In health care, clinicians and patients commonly seek independent second opinion consultations about diagnoses and treatment approaches. In psychotherapy, “second opinions” often occur during supervision, a process about which the patient is left relatively ignorant. While most therapists turn to supervision for obtaining new perspectives on their most challenging cases, the viewpoints offered may be distinctly colored by a school of thought under which the supervisor and therapist practice. Even those conversant in a variety of therapeutic methods risk missing the complete view of a challenging case unless skilled in integrating the different perspectives.
Many training centers, including the Department of Psychiatry at UCSF, teach diverse psychotherapy techniques, from psychodynamic to cognitive-behavioral to supportive. However, these are taught as separate capsules with little formal training in how the various techniques overlap, how and when to shift between different approaches in a single therapy, or how to incorporate the various approaches into an integrated model. The field is already eclectic, but the future is integration of the various approaches. The Second Opinion Consultations on Psychotherapy Treatments Program offers advice about ongoing psychotherapies to therapists who will continue to treat the patient.
The process typically involves obtaining information from the interested therapist, as well as an interview of the consenting patient. The case is discussed confidentially at a small conference with input from senior psychiatric residents and attending faculty. Based on the spectrum of expert opinions about the case, and with consideration for the psychotherapeutic and psychiatric literature as well as theoretical integrations of diverse schools, a written, concise formulation and recommendation guideline is prepared and sent to the therapist who seeks our services. The recommendations will include suggestions that can be utilized in ongoing therapy. The therapist may choose to share aspects of this information with the patient, as he or she deems appropriate.
Please call (415) 476-7612 to schedule a telephone discussion appointment. Billing can be arranged for the patient, the therapist, or the insurance company (as desired).
Referrals from all practicing psychotherapists are welcome.