<p>missypie,
Any reputable professional will know you can not ‘cure’ Aspergers. You can integrate coping skills and behavior modification such as you mention. With Aspergergs you treat the symptoms, and there is a very broad spectrum.
You know that, and a professional will too.
Have you tried contacting your local children’s hospital to see if they have a specialist who deals with adolescents with autism? There is sometimes debate weather aspergers falls under the autistic spectrum, however a specialist with knowledge of autism would have certainly had experience with aspergers. They may be able to refer you to someone who can work on very specific goals and life skills with your son.</p>
<p>
</p>
<p>I think you need to be included in the sessions. That’s the best way to know if the therapist is understanding the situation and making worthwhile suggestions. I bet your son would be fine with it. If not, split up the hour. Give him the first 15 minutes to be alone with the therapist.</p>
<p>I totally know which therapist I want to use…it’s just the paying for it that’s the issue. If I use her, after we’ve spent $10,000 in a year, insurance will pay for $41 per visit. When we get to the less expensive options, they have no experience with Asperger’s, or if they have experience, it is with small children. Finding someone with experience with college students with Aspergers who is accepting new patients is like finding a unicorn. So I guess I’ve found the unicorn…I just have to be willing to pay the price.</p>
<p>missypie- how about starting out with the therapist but for a limited amount of time and hiring a different less expensive person to handle some of the “mom” items.
I spoke with a Mom of HS senior. I am not sure of his diagnosis but I assume he has Aspergers based on his behaviors. I know he has executive function issues and ADD. He has an expensive therapist but the Mom recently hired someone to help with life skills and independent living skills. She advertised and ended up hiring a grad student who has experience teaching independent living skills. The first thing they did was buy a calendar and mark off some due dates. She has shown him how to use a bus schedule and figure out how much time he needs to get from home to bus stop and how long a trip and what time his community college classes start. They calendar and set an alarm on cell phone as to what time he needs to leave home. She has him taking two classes at the Community college to see how he handles the workload. She did say that one of the professors has online quizes and HW and assignments are not announced but all online. The mom has also given him a debit card and they are working on managing money. Keeping track of spending. They are also working on cooking skills and grocery shopping and healthy eating. Also she said she has turned over med management to her son. With the help of the helper he is supposed to reorder with Dr, go pick up meds at pharmacy and also take them daily. The mom said how he does with all if this will be a determining factor as to whether he goes away for college. In this case the mom came up with the “program”. The goal is for her son with the help of this coach to begin to take on some of the things his mom has been handling for him. She figures she is saving a lot of money not paying the therapist to work on life skill issues.</p>
<p>Mom60, what you are describing is what I am by necessity doing…myself. Finding an executive function coach is like finding the second unicorn. The going rate is $80 per hour. I’ve found one coach about 25 miles to the west of us and another about 25 miles to the east of us, and the idea of Son driving to see either in heavy city traffic seems like a nightmare. I’ve had a few people say, “I’ve never done it, but I’m willing to try.” Well, if that’s the deal, I want to pay them $30 an hour, not $80!</p>
<p>Missypie- I don’t know this mom well but via some other people I know she is paying $20. She did not want to pay the $80 on top of what she is already spending for the therapist. Obviously the person is not “trained” as a coach.
I know someone who works as a “behavioral coach” and I think she charges $80.</p>
<p>[url=<a href=“http://education.ucsb.edu/autism/aspergers/index.html]broad-center[/url”>http://education.ucsb.edu/autism/aspergers/index.html]broad-center[/url</a>]
Missypie- our local UC has a research center for autism and aspergers. I put the above link. Not sure if they will have anything of interest for you but thought I would put it out there.</p>
<p>
</p>
<p>Are the presenting issues improving? Are you feeling better? Are you noticing a decrease in symptoms? Are you making better choices? Have you started to figure out how you were contributing to whatever the presenting problems were and have you gained some insight and some skills to do things differently? If there are large issues that were unattended in your life and that have colored your life for years, are they being addressed and do you think you are getting a a handle on them or feeling hopeful that you will be able to with time and work? Are you gaining new skills where you may need them? Are people noticing a change? You should be able to answer those questions if you are the one in therapy and some of those questions if someone close to you is in therapy.</p>
<p>That sounds great! I’ve emailed faculty at sevearl Texas U’s that I’ve heard have received grants to study various aspect of folks on the autism spectrum. Most don’t want to have anything to do with real people facing real problems. The interest of most is purely academic. One state school has this pretty well publicized autism transition program…transititioning high school students to the work place. The pix on the web site show a lot of kids in hair nets. They’re all about helping the non-college bound but have no program for their own college students who may be on the spectrum</p>
<p>I am thinking along the lines of mom60, to find out if there is a research center near you which is actively engaged in autism/Aspie research. Yale, for example, has a wonderful center, and several of their leading researchers offer seminars in various locations. There are also Aspie support groups in many major cities; the group leaders would be able to offer suggestions for individual therapists. McLean’s outside Boston offers such groups.
