Who Ya Gonna Call?

Going to a ther­a­pist for med­ica­tion is like going to a urol­o­gist with a bro­ken arm – you’ll prob­a­bly leave with a refer­ral to anoth­er provider but no med­ica­tion and this won’t be the fastest route for address­ing your problem.

Read on for a break­down of dif­fer­ent types of men­tal health providers and what ser­vices they do and do not provide.

Psy­chi­a­trist

A psy­chi­a­trist is a med­ical doc­tor (MD or DO) who spe­cial­izes in the treat­ment of men­tal ill­ness. A psy­chi­a­trist can deter­mine diag­no­sis and pro­vide treat­ment rec­om­men­da­tions but gen­er­al­ly focus­es on pre­scrib­ing med­ica­tion to treat men­tal health symp­toms. Psy­chi­a­trists do not usu­al­ly pro­vide ther­a­py or coun­sel­ing ser­vices, how­ev­er, most are hap­py to make refer­rals. Note: Pri­ma­ry care providers can pre­scribe med­ica­tion for men­tal health symp­toms as well. If your provider is not com­fort­able with this, he or she may refer you to a psychiatrist.

But…Who ya gonna call? How do you know when to call a psychiatrist?

  • If your child has symp­toms of ADHD or relat­ed dis­or­ders and you’d like them treat­ed with med­ica­tion, first con­tact your child’s pri­ma­ry care provider. He or she might pre­scribe med­ica­tion or refer you to a psy­chi­a­trist if that is out­side of his or her com­fort zone.
  • If you or your child have symp­toms of anx­i­ety or depres­sion and you have already tried ther­a­py or are not inter­est­ed in ther­a­py but might be inter­est­ed in med­ica­tion, con­tact your pri­ma­ry care provider. He or she may feel com­fort­able pre­scrib­ing you med­ica­tions and if not, will refer you to a psychiatrist.
  • If you or your child have already tried sev­er­al med­ica­tions under the super­vi­sion of your pri­ma­ry care provider but your symp­toms are not improved or are get­ting worse, seek a sec­ond opin­ion with a psychiatrist.
  • If you have a his­to­ry of com­plex men­tal and phys­i­cal health prob­lems or are on sev­er­al med­ica­tions already, a psy­chi­a­trist may be nec­es­sary to help you find the right medication.
  • Any­one admit­ted to the hos­pi­tal for psy­chi­atric rea­sons or expe­ri­enc­ing psy­chi­atric symp­toms dur­ing a med­ical inpa­tient stay will be eval­u­at­ed by a psychiatrist.

Clin­i­cal Psychologist

Clin­i­cal psy­chol­o­gists have a doc­tor­ate degree (Ph.D. or Psy.D.) and are experts in the field of psy­chol­o­gy. Clin­i­cal psy­chol­o­gists teach, con­duct research, pro­vide psy­chother­a­py ser­vices, and pro­vide psy­cho­log­i­cal test­ing to deter­mine diag­no­sis and treat­ment needs. Some clin­i­cal psy­chol­o­gists com­plete court-ordered and cus­tody eval­u­a­tions. In a few states, psy­chol­o­gists can com­plete addi­tion­al spe­cial­ized train­ing and pre­scribe med­ica­tion under the super­vi­sion of a psy­chi­a­trist; how­ev­er, this is not yet occur­ring in Illinois.

When should you call a clin­i­cal psychologist?

  • If your child has some symp­toms of ADHD and you want to know for sure if he or she meets the cri­te­ria for this diag­no­sis, seek a psy­chol­o­gist who pro­vides psy­cho­log­i­cal eval­u­a­tions and can do testing.
  • If your child is hav­ing a wide range of emo­tion­al, behav­ioral, and aca­d­e­m­ic dif­fi­cul­ties and you aren’t sure where to begin, a psy­chol­o­gist can pro­vide a com­pre­hen­sive eval­u­a­tion to deter­mine diag­no­sis and pro­vide rec­om­men­da­tions for treat­ment and need­ed services.
  • Pos­si­ble learn­ing dis­abil­i­ties, cog­ni­tive prob­lems, or com­plex men­tal health or behav­ioral issues all war­rant a call to a psychologist.
  • If a judge orders a psy­cho­log­i­cal eval­u­a­tion, a clin­i­cal psy­chol­o­gist would pro­vide this ser­vice. Usu­al­ly the court would make arrange­ments for this type of eval­u­a­tion so you wouldn’t need to ini­ti­ate the eval­u­a­tion your own.
  • It is impor­tant to remem­ber that not all clin­i­cal psy­chol­o­gists offer the same ser­vices. For exam­ple, some may pro­vide learn­ing eval­u­a­tions but not court-ordered eval­u­a­tions. Oth­ers may pro­vide only assess­ment ser­vices and oth­ers only therapy.

