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Can someone out there share some insight on the whole idea? Thanks
Psychologist vs Psychiatrist
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psychRN said:
what idea? one is a PhD, the other is an MD. you talk to one without looking at 'em and you talk to the other while looking at 'em. one can't prescribe meds, the other can.
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psychRN said:
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A large part of the reason why psychiatrists dont do more counseling is that they are in short supply (and therefore cost a lot to hire), while PhD psychologists as well as therapists with other degrees are much more plentiful. Since psychiatrists are the only ones that can prescribe meds (generally speaking), most practices and hospitals will use the psychiatrists to handle the medical aspect of patient care and use cheaper, more easy to find psychologists and other therapists to counsel. Besides, PhD psychology training takes almost as long as psychiatry training, and psychologists focus almost entirely on therapy during their education while therapy is only one component (and often a relatively small one) of psychiatry training. Therefore, it makes sense to have the experts (the psychologists) do the therapy and have psychiatrists handle the medical things that they are specialized in. That being said, from what I understand there are psychiatrists who do therapy as a large portion of their practice.
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psychRN said:
There is a big difference in training and it isn't just the ability to prescribe drugs. MD in a psych residency will learn how to determine whether an patient's symptoms are due to medications are new medical problems or perhaps some combination. They have training in narrowing down potention diagnoses to just one. They have extensive training in pharmacology as well as counseling techniques. On top of this they also have the benefit of medical training. Many conditions that may be referred to a psychiatrist may be related to some physiological condition that is readily determined using imaging or lab tests. A classic example is a brain tumor whose position changes a person's demeanor. A psychologist does not necessarily have the training or expertise to order imaging studies, whereas a psychiatrist most certainly does.
A psychologist is trained in counseling only. There are states that give them limited prescribing rights...but they do not get the same level of education a doctor gets in learning when and how to prescribe.
There are psychologists who are fond of drugs just as there are psychiatrists who are fond of drugs.
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Why the negativity about Psychiatrists? I think psychology is fascinating and wanted to go into medicine... psychiatry seems like a great mix to me.
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How did you conclude that?
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I'm sorry, I wrote that at the same time you wrote your post. I was responding to the statement that it wasn't the psychiatrists who were diagnosing. My question was basically answered in your post.
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velo said:
****edit - i'm not sure what your actual stance is on psychiatry, but i'm not entirely happy with the joke. it doesn't help in this world that is pretty discriminatory towards psych-survivors or anything really having to do with mental health.
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o.k. context is good. thnx. actually wtf is scrubs, and a scrubs quote? oh, got it - some t.v. show likely on cable?
and - do you both substantially agree with this scrubs deal? i don't see any distance put from that perspective.
and - do you both substantially agree with this scrubs deal? i don't see any distance put from that perspective.
4paw said:
I don't completely agree with it, but, I also think the need for psychiatrists and psychologists is greatly exaggerated. A lot of my family comes from other parts of the world, mostly Europe, and you don't see many people there rushing to the shrink everytime a kid has trouble focusing in school or a family member dies. I think humans have an amazing ability to cope with things and heal on their own, we Americans have just learned to like being coddled a bit more than others, myself included unfortunately.
MFP
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mfpullen said:
but shrinks do help a lot of people. a friend of mine really pushes counseling to anyone and everyone. she was sexually abused by a step parent as a child and counseling has meant the world to her.
I, on the other hand, have never had therapy, but probably could have used it as a high schooler. I was very insecure and at times and even contemplated suicide. (wouldn't consider myself suicidal as I never would have actually done it)
Within the large crowd of people I know, very few people don't battle with insecurities, some of them severe. These are adults, who have dealt with the same issues for years, and just can't seem to beat them.
And with all of the problems in society, abuse, drugs, alcohol, those that are the abusers and the victims, obviously can use some form of help.
I subscribe to the concept that some people can pull themselves up and deal with their issues and insecurities, but there are those that need some outside help, and there are also those whom no amount of outside help will do any good because they refuse to take personal responsibility for their own well being.
noelleruckman said:
I think that's a great philosophy, Noelleruckman. I think therapy, just like most medications, agrees with some people and not with others. I personally don't think I would ever seek therapy, I tend to use family for that sort of thing, but I can certainly understand some people wanting an independant source of input or help. I do think, though, that therapy and related drugs are often overused in our society.
