How do I approach this? - SI requirement to see therapist (mental health), but no current issues...

C

CirrusGirl

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Background: I received my SI (for past depression) and per it's requirement I'm to see a therapist monthly (with aggregated reports of sent to FAA annually via AME). The depression went away when I left the abusive relationship causing it and I haven't had issues or seen a therapist for the several years since.

Question: What do I tell them I'm there for? what do we do for the sessions? and what do I tell them concerning the report's content/format? ... "Hi, I'm here because the FAA is requiring it, but I don't have any current issues..., oh and they want a yearly report from you, but I don't have any specifics about that...", then just smile and stare at each other blankly for the next hour?

I can't think of how to approach / ask a potential therapist about this... (input would be appreciated)
but once I find one, best I can reckon is let them read the HIMS report and SI; then each month, discuss the past month's events and make sure they mention in the report that no issues have been observed...

Thanks in advance for any input
 
Question: What do I tell them I'm there for? what do we do for the sessions? and what do I tell them concerning the report's content/format? ... "Hi, I'm here because the FAA is requiring it, but I don't have any current issues..., oh and they want a yearly report from you, but I don't have any specifics about that...", then just smile and stare at each other blankly for the next hour?

My worry with that approach is you would then look like a 'difficult patient' having problems admitting your problems. I'd suggest going in saying, "Here's my history. Here's the story. I think I've largely put the past behind me, but I've been recommended to seek additional help as a condition of my medical certificate, which I need to fly."

If possible (and I don't know that it is), Basic Med can be a great thing.
 
She’ll have to satisfy the SI requirements (monthly visits) until her medical expires. Otherwise the FAA will revoke her medical and then she’ll be ineligible for Basic Med.

Once the medical expires, she can go Basic (unless she’s headed for a flying career).
 
Uh… actually that’s exactly what you do… I know tons of folks who signed waivers to go to rehab (rehab joint required it) acknowledging that they were receiving treatment that wasn’t medically necessary.

FAA seems to think that mitigates something..

Look at it this way, you are satiating an ADMINISTRATIVE requirement. Plain and simple.
 
I pray that you are correct and the depression is gone but in the eyes of the FAA they, or their assigned person(s), are the ones to determine that, not you. @2-Bit Speed gave you some sage advice (post # 3) noting that the attitude in which you engage the therapist may tell them more about where you are than your denial of the facts.

I hope this is an easy road for you to cross but you'll have to play by their rules. Many of us don't like the way they do things but it is their ball, field, and rules ...
 
Is BasicMed an option for you?
My worry with that approach is you would then look like a 'difficult patient' having problems admitting your problems. I'd suggest going in saying, "Here's my history. Here's the story. I think I've largely put the past behind me, but I've been recommended to seek additional help as a condition of my medical certificate, which I need to fly."

If possible (and I don't know that it is), Basic Med can be a great thing.

BasicMed would work for me, but I would prefer to stay 3rd class for now so I can eventually be able to fly to Canada to visit friends I have up there.

The quoted part wasn't what I'd seriously say, it was more jokingly (I should have left it out or put "lol" after), the paragraph/part after that was what I thought would be best (along the lines of your suggestion), but I'm just not sure how to approach a therapist about why I'm asking to see them and what I'm expecting from them. As you point out, I will have to be careful so they don't try and apply problems to me, like you mention. But what you mention sounds like a good approach to the first session.

She’ll have to satisfy the SI requirements (monthly visits) until her medical expires. Otherwise the FAA will revoke her medical and then she’ll be ineligible for Basic Med.

Once the medical expires, she can go Basic (unless she’s headed for a flying career).

I won't be pursuing a flying career, just for fun and personal travel.

After receiving my SI, I checked with my HIMS and also had AOPA review the SI, they they both gave me the same answer as this; you have to satisfy the requirements and wait for the medical (& SI) to expire if I wanted to drop to BasicMed. If I choose to do so, then send FAA a letter in the months before the expiration stating that I don't intend to renew the 3rd class; then after expiration, go for BasicMed. They also warned that if I dropped to BasicMed before(if) FAA re-evaluates the need for a SI, I would have to go through the whole deferral and HIMS eval route again if I ever wanted to get a 3rd class certificate again in the future.

