Have you found that either yourself or your child has been referred for assessment or treatment for ADHD to a specialist, but you are not really sure what the difference is between a psychologist and a psychiatrist?
Many people come to us at ADHD Ireland for advice on where to go next once they discover that either they or their child may need an ADHD assessment.
This short guide outlines the difference between both professionals, so that you can be informed in your decision on taking the next step in your ADHD treatment:
The 3 Key Differences:
- Psychiatrists are qualified medical doctors, psychologists are not.
- Psychiatrists can prescribe medication, psychologists cannot.
- Psychiatrists can diagnose, manage treatment, and provide a range of therapies for all levels of mental illnesses, including ADHD. Psychologists can diagnose mental illnesses, but their form of treatment and therapy focuses primarily on non-medication-based treatment such as psychotherapy (talk therapy) to help patients.
Psychiatrists:
Psychiatrists are medical doctors with at least 12 years’ training, or more. They first do a medical degree at university before qualifying as a doctor and then they complete at least six years of training in the diagnosis and treatment of mental health problems.
They can treat complex conditions including severe depression, schizophrenia, bipolar disorder, etc.
Their methods of treatment include prescribing medication, psychological treatments, cognitive-behavioural therapy (CBT) and general medical care, including your health and response to medications.
Currently in Ireland, all consultant child psychiatrists and psychiatrists working with children and adults with intellectual disability can diagnose and treat ADHD. However, many consultant adult psychiatrists are not yet trained to do so. This training is now being provided for trainee adult psychiatrists as a first step in addressing this issue. This is organised by the HSE Adult ADHD National Clinical Programme in association with the College of Psychiatrists of Ireland.
Psychologists:
Psychologists have at least 6 years of university training and supervised clinical experience. They may also hold a Masters or Doctorate level qualification in psychology. If they have a Doctorate (PhD) a psychologist can call themselves ‘Dr’, but they are not medical doctors.
Clinical psychologists have special training in the diagnosis and treatment of mental health problems.
Psychologists are more likely to see people with conditions that can be helped effectively with psychological treatments. This might include behavioural problems, learning difficulties, depression, and anxiety. Not all psychologists are trained in the diagnosis and treatment of ADHD.
If you would like more information, please contact us on 01-8748349 or [email protected]
Information
Mental health services use a multidisciplinary approach, where a number ofprofessionals offer their particular skills in a co-ordinated and complementaryway.
Family doctor (GP)
Your GP is often the first person you will seek help from. He/she willassess the problem and may either provide medication and monitor your conditionor may refer you to a specialist, for example, psychiatrist, psychologist orcounsellor, if necessary.
Psychiatrist
A psychiatrist is a medical doctor that specialises in mental health.Psychiatrists are responsible for the medical care of psychiatric patients(medication, physical symptoms, etc.) and are also involved in counselling. Apsychiatrist usually works in a psychiatric hospital or unit or as part of acommunity care team but can also be part of a private practice. In most cases,your GP will refer you to a psychiatrist if he or she considers it necessary orif you request a referral. A psychiatrist will assess you to decide on the besttreatment. This may involve treatment with medication or referral to a memberof the mental health team. If a psychiatrist thinks it necessary, he or she maysuggest that a patient be admitted to hospital.
Psychologist
A psychologist is trained in the study of human behaviour and tries toexplain feelings, thoughts and behaviour. Psychologists can provide assessmentand treatment of a wide range of psychological problems. They can also helppatients examine the effects their illness is having on their lives and methodsof coping with those effects. Bringing a patient closer to an understanding ofhis or her illness is a key aim of a psychologist. When involved in the area ofmental health, the psychologist usually works as a clinical, community orcounselling psychologist, and unless also medically qualified, does notprescribe medication.
Clinical psychologist
The clinical psychologist has a specialist qualification in mental healthand works as part of the mental health team in a unit or hospital and isinvolved in assessment and counselling therapy. Family therapy may be providedwhere appropriate and a particular approach may be used for specific problems,such as a cognitive-behavioural approach for phobias. Referral is often througha GP or psychiatrist, but self-referral is possible.
Community psychologist
The community psychologist has a clinical qualification and works as part ofa community-based team with individuals such as social workers, speechtherapists and community welfare officers. The community psychologist isinvolved in assessing and working with those with a wide range of problems,including children with behavioural, educational and other difficulties.
Counselling psychologist
Counselling psychology, as a specialist area, encompasses a broad range ofpractices that help people improve their well being, alleviate distress andmaladjustment, resolve crises, and increase their ability to live more highlyfunctioning lives. Counselling psychologists can be found working in diverseareas such as schools and colleges, industrial workplaces and health services.
