was honest about my depression which is all based on my weight. Please help    — Laurie L. (posted on October 24, 2001)

October 23, 2001
Check this link:<br> http://www.adoctorinyourhouse.com/morbid_obesity/weight_loss_surgery/psychology/main_psychology.html <br> There's a LOT of information on what the psychologist is looking for there. If the link doesn't work try just going through the links at:<br> http://www.spotlighthealth.com/home.html <br> Go through Morbid Obesity / Weight Loss Surgery / Psychology <br> I am sorry you had the first experience with the Psychologist. If he wasn't referred by your surgeon, I would try one that is. The more WLS friendly a psychologist is, the better off your chances are. <br>Good luck in your journey,
   — Elizabeth D.

October 24, 2001
Thank you Elizebeth for your response. I will check it out. I just wanted to say that I AM depressed, and that is normal, right? This was suppose to be a psych clearance, he didn't ask me anything about how I am prepared for this surgery, or really anything concerning the surgery, he just focused on what makes me upset. Wasn't he supoose to ask me how I am prepared or something? Right away he said he didnt know me well enough to clear me, and that I needed several months of therapy with him because I am depressed. I felt he just wanted me as a patient to make money off of. He should of told me on the phone that he wasn't going to clear me, that I needed to see him for several months. I am very afraid of my next psych doctor. Am I suppose to act happy? Oh, this other doctor also said that he wanted me go on Welbutin, which I have already been on. I have tried all depression medication. Therapy and meds are not going to get me up the stairs, or go for walk, or play with my daughter. I am sorry for venting, but i am so upset that this guy didn't clear me. I am hoping the next one will go okay. Is my depression about my weight keeping me from this surgery, or is this paychiatrist just full or crap?
   — Laurie L.

October 24, 2001
As I've said many times in the past, shirnks (most of them) are only in it for the money. They string you along and it's a great money game for them. I had to go through all that crap 15 years ago to get approval for some other non WLS surgeries. I have learned never to be honest. It only hurts you and gives them more money. I'm glad most people on this site have had good experiences with shrinks, but "anything you say can and will be used against you". I majored in physchology (for awhile) in college although I did'nt want to pursue it. I've finally took what I learned and tell them what "they want to hear". They make mountains out of mole hills. I don't like the dishonesty but you will pay for honesty by years of wasted time and money. Unfortunaltly it sounds you are going to go through it too. Hope it can change for you.
   — Danmark

October 24, 2001
Hi Laurie, I think each therapist might have their own way of evaluating people. When I went, I had to sit in a room and answer about 300 multiple choice questions. When it came to questions regarding depression or abuse etc....I made sure I picked the answer carefully. Afterwards I was taken into the therapists' office and he spoke with me for about 10 mins. That was that. What you might want to do since "time is of the essence" is go to the "find peers" page of this site and find someone in or near your town and email them to see what therapist they used or could recommend. If your surgery is in 2 weeks I suggest you hustle. Good Luck!!
   — Kim B.

October 24, 2001
I think the key is just being honest and don't rattle on. I was lucky to have a really nice lady (prob in her late 40s to do mine.) She was so pleasant. Mostly (she told me herself) they are looking for people with eating disorders. You know, the ones that make themselves sick, bulimic, or other types,and of course your mental well being. (Your attitude) I have to say the lady I spoke with was nice and fun. Jacki (45 min session or so)
   — Jackiis

October 25, 2001
Amen anonymous!
   — Danmark

October 25, 2001
If you really want the surgery tell them what they want to hear ...and only that. Don't let them think that you are depressed and don't let tbem think that you have any doubts. The purpose of the psych consult is to ensure the insurer that you understand wls, that you have realistic expectations, that you understand the need for lifestyle/diet changes, that you can and will comply with those changes, that you will comply with lifelong medical follow-up, that you do not have any psych conditions that will interfere with wls protocols (...like depression...). No matter how you really feel....be positive, upbeat, confident and let them know that you have REALISTIC goals and expectations. Don't forget this psych reviewer works for the INSURER. His/her job is to find reason to DENY surgery and depression is the one they look for.
   — [Anonymous]

October 25, 2001
I had a negative experience with the psychologist also. I felt that the bottom line was - - are you seriously depressed? - do you have realistic expectations? - do you understand the surgery? - will you comply? So go in to a doctor's office with all of your homework done, your self-confident attitude, your emphatic belief that the surgery is what you want and preparation to make radical lifestyle changes. Your surgeon should be able to refer you to psychologists who support obesity clients and WLS patients. Getting one of two types of counselors is critical. Either: - one who just wants to push you through the process and doesn't really care, or - one who does support you and care, but recognizes that obesity itself is a major cause of depression and just wants to ensure you are prepared. Good Luck!
   — Lorri S.

October 27, 2001
Well, I went to the second doctor today, and he is clearing me for surgery!! What a nice guy, he was so understanding and easyy to talk to! Thank you everyone for all your advice. Best luck to you all, thanks again! I am now waiting for my big day on Nov. 8th. Can't wait!
   — Laurie L.

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