Uh… actually that’s exactly what you do… I know tons of folks who signed waivers to go to rehab (rehab joint required it) acknowledging that they were receiving treatment that wasn’t medically necessary.

FAA seems to think that mitigates something..

Look at it this way, you are satiating an ADMINISTRATIVE requirement. Plain and simple.

Thanks, I'll look into this route. I kinda look at it like this as well, just fulfilling a requirement.

It mitigates part of FAA's responsibility if there's an accident and the news media claims FAA is at fault for letting someone fly who isn't fit. Then gives FAA more power to push for only letting perfect specimens of health & mental fitness to fly... :p

I pray that you are correct and the depression is gone but in the eyes of the FAA they, or their assigned person(s), are the ones to determine that, not you. @2-Bit Speed gave you some sage advice (post # 3) noting that the attitude in which you engage the therapist may tell them more about where you are than your denial of the facts.

I hope this is an easy road for you to cross but you'll have to play by their rules. Many of us don't like the way they do things but it is their ball, field, and rules ...

Thanks, 9 years and I haven't noticed any of it or it's symptoms since leaving that relationship. but yes, in the eyes of the FAA, since I had an issue once, it can happen again; I kinda doubt they will ever remove the therapist requirement for this reason. But as you say, we have to play by their rules and all decisions are theirs.


Engaging with the therapist is a worry of mine, the last one loved slapping issues/labels on me (as my HIMS & I found as we reviewed the session notes), encouraged me not to give up on the (abusive) relationship and definitely wasn't my advocate (I stopped seeing them weeks before I decided it was best to leave that relationship). It's really going to affect my ability to trust this new therapist...
 
...but yes, in the eyes of the FAA, since I had an issue once, it can happen again...

It's really not all that far-fetched to think that someone could enter another abusive relationship; it happens all the time. And it wouldn't be much of a stretch to think that doing so could trigger a relapse of your depression.

It's really going to affect my ability to trust this new therapist...

Can your HIMS AME recommend someone? Preferably one who's not in love with a Dymo label-maker.... :)
 
Depression recurs. The more severe the depression the more significant the recurrence. ANY counselor worth his salt should understand that. I do think the FAA follows up for longer than necessary. But a professional realizes that...or he should.

....and if the duration is >24 months per DSM-5 it cannot be held to be "situational" per the DSM definition. Always "touchy" as to what the duration actaully was.....
 
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"Situational depression", if that's what it was, is often a lot different than major depression. You need to convince the FAA that yours was the former, and the FAA only wants a professional opinion rather than your own.
 
It's really not all that far-fetched to think that someone could enter another abusive relationship; it happens all the time. And it wouldn't be much of a stretch to think that doing so could trigger a relapse of your depression.

Can your HIMS AME recommend someone? Preferably one who's not in love with a Dymo label-maker.... :)
Depression recurs. The more severe the depression the more significant the recurrence. ANY counselor worth his salt should understand that. I do think the FAA follows up for longer than necessary. But a professional realizes that...or he should.

Unfortunately that's true, especially if the new situation hits the same buttons that drag up luggage from the last one. But along those lines, it's always possible that any individual could develop depression given the right set of circumstances... I understand why the FAA requires monitoring individuals that have had such issues in the past though. On the flip side, it's scary to think of existing pilots hiding any issues and not getting help for fear of loosing their medical>license>job>career>income...

I had to travel a to see my HIMS, I checked, they didn't know anyone near where I live (I'll likely have to travel to a larger nearby city to find a therapist as well).

"Situational depression", if that's what it was, is often a lot different than major depression. You need to convince the FAA that yours was the former, and the FAA only wants a professional opinion rather than your own.

My HIMS & I were hoping it would fit under situational, but once we had access to the previous records, unfortunately the previous therapist wrote it up as major depression complete with nonexistent symptoms just to tick the right boxes. (he probably would have thrown in "female hysteria" as well if this were ye olde times, lol).



(I really should have created a separate account to post here so I could get notifications of responses and not bother the mods with approving each reply..., next time...) (thanks for letting us post anon in this forum though :)
 
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