Who Provides Mental Health Counseling and Treatment?
In my last blog article, I talked about The Importance Of A Correct Diagnosis of Mental Illness. I spoke about the importance of getting a thorough medical screening by your primary care provider, first, to rule out any medical conditions that might cause physical or emotional symptoms. In this article, I will discuss some options for getting help by exploring the role of various psychiatric care providers so that you can make informed choices about getting help.
Medical and Other History Is Needed
Initially, when I talk to my patients, I will ask them about the history of their symptoms, and any prior diagnoses and treatment. In many cases, the clients are confused about who was a mental health provider and who was a medical provider delivering mental health treatment, since many providers can participate in their healthcare.
Who Provides The Diagnosis?
A diagnosis of a mental illness can be made by a physician who is familiar with the current diagnostic criteria for psychiatric conditions. Sometimes primary care or family practitioners feel comfortable doing that- but in many cases, they would refer to a specialist, a psychiatrist for confirmation and treatment.
What is a Psychiatrist?
A psychiatrist is a medical doctor, MD who has been trained in recognizing, diagnosing and treating mental conditions using various pharmacological treatment, psychotherapy or a combination of both. To become a psychiatrist one must complete medical school and take a written examination for a state license to practice medicine. They then must complete a 4-year psychiatry residency program. The first year of residency training is typically in a hospital setting working with patients with a wide range of medical illnesses, but at least three of the four years are spent specifically in the practice of psychiatry.
Split Treatment Model
However, even if the psychiatrists are trained to deliver both forms of treatment, most commonly the psychiatrist oversees the pharmacological treatment and another professional provides the therapy. This model is known as split treatment. This form of therapy works best when the psychiatrist and the therapist collaborate during the treatment. The psychiatrist should be versed in different types of therapies to make the appropriate referral to a professional, according to the patient’s condition that needs to be treated, the emotional strengths of the patient as well the patient’s receptivity for a long or short term therapy all matched with the professional’s specialty. For example, if a patient has an obsessive type of disorder, I can either refer them to an exposure prevention therapy trained professional or to insight-oriented therapy trained one. Some professionals train in one or more types of therapy.
Psychiatric Advanced Nurse Practitioner
In many clinics, a Psychiatric Advanced Nurse Practitioner can also diagnose, and treat mental health conditions and they work under the supervision of a Psychiatrist. They can deliver pharmacological treatment as well as some forms of therapy according to their training.
The different types of psychotherapies include psychodynamic expressive therapy, supportive therapy, cognitive behavior therapy, motivational interviewing, etc. Each of them can be even more specialized in attempt to focus on one type of mental health condition, such as exposure prevention therapy for OCD type disorders, dialectical behavior therapy primarily for borderline personality disorder or Eye Movement Desensitization and Reprocessing for PTSD.
What Is Counseling?
Counseling is the process through which a professional counsels on how to approach and solve different problems/situations, such as difficulties with school, marriage, relationship, work, etc. Depending on the credentials and training of the counselor, that can take the form of various therapies. Counseling often can focus on the past and how it influences the future. The therapist will focus on Identifying and treating disorders and pathologies, and the goal of treatment is typically to alleviate symptoms through behavioral, cognitive or analytic interventions. Most of the time the therapeutic process is longer, and deeper than the coaching process since it looks to change deeply rooted unconscious processes.
What is Coaching?
Coaching is different from therapy since it does not actively look for a connection between the past of the patient and the way he or she constructs the present but is more geared towards finding immediate solutions, using goals and timelines. Coaching is results-based, whereas therapy most of the time looks for a genuine understanding of how the past of a person influences the way the present decisions and choices are made.
Some of the professionals doing counseling or therapy, but not pharmacological treatment are psychologists (Ph.D.), social workers (SW), or counselors (LPC).
What is a Psychologist?
A psychologist has a graduate university degree in recognizing different states of mind, normal or abnormal, also able to do psychological testing to record and interpret cognitive performances and deliver various forms of therapy.
What is a Social Worker?
A social worker is a professional who has a Bachelor degree of Social Worker ( BSW) or a master degree of social work ( MSW). The primary focus is to deliver social services, social welfare, public health, and mental health counseling. Some of the BSW and MSW graduates specialize in various forms of therapy, counseling and/or coaching.
What Is A Licensed Professional Counselor (LPC)?
LPCs are doctoral and master’s level mental health providers trained to work with individuals, families, and groups who also can specialize in different forms of therapies or coaching.
Which Professional Should I Choose For My Mental Illness?
Since all of the above could appear complicated and confusing- what is somebody who first encounters depressive, anxious, or other symptoms supposed to do?
Do not disregard or ignore the symptoms! While friends and family can be a source of support, the best person to ask for professional help is your physician. A family practice MD who is comfortable and has training and experience with mental health conditions can diagnose you and even initiate treatment. However, as with other conditions, they might need to refer you to a specialist, a psychiatrist, like they would refer to an endocrinologist for a thyroid condition that they do not feel comfortable treating.
If you have a family history of mental illness, you should look for a psychiatrist when you too start having symptoms of anxiety, depression or another disorder.
If you begin to seek help from a mental health professional and have trouble managing your symptoms then discuss your condition with them and decide if you need another form of treatment such as medication, or an alternative approach.
Be Mindful And Seek Help If You Experience Side Effects
Please understand that even over the counter remedies, including herbal therapies could have side effects. So make sure that the person who recommends any to you is aware of them and of the potential health or interactions that they could have with medications you take for other illnesses such as hypertension, diabetes, as this may affect the treatment outcome of your mental illness.
Seek A Specialist When Needed But Be Specific In Your Request
Discuss with your psychiatrist the course of treatment according to the severity of your condition. Given the fact that a lot of mental health providers do not take insurance, it might be difficult to find professionals highly trained in what you need. Should you choose to call the insurance providers for guidance, be specific in what your request is: i.e. ” my psychiatrist recommended (Eye Movement Desensitization and Reprocessing Therapy (EMDR)… is there anybody on your provider list who specializes in that?”