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"Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending." - Carl Bard

"We tend to forget that happiness doesn't come as a result of getting something that we don't have, but rather of recognizing and appreciating what we do have. " - Frederick Keonig

"Stress is the trash of modern life- we all generate it but if you don't dispose of it properly, it will pile up and overtake your life." -Terri Guillemets

Monday, July 26, 2010

Untangling the Web of Mental Health Professionals

So many mental health professionals to pick from, so little time. I have answered these questions numerous times, as I'm sure many mental health professionals have: What is the difference between a Psychiatrist and a Psychologist? What do Marriage and Family Therapists do in comparison to Social Workers? How do I decide who I should see?

To begin with, it seems important to understand that Psychiatrists are the only ones who can prescribe medication. They are trained as medical doctors and have to do rotations just as all medical doctors do, but they specialize in mental health disorders, diagnosis, medication prescribing and monitoring, etc. Although your general practitioner can prescribe medication, it is often a good idea to see a Psychiatrist for medication to treat a mental health issue as this is their specialization. Psychiatry can also be broken down into Child and Adolescent Psychiatry, and Adult Psychiatry. As medication can differ for children and adults, it is a good idea to see a Psychiatrist who specializes in the age group in which you, or your family member, falls. A Child Psychiatrist may be more knowledgeable about how large of a dose to give to a child, what side effects could be more prevalent in children, and how long it will take their bodies to adjust to beginning medication and tapering off of it. Psychiatrists sometimes conduct individual therapy in addition to prescribing and monitoring medication, although many focus specifically on working with patients to find the best medication to meet their needs. Psychiatrists can help with more mental health issues than you probably care to read about right now, but it can range anywhere from mild anxiety, sleep disturbances, and slight depression, to Obsessive Compulsive tendencies, hallucinations, or phobias, to name a few. In addition, the best way to ensure that you are receiving thorough treatment would be to allow your Psychiatrist to communicate with your therapist so that they can work together and make sure that they are on the same page. You can sign a release of information so that they may communicate about your treatment.

Next up are the Psychologists. They are in fact doctors, but they aren't medical doctors as Psychiatrists are, they are either Doctors of Philosophy (with a PhD) or Doctors of Psychology (holding a PsyD). It seems that a couple of states allow Psychologists with proper training to prescribe medication due to a shortage of available Psychiatrists, but for the most part, and definitely in California at this point, Psychologists are not involved in prescribing medication. Psychologists can be found in universities doing research and/or teaching, or they may work in a clinical setting providing Psychotherapy. There are several different specializations of Psychology, but the ones that you find in a therapeutic setting are most often Clinical Psychologists or Counseling Psychologists. Not only can they diagnose and treat mental disorders by providing therapy with many different theoretical perspectives and techniques, but they are also able to conduct assessments that help determine such things as Learning Disabilities, Mental Illnesses, Intelligence, and Developmental Disabilities, to name a few.

Last but not least, people often get confused about what the differences are between Licensed Clinical Social Workers (LCSW) and Marriage and Family Therapists (MFT). In order to be able to call yourself an LCSW or MFT, you have to have a Masters Degree and have completed very specific requirements, including thousands of hours of supervised clinical experience, and have passed a licensing exam. The differences in the training of Social Workers and Marriage and Family Therapists can be quite varied or very similar, depending on the graduate program that they attend and the internships and work experience that they are exposed to. In general, Social Work programs may focus a bit more on accessing resources and services in a person's environment while also treating mental illnesses through the use of therapy. MFTs are trained to provide therapy for mental illnesses along with relationship issues and often utilize a systems approach to understanding and treating mental health issues. Overall, it is difficult to clearly distinguish between the professions because there is a significant amount of overlap between them.

Are you still with me here? Hopefully you are not completely confused by the descriptions offered here on the simiarities and differences between Psychiatrists, Psychologists, Social Workers, and Marriage and Family Therapists. Due to the fact that there is such a huge overlap between the mental health disciplines, it is important to keep many points in mind when trying to pick a therapist. Ask yourself some questions while shopping around for a therapist and trying to pick one:

  • Is their education level important to me?

  • How long do I want to be in therapy? Do I want to take my time dealing with this issue and my past, or would I like to focus on the present and find a solution fairly quickly?

  • Am I comfortable with this person's personality? Do I feel at ease with them and do I feel accepted and respected by them?

  • What is their therapy style and is that going to be a good fit for me?

  • What experience do they have with the issue that I am going to them with?

Ultimately, make sure that you are comfortable with the person that you decide to see so that you will be able to open up to them about personal concerns and feel that you can trust them. It is a lot easier to determine which therapist is going to be the best fit for you if you go on your gut instinct and level of comfort, rather than just by what degree or license they possess. If you are feeling uncomfortable with something, the best way to approach the situation is usually to discuss your concerns with your therapist before making a determination that you want to switch therapists, but it is your right to do so. Good luck with your search!

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