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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Kinny on December 5, 2003, at 17:52:56
I am in need of an evaluation for my son. Who does the evaluation and how long should I expect it to take? Can they make an informed diagnosis in one session or do they just try medication for responses??
Thanks
Posted by sarita0001 on December 5, 2003, at 19:41:31
In reply to Psychiatrist or Psychologist, posted by Kinny on December 5, 2003, at 17:52:56
Hi,
A psychiatrist usually makes a diagnosis in one visit- which I don't particularly agree with because they hardly know the person and the circumstances that produced the symptoms(depression, anxiety, etc). Most psychiatrists strictly use a medical model and go by symptoms then treat the symptoms with medication.
I would take your son to a psychologist or social worker first and after one or more visits can evaluate him to see if he does indeed need to see a psychiatrist. A psychologist or social worker will pay more attention to what produced the symptoms instead or simply treating the symptoms with medication. Sometimes counseling and medication are needed together. It also depends on what your son wants to do too.
Good luck,
Sara
Posted by stjames on December 5, 2003, at 23:09:27
In reply to Psychiatrist or Psychologist, posted by Kinny on December 5, 2003, at 17:52:56
Without knowing what issues/conditions are at hand
it is hard to say which doc is best. Some conditions
are best treated medically and some by a Psychologist. If the condition is medical in orgin,
as mant mental illnesses are, a Psychiatrist is indicated.
Posted by gardenergirl on December 6, 2003, at 11:59:23
In reply to Re: Psychiatrist or Psychologist, posted by stjames on December 5, 2003, at 23:09:27
As a clinical psychology student, I may be biased towards psychologists rather than psychiatrists; however, I agree with Sara. I psychologist can spend more time getting to know your son than many psychiatrists can, and can even conduct testing which can aid in diagnosis. If medication is warranted, then the psychologist can collaborate with a psychiatrist, as a psychologist cannot prescribe medication (unless you are in New Mexico).
Good luck!
Posted by stjames on December 6, 2003, at 12:55:20
In reply to Re: Psychiatrist or Psychologist, posted by gardenergirl on December 6, 2003, at 11:59:23
> As a clinical psychology student, I may be biased towards psychologists rather than psychiatrists; however, I agree with Sara. I psychologist can spend more time getting to know your son than many psychiatrists can, and can even conduct testing which can aid in diagnosis. If medication is warranted, then the psychologist can collaborate with a psychiatrist, as a psychologist cannot prescribe medication (unless you are in New Mexico).
>
> Good luck!I would agree, except in some conditions. How is a
psychologist going to help a floridly psychotic person in the first visit ? Manic phase BP ?
Posted by gardenergirl on December 6, 2003, at 14:06:14
In reply to Re: Psychiatrist or Psychologist, posted by stjames on December 6, 2003, at 12:55:20
>
> I would agree, except in some conditions. How is a
> psychologist going to help a floridly psychotic person in the first visit ? Manic phase BP ?
>
>Clearly in those cases, medication will be more immediately effective. I can't say I've done an intake on a floridly psychotic person as they would likely be sent to the hospital via campus police. However, I have worked with a manic phase BP. Much of what we did on the intake and subsequent sessions were to discuss the pros and cons of medication to try to gain the client's permission to make a psychiatric referral. We also provided supportive therapy to insure as much safety as we could given that the client was not interested in meds.
Posted by stjames on December 6, 2003, at 14:48:09
In reply to Re: Psychiatrist or Psychologist, posted by gardenergirl on December 6, 2003, at 14:06:14
I guess my point is, please give us more informantion. I wasited a year in thearpy
and spent tens of thousands of dollars trying
to do something about my depression. It was fixed in 2 months once I saw the pdoc, & I was out of pocket
about $200. Thearpy was very good for many things,
I in no way regretted it, but it never solved the core problem, for me.
Posted by Burnedout on December 6, 2003, at 15:27:23
In reply to Re: Psychiatrist or Psychologist, posted by stjames on December 6, 2003, at 14:48:09
Psychiatrist or Psychologist?
If you have a good one of each category, they will work together.
Therapy and medicine both have been shown to change the chemicals in the brain--put them back as they need to be. Therapy takes longer but is longer lasting. Medicine works quickly, but there are risks taking medicine.