If the therapists in your area are charging $200 an hour, you must be living in an urban area.</p>
<p>I am also wondering if it would be cost effective to lower your deductible. In my area, only those with BC/BS chose a deductible that must be met before visits are covered. Aetna, UHC, and UBH pay most of therapy costs from start of calendar year, provided you use a network psychologist.</p>
<p>Another suggestion is to look at the APA website for psychologists in your area. The background info would include areas of specialty and training.</p>
<p>Most people use insurance to pay for therapy. If you have too large a deductible and/or copay, it’s time to change your insurance and consider paying a larger premium up front.</p>
<p>I’m a marriage and family therapist in private practice. I’ll throw out a few thoughts on how to find the “right” therapist and how to find an affordable one. First off, don’t get too hung up on the license. People who are licensed to practice psychotherapy – in my state that is currently psychiatrists, psychologists, LCSWs and MFTs – are all well trained to practice psychotherapy. Their academic programs will have a different emphasis but the real training is the thousands of hours of supervised experience before licensure and that varies. For example, you can be an MFT who was supervised by an LCSW or a psychologist. You can train in a medical setting or a private practice. You might do most of your training with addiction issues or with something else. </p>
<p>Psychiatrists are MDs and where I live they almost all do solely or mostly psychopharmacology and the demand exceeds the supply. Many psychiatrists around here are not taking new patients and it’s a problem. Psychopharmacology is more lucrative than doing psychotherapy and most psychiatrists in my area outsource the psychotherapy. There are some who practice psychotherapy and probably in other areas that’s more common, but you will pay more. Good therapists know when to refer out for a psychiatric evaluation and/or psychopharmacology and have psychiatrists they work with and refer to. </p>
<p>Almost all therapists will spend some time on the phone with a prospective client. It is in their best interest as well as yours. You should give them enough information so that they can get a feel for what you need and honestly tell you whether they are experienced in what you need. Ask them how much experience they have with your issues. I will honestly tell people if I don’t think I’m the best person for them. There are certain things I don’t routinely work with that other people do. I will refer when appropriate. I can also assure someone when I am the right person in terms of expertise. Feel free to ask what you can expect. Will there be homework? How often will sessions be? How will you know it’s working? Pay attention to how you feel in the conversation. Does this person feel like a good fit? Do you like them? Do you feel comfortable? Do you feel that this person gets you and do you feel a sense of confidence that he or she can help?</p>
<p>Ask if they have a website. In this day and age, many therapists do and you can learn a lot about a therapist from their website. My website is very comprehensive and includes links to forms I use (such as my policies and procedures), a parenting corner with articles I’ve written on parenting, an About Me section, services provided, rates, links to free resources, and a lot of other information. Hopefully, it helps people make a decision. It’s one way to tell one therapist from another. Usually they will have their rates, insurance panels, policies on sliding fees, etc. there. Which leads us to…</p>
<p>Finding an affordable therapist. First, there is insurance – some are on panels and some aren’t or aren’t on your particular panel. Some therapists (and some psychiatrists) choose to not be on insurance panels feeling they are underpaid for their services and that they have to do more paperwork. You need to find out what your plan covers. Don’t ask if they cover counseling. Ask if they cover outpatient mental health services. Be informed about what they will and won’t cover and ask about parity diagnosis. In some states a parity diagnosis changes the coverage and in some it doesn’t. I don’t want to speak to insurance coverage issues more specifically because everyone has a different plan, lives in a different state, etc. but you should ask about that as it may alter your coverage. (A parity diagnosis is one that is considered the same way a medical diagnosis is. Also ask about a biologically based disorder which may be the language of some states.) Also, if you have a PPO plan, remember you may get some coverage if you go out of network. EAP benefits have already been covered on this thread.</p>
<p>But let’s say you don’t have insurance coverage or, for a number of reasons, you don’t want to use it or aren’t happy with the choices there. While it may not apply to many people here, I’d like to point out that there are free services available to those who have served in the military in some circumstances. I am a member of The Soldiers Project, a non-profit that provides free therapy to those who have served in recent wars and for their family members. Give an Hour is another organization. Also, in my state, and maybe others, there are Victims Assistance Programs. In addition to providing assistance with other things, such as funeral costs, therapy is covered for people who are traumatized by having been a crime victim or having lost a family member to a crime (or maybe having witnessed one.) Those categories may not help anyone here but I thought I’d mention them. Someone mentioned grad programs. There are also many settings where interns do their training, after obtaining their degrees, and accrue their hours before getting licensed. While I can imagine many saying that they would never want to see an intern, it can be a good option. Interns are very closely supervised by very experienced therapists which means your case is getting the attention of the person you are seeing, their supervisor and sometimes a group supervision process. Your therapist is probably thinking about your case more than the average therapist and some interns are truly excellent. All good therapists started as interns and I’ve known some outstanding ones in my day who went on to become outstanding therapists. Also, because the process is so darn long, some interns have actually been practicing therapy for years but have not gotten licensed yet. </p>
