How does psychiatric medication and therapy treatment work together?

First let’s begin with the difference between psychiatry and psychology, as it can be confusing! Professionals in psychiatry and psychology are both experts in mental health – their area of expertise is the brain — and the way it affects behavior and well-being. They often work together to prevent, diagnose, and treat mental health conditions and illnesses. The difference between a psychiatrist and a psychologist is in the way they focus their treatment.
Psychologists typically obtain an education in how guiding a discussion with a patient about their thoughts, experiences, emotions, and behaviors can affect their emotional health and wellbeing. Psychologists, and other types of talk therapists (including some Social Workers, Licensed Marriage and Family Therapists) use various methods of discussion and exploration to improve someone’s symptoms. Psychotherapy, or talk therapy, is a way to help people with a broad variety of mental illnesses and emotional difficulties. Psychotherapy can help eliminate or control troubling symptoms so a person can function better and can increase well-being and healing.

While psychiatrists often also receive training and practice psychotherapy, psychiatrists go to medical school and prescribe medications to treat mental health disorders. Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders. A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, and psychiatrists are qualified to assess both the mental and physical aspects of psychological problems and can prescribe medication to treat.

At Remedy, for optimal mental health, we wholeheartedly believe in:

  1. Lifestyle changes first (including a healthy whole foods diet, limited substances, exercise, limiting stress)
  2. Psychotherapy, or ‘talk therapy’ (of which there are many different types of therapy and qualified therapists)
  3. And as a final part of the treatment plan when appropriate: medication. Medication can be prescribed by medical doctors, nurse practitioners and physician assistants. While medical doctors can prescribe independently, nurse practitioners and physician assistants prescribe under the supervision of a medical doctor. At Remedy, our team includes highly skilled and experienced psychiatric nurse practitioners, under the supervision of a medical doctor, a psychiatrist.

While we encourage all of our patients to pursue therapy, we aim to provide very affordable care and therefore keep our costs to patients low by only focusing on the psychiatric medication management piece, not the talk therapy piece. We have highly skilled therapy referrals that we can refer our patients to. And, with patient permission, we will work very closely with a patient’s therapist to have a collaborative team in place to provide the best care to the patient. Below is an example of collaboration from one of our therapist partners, Perri!

” I referred both clients and personal friends to Remedy during this past year and every person I referred to the practice came back with rave reviews. Everyone reported it was easy to make an appointment, felt understood and connected to their prescribing clinician, which isn’t always easy over telehealth, and felt the service was affordable (another hard thing to come by). I just wanted to let you know and thank you for offering this as an option to people really in need during this time.”

–  Perri Sun, LCSW, Therapist, Los Angeles

See below for a Q&A with Clinical Director, Melissa Boudin from Choosing Therapy:

How do you determine when a patient needs to be referred to a psychiatrist for potential medication treatment?

I refer for medication management when symptom severity persists despite active engagement in therapy, or when it is too high for a client to be able to engage effectively in talk therapy. When depressive, anxiety, bipolar, or sometimes psychotic symptoms are interfering with a person’s ability to actively/positively participate in therapy, or inhibit them from actively putting the skills learned in therapy to work outside of the therapy room, I feel it is time to refer for a psychiatric evaluation. With medication management symptom severity often reduces enough for the client to then truly benefit from talk therapy. I also refer to a psychiatrist in crisis situations, as I feel additional support is always beneficial in those circumstances.

How do you collaborate with psychiatrists to provide the best care to patients when appropriate?

If I know that a therapy client is also seeing a psychiatrist, I request a release of information from the client, allowing an open line of communication between myself and the psychiatrist. Communication between providers, between the client appointments is crucial, particularly when there have been any changes in treatment plan, medications, etc. Collaborating on diagnoses and conceptualizing a case in the beginning of treatment can also be important, so that all providers are on the same page with treatment and provide consistent information to the client. When collaborating I ask the treating psychiatrist to keep me up to date on the medications prescribed and potential side effects, as well as progress, so that I am aware of what the client may experience and what to expect. I also inform the psychiatrist of any changes in my treatment plan for the client, and of progress toward treatment goals, so they too can also know what to expect and adapt treatment to be in line with that information.

Melissa Boudin PsyD

Clinical Director, Choosing Therapy

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