The M.D. or D.O. can do therapy, but he's more apt to prescribe a medication, and doesn't do much in the way of counseling.
A good therapist can't prescribe a medication, but know how to help a person learn to think, so the problem can be resolved.A good psychologist is going to know when medicine is indicated. A good psychatrist is going to know when more than just medicine is needed. They can work together--but often don't. Mine do.
Unless in crisis, I'd see the psychologist first to get a clear diagnosis.
If the diagnosis isn't schizophrenia, bi-polar, or something like that, something that needs strong intervention, right now, such as mild depression (still a serious condition), mild OCD, etc., the therapy might be able to help all by itself. And it will be long-lasting.
A therapist usually has time to take a more thorough history than a psychatrist and give psychological test that used in conjunction with talking, will get a prettty good handle on what's wrong.
So, I'd vote for using both. Generally, a clinical psychologist first. Then on recommendation, to the psychatrist.
My psychatrist manages my medicines, my therapist works to help me to be able to achieve the same results without medicines. The ultimate goal of both, I think, is to not need either.
Medicine is a short-term answer.
To get the same affect, it may need to be taken forever.
The techniques learned in therapy, can be used all the time, without having to go to the drugstore.Each has it's merits. I vote, unless in crisis, let the therapist do the diagnosis and the psychatrist prescribe any medicine, if needed.
Posted by stjames on December 6, 2003, at 16:35:12
In reply to Re: Psychiatrist or Psychologist, posted by Burnedout on December 6, 2003, at 15:27:23
Medicine is a short-term answer.
NO IT IS NOT. NO ONE HAS EVER MADE SIG. IMPROVEMNTS IN BP and PSTCHOTIC CONDITIONS WITH TALK THERARY, AS LEAST AS COMPAIRED TO MEDS.
THESE ARE MEDICAL CONDITIONS.
Posted by Viridis on December 7, 2003, at 2:10:41
In reply to Re: Psychiatrist or Psychologist, posted by stjames on December 6, 2003, at 16:35:12
I've had lots of therapy (various kinds) and generally, the conclusions of the therapists/psychologists have been that I seem quite rational and simply have problems with brain function that require treatment with medication. That's just me, and I have had some very helpful and insightful discussions with therapists -- but, in the end, the right medications were vastly more helpful, much more quickly, than hours of talk.
I should add that I've had a pretty nice life, good family, no substantial trauma, etc. For someone with major issues (due to their background and experiences), I expect that therapy could be very helpful -- these things just don't apply in my case.
I've also had some awful GPs and psychiatrists who insisted that I keep taking meds that were totally inappropriate for me. After a lot of searching, I finally have an excellent psychiatrist who listens to what I say, is flexible with meds and is happy to discuss my suggestions (many based on information learned here). He keeps his client base small and spends a lot of time with his patients, so there's actually a "therapy" component too, in that he's genuinely interested in what's happening in his patients' lives and will suggest behavioral as well as drug adjustments.
I think I hit it lucky, but it also took many years to find the right person. BTW -- this not some expensive, big-city "executive" psychiatrist, but a pretty low-cost, down-to-earth guy who just loves what he does and is eager to do it better.
Posted by gardenergirl on December 7, 2003, at 8:16:33
In reply to Re: Psychiatrist or Psychologist, posted by Viridis on December 7, 2003, at 2:10:41
but, in the end, the right medications were vastly more helpful, much more quickly, than hours of talk.
>I'm glad you found what works for you. From what I've learned, medication and therapy together can be more effective than either alone, but in every case, it depends on the individual and what is most helpful for them.
>
> I think I hit it lucky, but it also took many years to find the right person.Yes! Isn't great when you find someone who will work with you and really listen--whatever the discipline. I'm glad you kept trying until you found this guy. I'm still searching, although my GP and I have a more reasonable collaborative relationship than when we started.
Posted by Dr. Bob on December 9, 2003, at 1:43:51
In reply to Psychiatrist or Psychologist, posted by Kinny on December 5, 2003, at 17:52:56
> I am in need of an evaluation for my son...
Since this isn't specifically about medication, I'd like to redirect this thread to Psycho-Social-Babble. Here's a link:
http://www.dr-bob.org/babble/social/20031207/msgs/287920.html
Thanks,
Bob
This is the end of the thread.
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