<p>Lastly, many therapist do have a sliding-fee scale which they may or may not disclose. Some therapists reserve a spot or two to see clients for a low fee. Most therapists really did get into this field out of a genuine desire to help people and having a few low- fee clients allows them to give back. I have a full fee and use a sliding-scale fee. The low end may still be out of reach for some people. It may sound odd, but many of us would prefer to take a lower fee that is the same or slightly lower than an insurance panel rate without having to do the paperwork. It is always worth asking, even if you don’t see it on their website or elsewhere. The economy has affected therapists as much as anyone else. People scale back on the number of sessions. I have lost clients who were suffering with the economy and had to stop therapy. Many therapists may be more willing than usual to take a client at a lower rate as opposed to having an empty hour.</p>
<p>[Book</a> Page: Growing up on the Spectrum](<a href=“http://education.ucsb.edu/autism/GrowingupontheSpectrum.htm]Book”>http://education.ucsb.edu/autism/GrowingupontheSpectrum.htm)
The director of the UCSB Autism center has a book Growing up on the Spectrum. It might interest some of the asperger parents on CC.</p>
<p>Thanks everyone. To address a few issues: </p>
<p>No one in the mental health world is going to pity me for paying full price out of pocket…I make what many consider a nice income…but $150 a week out of pocket is still a sting.</p>
<p>Years ago, the cost of insurance at our firm was escalating greatly, so the partners made the decision to have a very high deductible ourselves so that our staff and associates could have a much lower deductible. Noble and all, but in years like 2008 and 2009 the staff and associates get paid 100% and the partners don’t.</p>
<p>I spent hours on the APA website and made a list of 34 therapists (with all sorts of credentials) to research. Upon inquirty, none had experience with adolescents or adults with Asperger’s.</p>
<p>We have this health advocate service where a consultant will find you the type of specialist you need that is reasonably nearby and that takes our insurance. After searching the entire metropolitan area for several weeks, they gave me two names. Doctor no.1: No, I don’t have any experience with Asperger’s. Doctor no. 2: Yes, I have experience with Asperger’s but only see children.</p>
<p>I contacted the insurance company and asked for a ruling on what they would pay the one therapist I had found. After about a month, I received the after $10,000 they’ll pay $41 letter.</p>
<p>I did find another guy through yet another google search…not too far away, has written a book on the subject…but he had one opening and son would have had to have dropped his two academic community college classes to see him at that time. </p>
<p>So see, I have turned over quite a few stones. The therapists who have admitted having no experience with Asperger’s have recommended the lady we already know about. We’ve just got to pay for it.</p>
<p>If you’re not going to get the money back from the insurance company, consider paying cash and not putting it through insurance. Why? Because then the insurance company does not have access to the records. </p>
<p>I’m a cynic. If I used psychotherapy for myself or for my family, with the current stigma on mental illness, I would want it to be completely private. And that means paying cash. </p>
<p>(However, I wouldn’t have a choice anyway–my insurance doesn’t cover mental illness.)</p>
<p>With an adult with Asperger’s, that raises the whole issue of whether to disclose to employers. You have to weigh privacy/possible stigma against ADA protection.</p>
<p>Missypie- not that you need another job to add to your full plate but my friend has success with her insurance company covering an out of network psychiatrist for her D. She presented documentation that in our area the Dr’s on the list did not specialize in working with teens with her D’s condition. Also we found that depending on how the therapist coded the visits the insurance company would pay a different amount. In our case if we went with one code they covered weekly visits otherwise they covered 12 visits a year.
Aside from traditional therapists you might see if you could find a support group for YA with Aspergers. Or maybe your son could start one. I think you mentioned somewhere that he is eating a lot. Another place he might find some help is OA. 12 step programs can do wonders. And best of all it is free. Not a subsitute for therapy but as a supplement.
Regarding insurance companies and mental health coverage. We have found they don’t want to pay for weekly therapy or even a good longer term facility but are willing to pay for an extremely expensive stay at the psychiatric ward of a hospital after a crisis. A crisis that probably could have been prevented if quality mental health care had been available at a price that more people could afford.</p>