Quick Answer: Psychiatrists are qualified to offer both regular therapy sessions and medication management appointments, but each psychiatrist determines the focus of their practice and the services they provide.
Key Points:
- Psychiatrists are medical doctors (MDs), which means they have extensive training in biology and human physiology that enables them to safely manage and monitor both treatment progress and the side effect profile associated with psychiatric medications.
- Some psychiatrists focus on assessment, diagnosis, and medication management, rather than psychotherapy.
- Other psychiatrists receive additional training in standard psychotherapeutic techniques, and offer regular therapy sessions in addition to assessment, diagnosis, and medication management
Therapy, Medication Management, or Both?
If you receive a diagnosis for a clinical mental health disorder, one of the first things you want to know is who to see for treatment and support – and one of the first questions you might ask is about potential mental health providers. For instance, when deciding between a psychiatrist and a therapist, you might want to know whether psychiatrists offer regular therapy sessions, focus mostly on medication management, or do both regular therapy and medication management.
If you receive a diagnosis for a clinical mental health disorder, one of the first things you may want to know is who to see for treatment and support – and one of the first questions you might ask is about potential mental health providers: for instance, when deciding between a psychiatrist and a therapist, you might want to know whether psychiatrists offer regular therapy sessions, or if they focus mostly on medication management.
It’s a valid question, because some psychiatrists offer regular therapy sessions, some don’t, and some fall somewhere in between: they may offer them, but in most cases, not with the consistency you might expect from therapy sessions with a clinical psychologist. Instead, those psychiatrists focus on the medication management aspect of psychiatry, and their role in monitoring how the different parts of a treatment plan – i.e. medication, therapy, biological/physiological factors – impact treatment progress.
The Role of Psychiatry and Psychiatrists in Mental Health Treatment
To help you decide who you might need to see for support, let’s take a look at what psychiatrists do – meaning their official roles and duties – according to the American Psychological Association (APA).
First, their definition of psychiatry:
“Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders.”
Now, the APA explanation of what psychiatrists do:
“A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are qualified to assess both the mental and physical aspects of psychological problems and prescribe psychiatric medication.”
Diagnosis, treatment, and prevention: those are the official duties of a psychiatrist. They train for more than a decade to earn appropriate licensure and accreditation to patients with mental health challenges and/or disorders.
What is Medication Management?
Since the goal of this article is to answer the question we pose in the title, we’ll focus on the treatment component of psychiatry. First, we’ll discuss medication management. Here’s a basic definition, adapted from various public and private resources:
Medication management in psychiatry is the practice of prescribing, monitoring, and adapting dosage of medications based on diagnosis, safety, treatment response, and patient preference. It also includes determining whether a patient is compliant and adheres to the medication component of a psychiatric treatment plan, or noncompliant, and does not adhere to the medication component of a psychiatric treatment plan.
Additional things to know about psychiatrists and medication management:
1. Level of Engagement Matters
Look for a psychiatrist who indicates they’ll take an active role in your treatment and recovery. If you get the impression a psychiatrist wants to prescribe and forget, consider a different psychiatrist. That doesn’t mean they have to offer therapy, but rather, it means they’ll communicate with you and your therapist (if you have one) on your treatment progress and any concerns or issues.
2. Diagnosis Education and Medication Education is Essential
Engaged and involved psychiatrists – like those we mention above – will educate you about your diagnosis, your medication, and what you can expect from your medication in terms of your diagnosis. They should be ready and willing to answer any and all questions or concerns you have about your diagnosis and treatment plan, and take the time to answer every question you have fully and to your satisfaction.
3. Training in Hard Sciences Protects You
The value of their medical degree. While clinical psychologists also spend years training before they treat patients, it’s important to recognize the importance of an MD’s scientific training. They learn core principles of biology, physiology, chemistry, and other hard sciences as they apply to medicine and health, including mental health and brain function. In that way, a psychiatrist can keep a treatment plan grounded not only in the latest psychotherapeutic techniques, but also in the latest information on safety, efficacy, and side-effects of psychiatric medication.
Medications a psychiatrist may prescribe include, according to the APA:
- Antidepressants, which may be appropriate for:
- Depression, anxiety, obsessive -compulsive disorder (OCD), post-traumatic stress disorder (PTSD), borderline personality disorder, and others
- Antipsychotics, which may be appropriate for:
- Schizophrenia, bipolar disorder
- Stimulants, most often used to treat
- Attention-deficit hyperactivity disorder (ADHD)
- Mood stabilizers, which may be appropriate for:
- Bipolar disorder
- Sedatives, which may be appropriate for:
- Anxiety, sleep disorders, panic attacks
When you receive a prescription for medication, it’s essential to have expert medical guidance and how to take the medication and what to watch for. In mental health treatment, that’s a core responsibility of a psychiatrist, since among mental health professionals, they receive the most extensive training in human biology, physiology, and how medications interact with the human body and brain.
Next, let’s look at what types of psychotherapy offered by psychiatrists who do offer regular or semi-regular therapy sessions.
Psychotherapy in Psychiatry: Psychiatrists and Types of Therapy
The APA indicates that after their psychiatry residency, psychiatrists-in-training may spend additional time learning the following psychotherapeutic techniques:
- Cognitive Behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Group, family, or individual therapy
- Interpersonal psychotherapy
- Supportive psychotherapy
Psychiatrists may provide therapy sessions with any of those approaches, in combination with medication management. However, if they don’t, an engaged and involved psychiatrist will communicate with the provider offering therapy – typically a clinical psychologist – during your entire treatment journey. They’ll collaborate with you, your therapist, and any other providers involved in your care to ensure you meet your treatment goals. And if you don’t they’ll work with you, and one another, to adjust your plan for optimal results.
Who Should I Look For? Psychiatrists, Regular Therapy, Medication Management, or All of the Above?
The best way to decide is by starting with a full psychiatric evaluation administered by a psychiatrist or a clinical psychologist. They can both evaluate psychological conditions and diagnose mental health disorders.
What happens next, i.e. who you choose, will depend on the outcome of the evaluation. If you receive a diagnosis for a clinical mental health disorder that evidence shows may benefit from medication, then you may want to choose either a psychiatrist who offers therapy, or a psychiatrist for medication management and a psychologist for therapy.
However, if you have an emotional/psychological/thought issue you need to work through but can’t seem to manage yourself, problems with people at work, difficulty in a relationship, or habits that impair your daily functioning – and you don’t have a mental health disorder – then you may want to choose a psychotherapist. They’re experts at helping people work specifically on problems/issues like those.
On the other hand, if you’re in therapy and you’re not satisfied with your progress, if you’re having severe mood swings that threaten your personal safety or the safety of others, or you experience visual or auditory hallucinations not connected to drug use, or you already think you need to try medication to address your needs, then you may want to choose a psychiatrist, especially in the early stages of your care.
In any case, if you have mental health problems and think you need professional support, the best first step is a full psychiatric evaluation administered by a licensed, qualified mental health professional.
