The 3 Psychs

1. Psych – iatrist, 2. Psych-ologist and 3.Psych-otherapist.

The psychiatrist is a medical doctor who has chosen to do their internship in a psychiatric ward at a hospital.  They can prescribe medication but have not necessarily studied psychology.  They are generally found in a hospital or a mental health clinic.  Sometimes they work in private practice and conduct psychotherapy services.

The psychologist has either a Ph.D. or Psy.D. in psychology and can also prescribe medication (in some states).  They can be in the same locations as the psychiatrist and sometimes work in private practice also.  Unless they have met the criteria for psychotherapist in the state they are in, they would most likely refer to themselves as a psychologist.  Often they are involved in testing and complete comprehensive psychological evaluations.

The psychotherapist has a minimum of a master’s degree but can have a doctorate as well.  In order to practice you must have a license or be an intern under the direction of a licensed practitioner, as per your state guidelines.  Generally speaking you would see the license being held is as a Marriage and Family Therapist, Professional Counselor or Social Worker (each state has different initials for these categories, though you will at least see MFT, PC or SW added after an L or LI or LC).

If someone has a mental illness, they would generally work with a psychiatrist/psychologist and a psychotherapist.  Although the psychologist could both prescribe and would be more apt to conduct therapy as well.  A psychiatrist may also do therapy, it would depend on whether they are in private practice or in a hospital where there is someone else to provide the psychotherapy services.

Psychotherapists generally see clients who are dealing with daily stress issues and while they may have a mental health diagnosis, it might not include medication.   Again, if the client is on medication, they HAVE to be seen collaboratively with a doctor, wherein all information is shared between the two parties.

Many people are confused and think that psychotherapy is for “crazy” people.  The term crazy is NOT a professional term and is not used in documents in regards to mental health patients.  This is a socially inadequate term used to define people who are different or veer from the norm.  It is used by people who do not understand someone’s behavior because they are not in the field of psychology.  This is a term for pushing away someone who makes you uncomfortable.

All of us are “crazy” at some point in our lives.  We all go through lessons that come out of no where such as abuse, death, job loss, divorce, or even identity and spiritual confusion.   This causes us to react depending on the situation and based on our emotional level at the time of the occurrence.  We have psychotherapy available to those who are dealing with these lessons and help us to get through it, so that we don’t become emotionally out of control.  Without some sort of support our emotions can become out of balance and this is when people will be seen as going to the extremes.

Mental illness has gone back and forth as to whether or not it is genetic.  We now know that there is a link and that when we see a client with bi-polar or schizophrenia, for example, we will most likely see someone else in their family history who went through the same thing.  The same thing does not necessarily mean the exact same diagnosis.  This is because a parent or grandparent may not have been diagnosed properly or the family ostracized them for being “crazy.”  Often I will ask a client if they have had anyone who was in a psychiatric facility or insane asylum.  I will use social terms known throughout history because these are words we have heard.  A client may not know if their ancestry had mental illness but they will know if they were “locked up,” or pushed aside or put somewhere for their safety.  Other clients have mentioned “they were just not right in the head.”

If someone in your immediate family is suspected of having a mental illness or not being quite right, it is best to have them seen by a doctor to start with.  If this is a child, you would want to push for testing at the school through the Individual Education Plan (IEP).  You will also want to start them out with a psychotherapist as well.  Many times children are mis-diagnosed as people jump the gun.  Through testing and psychotherapy, it is easier to find out the root of the problem.  My experience has shown me that parenting issues are the biggest concern when a parent thinks they have a child who is mentally ill. This is not to say that all situations are like this, it is only to say that the majority of the time the family household is in disarray and that the parents would benefit more from therapy.  It is easy to blame children because they are young and naive and tend to react “immaturely” (as they should) to stress in the house. 

These are just basic guidelines and you should always do your own research online and read various sources to obtain the answers you seek.  Psychology is a fascinating topic of interest, one that I love very much.  However, even us pros have to consult manuals ourselves, and discuss these issues amongst our colleagues.  This is no different from what you see on television with ER, Private Practice or Grey’s Anatomy – doctors questioning the disease and getting various opinions before making a decision.  There are different ways of looking at the mind and body because nothing is black and white in this world, and our biases will always get in the way.

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