Last week Sadie and I had to update my ANSA and treatment plan yet again. She expected that we could do all this in one session and still have a little time left over to talk. She was mistaken. We got the ANSA done with 5 minutes to spare and she asked if I wanted to do the treatment plan “really fast” or come in another time. There is no way we could have gotten done in 5 minutes, so I agreed to come back the next day to complete it.
The next day I came in and it took us at least 30 minutes to get the treatment plan done. She said that I’m more goal-oriented than most of her clients, who usually say their goal is “to be happy” and don’t care what else she writes. That seems utterly unproductive to me. Happy is not quantifiable.
My overall ANSA score, which tells her what level of services I need, has gone down from a 4 to a 3. This is great news. Less great was when we did the Suicide module and she said, “If I didn’t know you, I’d send you to inpatient based on this score, but I don’t think you need inpatient. Do you?” No I definitely didn’t. Part of the score is based on history of attempts. My Benadryl overdose counts as an attempt, so that part of the score will never decrease. At the time we talked I had a concrete plan (but I will always have some form of plan) and had thought about it in the past 24 hours (because someone else was discussing a loved one’s suicide attempt), so that looked rather alarming. However, I had no intent to act on it.
I am displeased with the new format for treatment plans. The previous one was very open to filling it in however we saw fit. This one pulls in the highest needs from the ANSA and forces you to choose from a list of options for things that need addressed in that area. There is the option of adding in your own ideas, but I feel like what I actually want to work on is not addressed in the treatment plan.
However, this will be the last treatment plan. Sadie has seemed to be pushing me away for the past few months and most recently responded to a request for help by indicating that I don’t need it. Of course my instinctive impulses were self-destructive: overdose, self-injury, going off my meds, cancelling my appointments and not ever speaking to her again. I refuse to let her be the reason I self-destruct. However, after a couple of days of thought, I’ve decided that when this treatment plan expires in 3 months then I’m done. It doesn’t feel that productive anymore.