Social Work­ers, Coun­selors, & Therapists

Social work­ers have master’s degrees in social work, a field des­ig­nat­ed to pro­vide help to those in need. Social work­ers work in schools, hos­pi­tals, nurs­ing homes, the mil­i­tary, and in men­tal health cen­ters. The state licens­es in Illi­nois for social work­ers are the LSW (Licensed Social Work­er) and the LCSW (Licensed Clin­i­cal Social Work­er). Social work­ers assess, diag­nose, and treat men­tal health dis­or­ders. They may run social ser­vice agen­cies and pro­vide advo­ca­cy. Social work­ers can also work in admin­is­tra­tive roles in clin­ics. They do not pre­scribe medications.

Coun­selors are clin­i­cians with a master’s degree in one of sev­er­al dif­fer­ent fields includ­ing psy­chol­o­gy, coun­sel­ing, com­mu­ni­ty men­tal health, school psy­chol­o­gy, and coun­sel­ing edu­ca­tion. Coun­selors give guid­ance for per­son­al, social, behav­ioral, or psy­cho­log­i­cal prob­lems and work in many dif­fer­ent set­tings. They are trained to assess, diag­nose, and treat men­tal health dis­or­ders. The state licens­es for a coun­selor in Illi­nois is the LPC (Licensed Pro­fes­sion­al Coun­selor) and the LCPC (Licensed Clin­i­cal Pro­fes­sion­al Coun­selor). They also do not pre­scribe medications.

Note: The edu­ca­tion and train­ing of a social work­er and a coun­selor have many sim­i­lar­i­ties but their pro­grams are in dif­fer­ent depart­ments and stu­dents of each can end up in very dif­fer­ent posi­tions after grad­u­a­tion. How­ev­er, when seek­ing coun­sel­ing , you will find both social work­ers and coun­selors pro­vid­ing this ser­vice as both can be employed as men­tal health coun­selors. Often, your insur­ance will tell you which type of provider is cov­ered and it is wise to start by get­ting list of approved providers before sched­ul­ing an appointment.

Ther­a­pist is a term often inter­changed with social work­er and coun­selor. You might also see psy­chother­a­pist or behav­ioral health ther­a­pist used this way. The term ther­a­pist itself refers to any per­son trained to pro­vide a par­tic­u­lar type of ther­a­py. There are many types of ther­a­pists – phys­i­cal, occu­pa­tion­al, speech, music, mas­sage, res­pi­ra­to­ry, and behav­ioral health are just some of them.

When should you call a social work­er, coun­selor, or therapist?

  • If you know your child has ADHD and you want him or her to learn impulse con­trol strate­gies or you want fam­i­ly ther­a­py to learn to work with your child’s symp­toms, start by con­tact­ing your insur­ance com­pa­ny to find out which therapists/​counselors/​social work­ers are cov­ered in your area.
  • If you are expe­ri­enc­ing anx­i­ety or depres­sion symp­toms and want to learn cop­ing strate­gies for reduc­ing or man­age­ment your symp­toms, ther­a­py with a social work­er or coun­selor is the way to go.
  • If you have expe­ri­enced a trau­ma and it is hav­ing a neg­a­tive impact on your day to day life, seek coun­sel­ing services.

Case Work­er

A case work­er or care man­ag­er typ­i­cal­ly has a bachelor’s degree or high­er in a social ser­vice or health­care field and works to pro­vide patients with advo­ca­cy, infor­ma­tion, and to make con­nec­tions to nec­es­sary sup­ports and ser­vices. Case man­agers might work in men­tal health cen­ters, for the Depart­ment of Child and Fam­i­ly Ser­vices (DCFS), or in hos­pi­tals and clin­ics. Typ­i­cal­ly, case work­ers and care man­agers are assigned to peo­ple as need­ed to address finan­cial, social, or health relat­ed dif­fi­cul­ties. Often doc­tors, psy­chi­a­trists, social work­ers, and coun­selors will refer their patients to case/​care man­agers for addi­tion­al assistance.

Thanks for reading!

Next week’s post will focus on the pros and cons of med­ica­tion ver­sus ther­a­py to treat spe­cif­ic types of men­tal health symptoms.

Until then,

Nik­ki