Instruction manual for Clinical Psychologists Part 1
Psychology and Psychiatry are closely knit professions, both of which are extremely crucial in ensuring that quality mental health care is provided to all the patients/clients. There are several instances where as psychologists and therapists, we see a need for the patient to be recommended to a Psychiatrist due to various reasons and there is a very obvious and justified fear that is observed in the clients/patients when we mention a psychiatrist. This manual/article encompasses all the information that you can give to your client to ensure that they are well informed and know what to expect from their psychiatric consultation . This makes the clients less fearful and apprehensive of the psychiatric consultation and also makes them aware about the things that they need to discuss with the Psychiatrist to get the desired outcome.
Psychiatrists generally look for something called a Functional Diagnosis, which means they gauge how similar the presenting symptoms are to a particular disorder in order to decide the appropriate psychiatric medication for the Patient. It is important to note that this diagnosis should not be taken as the final diagnosis. The aim of this is to decide the appropriate medication and nothing else. This initial diagnosis gradually evolves as the Patient has more sessions with them and as more information is provided to the psychiatrist by the Psychologist/therapist.
In the first session with the psychiatrist, the doctor will provide the patient with a low dose psychiatric medication to check if:
The level of effect of the psychiatric medication prescribed
There are any side effects of the prescribed medicine(s)
In the follow-up session with the client/Patient, the Psychiatrist will check if:
The patient saw reduction in symptoms as expected from the prescribed medication
The prescribed medication has had any side effect
The prescribed medication has not had the intended effect
Based on the observed outcome of the psychiatric medication, the Psychiatrist will do the following:
If the psychiatric medication has benefitted the client and has the desired intensity, the psychiatrist will ask the patient to continue the medication at the same dosage and will give a prescription for a longer duration.
If the psychiatric medication has benefitted the client but not at the desired intensity then the Psychiatrist will increase the dosage of the medication that was previously prescribed or add other medicines.
If the psychiatric medication has had side effects then the Psychiatrist might change the medications prescribed or prescribe additional medicines to counter the side effects.
If the medicine has had no effect then the Psychiatrist will change the medication prescribed.
It is important to note that Psychiatry is a Symptom control speciality of medicine.
Its aim is to improve the quality of life of a patient/client via reduction or removal of symptoms and support psychotherapy.
What is the difference between a Symptom Control Speciality and a Curative Speciality?
A Symptom control speciality aims at reducing and controlling the symptoms of a particular disease or disorder and not at curing the disorder itself. For example, Optometry focuses on how the vision related issues caused due to retinal damage or other problems can be managed through the use of Spectacles/lenses. Similarly, Palliative care is a symptom control speciality where the focus is on alleviating the problems caused by cancer in an individual’s life and not curing cancer.
Conversely, when we talk about a Curative Speciality, the aim is to cure and eliminate a disorder from its very root. It aims at identifying the causes of the issues being faced by an individual and providing treatment to eliminate those causes. For example, Ophthalmology is a curative field where the causes of the eye problems are examined and eliminated. Similarly, Oncology is a curative speciality where cancer is treated and eliminated.
Therefore, it is important for us as Practitioners to be aware about the advantages and limitations of Psychiatry as a speciality to ensure that the best form of care is provided to the Patient/Client.
This article is part of a series of instruction manuals for psychologists compiled by Team CINQ.IN. We will be regularly posting articles on various topics to support psychologists working in clinical settings.
About CINQ.IN: We provide evidence-based therapy for anxiety, depression, and more. We offer therapy and counselling services in Baner, Pune. For more information, contact us at +91 8009105005 / 8007566553.
Article by : Bharvi Ratanghayra
This is a fantastic and informative post on psychiatric consultation and medications! I really appreciate how you clarified the distinction between symptom control specialties and curative specialties — that's something many people misunderstand. Your explanation of the psychiatrist’s process, especially the importance of the initial functional diagnosis and medication adjustments, is very helpful for setting client expectations.
I’m curious: how can a psychologist and psychiatrist work together more seamlessly to ensure the best outcomes for clients, especially when it comes to adjusting treatments?