Unsympathetic Dr

DaisyGirl said:

Do not assume that the GP is doing the right thing or that they know what they are doing. They might be making it up as they go along.

But equally

Do not assume that the GP is doing the wrong thing or that they don't know what they are doing. They might not be making it up as they go along.

I think it is good to try and understand what the doctor might be trying to do. Don't jump to conclusions. It may be a bad thing to do in this case or it may be appropriate care. I don't think we know enough about the individual or about the doctor's expertese to come to a judgement.

Lastly, a lot of people on this forum are very high functioning and find being challenged by normal CBT is fine for them. For a very large number of people with autism any form of simple CBT is absolutley impossible and causes high levels of anxiety, some of us just can't do it, we don't "get it" and it is not for us. People who are of normal intelligence but whose autistic triats are very pronounced need people with true expert knowledge of autism, these therapists can then use a modified form of CBT which is very specific to the triats of the individual.

Agreed that simple CBT may not be appropriate but that some form of CBT might work for him. I'm not exactly sure what simple CBT would include and would have assumed that CBT would always have to be tailored for the individual.

Hi there,

First get in touch with the patients association helpline and get their advice, also go to the CAB and get their advice regarding ESA. This sound very very strange to me and some GPs e vastly overstep their expertise. No GP has the neccessary expert training to offer any form of CBT to someone with autism, few clinical psychologists or psychiatrists do either. This GP is acting to control your son's life, you need to see another GP and get a referral to see a psychiatrist who specialises in people with Autism. Only accept an appointment with a psychiatrist who has a special knowledge of autism, not a general adult psychiatrist.

Look closely at the GMC Good Medical Practice and see if you think this doctor is overstepping their bounds. Especially if the CAB or the patients assocaition think this is odd.

Next, do you go with your son? If you do, covertly record this doctor on a digital device, do it every time and save the results. Also get a copy of your son's medical records and make sure you know what this doctor is writing. You have to take control of this situation.

Do not assume that the GP is doing the right thing or that they know what they are doing. They might be making it up as they go along.

Lastly, a lot of people on this forum are very high functioning and find being challenged by normal CBT is fine for them. For a very large number of people with autism any form of simple CBT is absolutley impossible and causes high levels of anxiety, some of us just can't do it, we don't "get it" and it is not for us. People who are of normal intelligence but whose autistic triats are very pronounced need people with true expert knowledge of autism, these therapists can then use a modified form of CBT which is very specific to the triats of the individual.

I hope you can get the right help for your son, and stop this GP.

Hi,

Totally support Coogy's contribution on this. We sometimes need to be challenged rather than taking the easy path. An essential part of CBT is that fixed, but destructive, ideas are challenged. This doesn't mean violent confrontation or discipline but it does mean attacking the issue with reason and fairness. The GP may be making a concerted effort to challenge your son's behaviour and that is reasonable - the GP is responsible for helping the patient to improve and also responsible for spending our (society's) resources responsibly.

I don't think you are scroungers, a scrounger would never post such a question on a forum like this. However, you may fall into a dependency trap where it is easier to keep the peace by letting him not do the washing up etc. I expect that he agreed that this was a reasonable thing to do when the doctor proposed it. With the right support and persuasion then should he not be capable of this? If he can achieve this small goal then he can perhaps be enticed to greater achievements?

Hi,

I don't know your sons situation, but I can guess from what you say, that a lot of his early experiences have been very negitive and that this has had a detrimental impact on him.

However, I think that if you are lying to her each time you visit; about your sons accomplishments, She probably does feel as though she's setting small tasks that she believes are achievable by your son and that these are successful because of the feedback she gets.

Have you considered reading, 'Living Well On The Specrum,' by Valarie Gaus to help your son? It's a work book with great insights and may help your son.

As parents it would be very easy for us to sit back and let our children stay in their room on the computer all day. After a serious assault on my son, that's exactly what happened to him. It was nearly 2 years before we managed to move him out of his comfort zone and we very nearly gave up. Sometimes we need to push the boundries a little with our children, if only to reinforce a more positive self-esteem.

I realize this can be hard. My son did an ASDAN course for life skills and did well in the course, but translating skills learned in a class environment to everyday living is a completely different senario and it's often difficult for those with ASD to even identify when these skills need to be applied. My son still requires considerable support and steering in daily living, but given instruction and guidence he does achieve small tasks.

The thing is, that with regular exposure and patience it is possible to learn new skills and this can have the effect of lifting morale as different goals are achieved.

If I were you, I would talk to the GP and mention that your son finds these tasks set by her, stressful (If that really is the situation.) Tell her that you are happy to visit each month, but that you would like to take control of setting your son some tasks yourself, as you have found a workbook that focuses on an individuals weaknesses and uses them to achieve positive outcomes. Tell her that you are happy to return on a regular basis to see her and show her the book if necessary. This will give control of any tasks set, back to the family and reduce his anxiety over the visits. Also it will reduce the need for you to lie. You never know, she may even give you a longer note. while you start working with him.

Discuss the workbook with your son first or course, and then see if he would like to explore and identify some of the issues he struggles with and look at ways of achieving other things.

Your son made a valid point. 'Why would I do anything that has no self gain?' If you expect your son to learn some life skills, you have to give him the reason for doing it, which benefits him. Keep that in mind as you look at the different aspects of living well on the spectrum.

No one is in a better position than youself to say whether your son should be entirely supported or not. This is a judgement call for you and you only, but it is possible with the right support to make small progressive steps toward a little more independance. My son will always need support, but their are some things he can do if prompted.

I think this issue of being vewed as a scrounger is very detrimental to those with ASD. It can force those who are not ready, into situations that they cannot cope with (For not wanting to be viewed as such.); or on the flip side, make others feel worthless. Support is there for those most in need. If that is your son, then accept his limitations and support him as best as you can. What others think is not your issue or their business.

All of us need a purpose in life, no matter how small. It may be that this Gp's level of knowledge about ASD is poor, but if that's the case, she needs enlightening. It may be that she sees many others without ASD, who are just playing the system.It's her job to decide who they are and act accordingly.

I hope my ramblings are of some help.

Coogy

If you go on the nhs choices website there is a section for gps in your geographical area + it shows whether they're accepting new patients.  Personal recommendations by family, friends, colleagues etc shd be sought to help guide you.  Also on the nhs choices site you'll see how the different gp practices are rated on a number of indicators.  Have a look.

You have a right to see another doctor, so would be justified in changing surgery if that is possible for you: check first, some surgeries do have waiting lists.  Also be aware that there's a risk the new doctor might be even harder to get a note off!  I can't comment on whether your son deserves it from the details you've given, but it sounds like you know he does genuinly need it.

Is the doctor you've been seeing at the surgery the senior doctor?  I'd consider writing to another senior doctor there saying what you've said here.

You might also try writing to the doctor he's seeing first.  I think most people would say that's the first thing you should do, but if it was me I'd find it hard to talk to her!

I think she probably genuinly thinks she's helping.  It may be that she thinks she's 'suggesting' tasks and your son takes it as orders.  It does sound like she is short on understanding though.  Does she think anyone applies for ESA who doesn't want the money?!?  Maybe if that's her attitude she should try working without wages.

This sounds strange to me.  I'm presuming we're talking about your GP?  Is there any way you can get referred to an nhs psychatrist, who would then have the final say regarding your son?  You cd broach it by saying you are keen that he progresses further.

Quite shocked, actually.