Behavioural therapist
Behavioural therapy works on the premise that you can change what people doby teaching them to respond to things in a different way. Behavioural therapyaims to help the patient control undesirable habits or irrational fears and canbe used in the treatment of behavioural conditions like eating disorders andphobias. In many cases, behaviours can be learned or unlearned through basicconditioning techniques. Behavioural therapy uses such techniques as aversiveconditioning, where unwanted habits are paired with unpleasant stimuli, andsystematic desensitisation, where a stimulus that causes anxiety is paired witha pleasant one. Some behavioural therapists may also be psychiatrists orpsychologists but this is not necessarily the case. They may be people likepsychiatric nurses or social workers who have received the relevant training towork in this area. While this kind of therapy is frequently used in thetreatment of behaviour disorders, it may not be available in all regions.
Cognitive behavioural therapist
Cognitive behavioural therapy (CBT) aims to reduce dysfunctional emotionsand behaviour by changing behaviour and thinking patterns. Professionals whospecialise in this kind of therapy believe that a change in symptoms andbehaviour follows a change in thinking. This change can be brought about in anumber of ways, including the practice of new behaviours and analysis of faultythinking patterns. The purpose of CBT is to reduce distress or unwantedbehaviour by undoing this learning or by providing new, more adaptive learning.Again, cognitive behavioural therapists may not all be psychologists orpsychiatrists and you should check with your Health Service Executive (HSE)Area to see if the service is available in your area.
Counsellor
There are many forms of counselling available for a wide range of problemsand many counsellors specialise in particular areas such as addiction orbereavement. All approaches emphasise non-judgemental, attentive listening andrespect for the client. Counselling aims to enable people to take control oftheir own lives. Self-referral is the usual route to counselling, although aGP, psychiatrist or trusted friend may be able to recommend someone suitable.Some counsellors are qualified psychologists, but many are not. Those who arenot may have a basic degree or training in other areas and/or relevant workexperience (for example, teaching, nursing, etc.) plus a counsellingqualification. These qualifications can vary from Masters degrees to short-termcourses. It is important to make sure you are happy with the training andqualifications of any counsellor that you choose. Counselling is often onesession per week and tends to be short-term rather than longer-term, althoughthis can vary.
Addiction counsellor
Addiction counsellors provide assessment, counselling, information andtreatment services for people suffering from alcohol, drugs and gamblingaddictions. Before receiving counselling for addiction, a patient must gothrough a detoxification programme, if necessary. The patient is then referredto the community-based addiction treatment service. Individual and groupcounselling is often used with an emphasis on the consequences of the addict’sbehaviour. The main aspect of treatment examines the triggering factors thatlead to the development of the addiction. Target goals are set to try andestablish new patterns of healthy behaviour. An important part of the treatmentis the involvement of a family member, which can help to achieve these targets.The programme lasts for an average of six to eight weeks and is followed by anafter care service.
Psychotherapist
Psychotherapy tends to be more in-depth than counselling. It is based on theidea that the less aware we are of our motives, feelings and actions, the morethey control us and the more we stay stuck in old patterns that may be harmfulto us. A psychotherapist can help patients to examine their subconscious mind.By bringing any unconscious motives, fears and feelings to light and dealingwith them, patients can often get relief from their symptoms. Psychotherapistsusually undertake a long postgraduate training that requires trainees toundergo therapy.
Psychiatric nurse
The psychiatric nurse plays a central role in the care of the psychiatricpatient, both in a hospital setting and in the community. He or she workswithin a psychiatric service as part of a health care team. Nurses provide bothphysical and psychological care to their patients and can also provideessential support and encouragement to the patients’ families. The nurse’sactivities are varied but can include:
- Day patient care
- Detoxification programmes
- Education of student nurses and community groups
- Family education and support
- Group therapies, individual counselling
- Acting as a liaison with in-patient services, GPs, strategy and voluntary organisations
- Organisation of admissions to hospital and reception
- Initial assessment of referrals from GPs
The community psychiatric nurse usually follows up patients on dischargefrom hospital, calling to their homes and attending out-patients’ clinics andday care centres.
Mental health social worker
Mental health social workers work as part of a team to provide counselling,information and coping strategies. Mental health social workers help tocoordinate different services. In addition to health services, this couldinclude housing, social welfare and employment services.
Occupational therapist
Occupationaltherapists provide services to people whose ability to cope with everydayactivities is affected by physical, psychological or developmental problems.Occupational therapy aims to enable the person to be as independent aspossible. Treatment can include self care, personal development, mobility andaccess, skills and training, home management, work preparation and stressmanagement.
Vocational supports trainer
Vocational training provides skills, knowledge and attitudes to help youenter employment, further training, education and self-employment. Referral isusually through a professional such as a psychiatrist, but self-referral isalso possible. While some trainers are mental health professionals, such aspsychiatric nurses, others may not have specific medical training.
