do psychiatrists do "counseling"

[ronaldo23]

or focus on more serious mental conditions like add and schitzophrenia, and leave counseling to the psychologists.

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[toby jones]

Psychoanalysis was traditionally associated with psychiatry even though Freud was a Neurologist. It used to be the case that you had to be a psychiatrist (specialist medical doctor) to train and practice as a psychoanalyst. The psychoanalytic institutes have since opened their doors to related health professionals in psychology and social work, however. There are some psychiatrists who are trained as analysts and who work in private practice giving people therapy, sure.

Psychiatrists typically learn a little about psychotherapy (psychodynamic, humanist, cognitive behavioural) in their training. They typically have to have however many hours of delivering psychotherapy to patients (though it depends on precisely where they train and precisely what their training institution focuses on, I guess). Some biologically minded psychiatrists / programs are fairly hostile to psychoanalysis and perhaps therapy more generally. Other psychiatrists / programs have more emphasis on varieties of therapy and hence more emphasis on psychiatrists having experience with delivering therapy.

Typically psychiatrists aren't funded to deliver psychotherapy in the public sector. Cheaper to get someone else to do it (e.g., a psychologist or social worker). So typically... Drugs drugs drugs I guess.

BTW... Therapy can be an effective treatment for people with 'serious conditions' such as schizophrenia.

 

[strangeglove]

I'd agree that the field has changed a great deal since Freud. However, the majority of psychoanalysts (at least on the East Coast) are psychiatrists, as are the majority of people obtaining analytic training. Some psychiatry training programs, especially in cities like New York and Boston (Cornell, Columbia, Cambridge all come to mind), heavily emphasize psychotherapy training. Psychiatrists who graduate from these programs will often manage meds and do psychotherapy with the same patients.

I agree that there is a role of psychotherapy in schizophrenia, however I'm sure that psychotherapy cannot cure this disease. An important aspect of schizophrenia is the role of psychosocial stressors as triggers and exacerbators of psychotic episodes. Psychotherapy is very important for mitigating those, in addition to addressing the social problems (family, work, housing) that are faced by people with schizophrenia. Similarly for major depression: psychotherapy has a role to play in mitigating some of the symptoms of depression, but is best when combined with medications. Some would argue that this is the reason why it is a good idea for psychiatrists to do psychotherapy - so that they can provide complete treatment for their patients. Plus, it's really quite interesting and fun, once you get into it. It can be scary to many people who go into psychiatry, though, which I think underlies much of the criticism.

 

[Solideliquid]

I'd agree that the field has changed a great deal since Freud. However, the majority of psychoanalysts (at least on the East Coast) are psychiatrists, as are the majority of people obtaining analytic training. Some psychiatry training programs, especially in cities like New York and Boston (Cornell, Columbia, Cambridge all come to mind), heavily emphasize psychotherapy training. Psychiatrists who graduate from these programs will often manage meds and do psychotherapy with the same patients.

I agree that there is a role of psychotherapy in schizophrenia, however I'm sure that psychotherapy cannot cure this disease. An important aspect of schizophrenia is the role of psychosocial stressors as triggers and exacerbators of psychotic episodes. Psychotherapy is very important for mitigating those, in addition to addressing the social problems (family, work, housing) that are faced by people with schizophrenia. Similarly for major depression: psychotherapy has a role to play in mitigating some of the symptoms of depression, but is best when combined with medications. Some would argue that this is the reason why it is a good idea for psychiatrists to do psychotherapy - so that they can provide complete treatment for their patients. Plus, it's really quite interesting and fun, once you get into it. It can be scary to many people who go into psychiatry, though, which I think underlies much of the criticism.

I'm not sure that medications can cure Schizophrenia. However as to this and other psychotic disorders, it largely depends on the patient and their needs.

For example, a patient suffering from schizophrenia that doesn't have much insight may benefit from Supportive Psychotherapy. Meaning there are several forms of therapy and you want to use the one that can be most helpful to a particular patient. Another example, psychoanalysis and interpretive psychotherapy aren’t going to be very helpful to low-functioning schizophrenics.