Tuesday, December 1, 2009

Doctors and Counselors, Which one do I need?

When a parent understands their child may need psychiatric help, it is a crisis. Then the realization that you may not know what kind of help your child would do best with becomes reality. Do you need a psychiatrist, or maybe a Phd? How about a counselor or a therapist? Is there any difference? There are vast differences between the different types of help in the world of psychiatry, and I'll try to explain them simply here.
A psychiatrist is the medical doctor of the group. This professional has completed medical school, residency, internships and specialty rotations in a chosen field like psychiatry. They may be " boarded" by passing a rigorous exam in a practice area of expertise, like child psychiatry. These doctors can prescribe medications and have all the privileges ad responsibilities of a medical doctors, just like a pediatrician.
The next type is a PhD. These are academic doctors and have an extended education in a chosen area as well. Psychology is one area. The expertise can go farther into testing and family therapy. Some PhD's specialize in analysis which is a very long process of therapy. Some are especially trained in developmental psychology which focuses on the various stages a child goes through and what can cause them problems along the way.
The next possible level is either a LMSW (liscensed medical social worker, a Marriage and family therapist or an LPC. Liscensed Professional Counselor. These all require varying degrees of formal education at post graduate level plus a huge number of hours in internships working with the population they choose to specialize in. The latter 3 credentials usually charge less per hour, but if you pick the right one, they can give you just as much value and progress for your time and money. Unless you need testing, an expert in family dynamics or a doctor to use medications, the best place to start with is an LPC or LMSW. These professionals are very talented therapists,and can tell you after a couple of sessions if they can handle the situation and what the plan will be. They can let you know what they expect from you and your child and can enlist your help in creating a plan of care that will work well for you. They are also very good at letting you know if it is time to pull in a higher level of therapy for a consultation. A consultation generally is a short term visit with long term effects. A referral to another mental health provider simply means the therapist wishes to go to their strongest player on the team for a clear picture of the issue. The use of medication is probably the ultimate " go to the bench" play when there seems to be no other way to effectively and quickly interrupt symptoms that are are causing extreme disruption of the child's life. Your therapy experience may include one or all of these providers but rarely all at one time. Therapy is a process and in children, just like with their clothing, the kind, style and size needs to change as the child grows. It is not a quick fix and requires a commmitment on your part to follow the plan. It can be very beneficial and very helpful to you and your child. Wishing you all great mental health!

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