MFP
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yeah, i don't really think of drugs in relation of psychology/psychiatry. (although i realize that psychiatrists do use drugs to help patients) I think more about counseling when I think of psych. I already practice on people I work with 🙂 j/k My intention is to get a IM/Psych dual residency, and be an internist, but be fully qualified to also deal with Psych issues in my patients (I see this mostly playing out in counseling, not prescribing meds) Actually, the big reason I want to do the psych part is human psych fascinates me (as I already said). I don't know if I'll actually use it, but I really like it. I don't want to do a psych residency alone though, because I don't really want that to be all I do. Since I like counseling more than prescribing, if I wanted to go strictly into psych, I should have gone into psychology instead of medicine.
noelleruckman said:
Sounds very interesting. I plan on going into internal medicine, too, but more to get into infectious disease. I don't think I want to play with people's heads, hehe. I wouldn't be very good at it. Keep us posted on your progress!
MFP
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4paw said:
Its a show on NBC, very popular with medical students (and pre-meds alike)
I don't have to agree with the Scrubs' quote to find it funny as hell.
You'll walk easier if you remove that stick from your ass
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velo said:
?
Your reaction seemed a little strong to me.
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you are all acting like all psychiatrists do is perscribe adderall to little teens... my mom is a psychiatrist and all of her patients tend to have either severe clinical depression, bi-polar, or schizophrenia who are a danger to themselves and/or others... ADD is the common cold of the psychiatric world so say what you want, but very few people outside of scientologists would deny the usefullness and need for psychiatrists in the cases that most psychiatrists concentrate on
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mfpullen said:
It's easy to say you would never seek therapy because I'm guessing you've only had problems that your mind and body have been able to cope with. Not saying you had an easy life or anything, just that your coping mechanisms are stronger than others. If, God forbid, you're ever pushed to your limit, you might sing a different tune. When people criticize psychiatrists, it's an issue with me. People who have mental illness are looked down upon in this society. If someone has the flu, they're told to call the doctor, but if someone suffers from severe anxiety, they're told to just relax. There's a double standard if I ever heard one.
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velo said:
ok, sorry.
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UMP said:
Thats always what I thought psychiatrists did. I thought most of them worked for instituations or hospitals and saw individuals with serious psych problems. thats why I don't really want to be a psychiatrist, because I'm more interested in the counselling aspect.
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mfpullen said:
I feel the need to speak up here, as I must take exception to something that you say MFP...It is one thing when one believes that medication is overused in society, especially in children (See Tom Cruise for the uber-extreme, non-negotiable form of that philosophy). I don't really have enough experience to comment on this (I'm a psychiatry intern), but its quite possible that it is true, largely out of frustration by parents or teachers about deficiencies that occur in their childrens performance which may reflect more on the parents skill in raising the children than anything else. However, its entirely another thing to suggest that "therapy" is "often overused in society".
Do you really hold the belief that seeking another persons help to better yourself is not a good idea?
You claim that you seek help through friends and family, but somehow you naively assume that others can find help in these places. In fact, friends and family are often extremely destructive forces in people who need psychiatric care (abuse, neglect, unstable relationships, inexperience in giving appropriate advice all come to mind in thinking about the limitations of your model). Thus an objective eye from someone trained in behavior, relationships, development, the brain, pharmacology and medical illness to try to sort out the roots of someones problems, or at least to help put those things in perspective, is often extremely helpful to people. The "therapy" is really defined as someone trying to better themselves.
The role of a trained professional in mental health is to try and recognize patterns of behavior or thinking and use whatever is in their arsenal to improve the quality of life of the individual who seeks help. Sometimes, the best therapy is to listen to someones story and normalize their experience and try to help them find ways to cope with things. At its essence, I find it so difficult to understand why someone would be opposed to the principal itself of "therapy". The only thing I can think of is that society attaches a stigma to therapy, they have a narrowminded idea of what therapy is, or they have some personal resistance to the idea due to their own defense mechanisms.
A different, more constructive conversation would be to realize that therapy has limitations in empirical validation, and that sometimes individuals are looking for quick fixes (read: pills) for things. To recognize that the field of psychiatry (the study of the brain and behavior) is in its infancy in many ways from a scientific perspective, and in other ways may never have truly satisfying answers to many questions is important if you are training to be a doctor. But thats what makes it fascinating, because psychiatry is a medical field that deals, at the end of the day, with specializing in improving people's quality of life. That is all encompassing and fundamental to being a healer. As you progress through your medical training you'll realize that from a humanistic point of view, all the number crunching and memorizing you do is completely irrelevant if it doesn't improve a patient's quality of life.
Best,
worriedwell
And, oh yeah, I firmly believe that appropriate pills do have their place as part of the arsenal of the healer. Not using pills might take years of productive quality life away from someone compared to using them, and this has been proven scientifically repeatedly. Not quite as effective or refined yet, but analogous to what insulin does to people's quality of life with diabetes. You could make the argument that people could avoid pills for diabetes if they just went and exercised (the same way you can make the argument that exercise treats mild depression) but then you are getting into a paradigm shift in Western culture and how medical doctors role is defined. Its still largely not a preventative discipline, but a treatment discipline.
And if you don't believe me, ask how debilitating depression, anxiety, bipolar illness, or psychotic illness is to those who suffer from it and tell me that there shouldn't be doctors in the business of helping with those chronic diseases the same way there are doctors treating diabetes.
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I'll preface this by saying I haven't really taken the time to read through this thread, but it came up in another thread, so I'm reposting what I said there here:
As a Psych major that's going to med school (I love psychology, but I have *no* desire to be a psychiatrist), I had a class that dealt with these issues a lot. Basically, Psychologists think that psychiatrists prescribe too often, and psychiatrists think that psychologists spend too much time focusing on psychotherapy when medication is needed. These biases obviously stem from the differences in how the two professions are trained (to think that they're superior to the other). Basically, every single study on every type of psychological disorder has reached pretty much the same conclusion - medication is good at getting disorders under control in the short term, and psychotherapy is necessary for maintating that improvement long term. It doesn't have to be one or the other. Also, there are Psychiatrists out there who do know how to do psychotherapy properly - they should know how to - I don't agree that nobody can provide good, comprehensive care. Unfortunately, it may be difficult to find, but there are good people out there 🙂
As a Psych major that's going to med school (I love psychology, but I have *no* desire to be a psychiatrist), I had a class that dealt with these issues a lot. Basically, Psychologists think that psychiatrists prescribe too often, and psychiatrists think that psychologists spend too much time focusing on psychotherapy when medication is needed. These biases obviously stem from the differences in how the two professions are trained (to think that they're superior to the other). Basically, every single study on every type of psychological disorder has reached pretty much the same conclusion - medication is good at getting disorders under control in the short term, and psychotherapy is necessary for maintating that improvement long term. It doesn't have to be one or the other. Also, there are Psychiatrists out there who do know how to do psychotherapy properly - they should know how to - I don't agree that nobody can provide good, comprehensive care. Unfortunately, it may be difficult to find, but there are good people out there 🙂
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👍 worriedwell, that was a very good post.
Worriedwell,
I'm terribly sorry you didn't have the time or initiative to read my entire post, I know it was fairly lengthy (/sarcasm). I stated very clearly that while talking to my family was enough for me, I could understand why others may want to seek help from a therapist in order to have a listener independant from their family. I can completely see why this is something that would help a tremendous amount for some people. I would think that, being a psych intern, you would understand that no treatment works for every patient, just like medications. Again, please don't pass judgement on someone when you didn't even take the time to read and digest a one paragraph post.
MFP
I'm terribly sorry you didn't have the time or initiative to read my entire post, I know it was fairly lengthy (/sarcasm). I stated very clearly that while talking to my family was enough for me, I could understand why others may want to seek help from a therapist in order to have a listener independant from their family. I can completely see why this is something that would help a tremendous amount for some people. I would think that, being a psych intern, you would understand that no treatment works for every patient, just like medications. Again, please don't pass judgement on someone when you didn't even take the time to read and digest a one paragraph post.
MFP
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mfpullen said:
Yes, but he did also address other negativity towards psychiatrists that was shown in this thread. I don't know that his whole post was aimed at you.
