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psychiatry

court922court922 Posts: 240Registered User Junior Member
edited November 2012 in Careers in Medicine
Is it true that psychiatry no longer includes therapy , they just prescribe medicine and let therapists and psychologists do all the other work ? I ask this because this is what I heard and I want to go into Forensic Psychiatry but I don't want to ONLY prescribe medicine. I'd like to do other things too.
Post edited by court922 on
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Replies to: psychiatry

  • WayOutWestMomWayOutWestMom Posts: 6,568Registered User Senior Member
    Psychiatry's emphasis is on understanding and managing the underlying neuro-chemical imbalances in the brain that cause mental illnesses. Management is largely done thru medications. Most psychiatrists no longer do "talk therapy"--that is done by clinical psychologists.

    Psychiatrists do talk with their patients to understand their pathology and to find the best route to returning them to functionality, but they no longer engage in extended Freudian (or Jungian or whatever theory you subscribe to) analysis.
  • PhilovitistPhilovitist Posts: 2,737Registered User Senior Member
    (psychiatrists do prescribe talk therapy, though)

    It's just too expensive to pay a physician to do what a psychologist could do. Besides, think of the opportunity cost.
  • MaineLonghornMaineLonghorn Posts: 18,450Super Moderator Senior Member
    I found a doctor for my two sons who does do talk therapy. The insurance company won't pay for the amount of time he likes to spend with patients, so he hasn't been accepting insurance. He's decided to start, so I'm not sure how that will affect his practice. We are SO fortunate - this man is almost always available when I'm worried about the boys. They know they can call or text him, and he will respond quickly.
  • WayOutWestMomWayOutWestMom Posts: 6,568Registered User Senior Member
    ^^ So does the clinical psychologist that I used to see. Availability to patients and responsiveness is part of the job description.

    Clinical psychs often work quite closely with psychiatrists, each employing a different approach to manage a patient's illness. In some states, clinical psychologists have limited prescription privileges and can write 'scripts for neuro-psychiatric drugs.
  • MaineLonghornMaineLonghorn Posts: 18,450Super Moderator Senior Member
    "Availability to patients and responsiveness is part of the job description. "

    Then I guess a lot of professionals aren't doing their job, because I've heard differently from other patients.
  • court922court922 Posts: 240Registered User Junior Member
    So basically psychiatrists don't do any talk therapy? I'm not really into talk therapy , just mainly forensic psychiatry.
  • MaineLonghornMaineLonghorn Posts: 18,450Super Moderator Senior Member
    No, some definitely do it, it's just not common. One of my sons had a psychiatrist in his college town who also did it.
  • i_wanna_be_Browni_wanna_be_Brown Posts: 5,260Registered User Senior Member
    There are psychiatrists who do talk therapy but they are in private practice and don't take insurance. Thus their clientele is typically upper class people only.

    You don't want to do talk therapy but you don't want to ONLY prescribe drugs...so what exactly do you want to do? Don't just say Forensic Psychiatry. Be more specific.
  • court922court922 Posts: 240Registered User Junior Member
    I apologize for that. I mean that I don't want to do just one , or one over the other. I prefer to do both . For example , talk to the patient so that I am able to prescribe a certain type of medicine as a Forensic Psychiatrist.
  • WayOutWestMomWayOutWestMom Posts: 6,568Registered User Senior Member
    All psychiatrists need to talk with their patients to understand what is going on with them /to understand their pathology if that's what you're trying to get at. Psychiatrists don't just walk into a room, stare at a patient for 60 seconds, write and 'script and leave. There's dialogue during the diagnostic process and during follow-up care.

    D2 works for a research psychiatrist -- and I guarantee he talks with his patients. (Have numerous first hand reports of him doing so.)

    P.S. Forensic psychiatrists require highly specialized training via a post-residency fellowship in order to be court-certified.

    Take a look at this:

    Forensic Psychiatry Fellowships
  • i_wanna_be_Browni_wanna_be_Brown Posts: 5,260Registered User Senior Member
    Do you understand what a Forensic Psychiatrist is? You certainly don't need that type of training to administer in therapy and/or medical treatment.

    The key difference in talk therapy vs. drug therapy is mainly the amount of time spent talking to the patient. A true freudian analyst is going to see their patients 4-5x/week for 45mins-1hr. A sterotypical prescription oriented psychiatrist will probably spend only 30 mins tops with a patient and see them every couple weeks to months. But again, how a psychiatrist structures their practice is up to them, their market, and the insurance they accept. The reason is that most insurance companies pay a much higher "hourly" rate for doing drug therapy than talk therapy.
  • court922court922 Posts: 240Registered User Junior Member
    @i_wanna_be_Brown was that question towards me?

    And for you both, I do understand what forensic psychiatry is, I just wanted to know if what I heard was true about it. Thats all.
    You both are helpful, thank you, but now I'm a little confused because both of yall are points are different. Aha.
  • i_wanna_be_Browni_wanna_be_Brown Posts: 5,260Registered User Senior Member
    My question was directed at you. Forensic psychiatry, as far as I understand it, has a few different paths but they are all very specific and deal with the intersection of the law and mental health whether it be profiling (the vast minority of forensic psychiatrists), determining if someone is competent to stand trial (the minority), or determining if someone is legally responsible for mental damage (the majority). While many forensic psychiatrists have practices, the training required to run a standard practice does not require a forensic psych fellowship.

    I think for the most part WOWMom and I are saying the same thing. The question is what does "just prescribe" mean to you. No one "just prescribes" medicine. Every physician talks to their patients, the question is how much talking are you looking to do with each patient, and what kind of patient base are you looking to interact with?

    Probably the most important question though in the clinical psych vs. psychiatry tree is how interested are you in psychopharmacology? Whether or not you do talk therapy, a psychiatrist will be prescribing and subsequently managing the many side effects and drug interactions of psychotropic drugs. A clinical psychologist will not. The psychiatrist needs to be an MD so that he can understand how to treat the myriad of somatic effects that psych drugs have.
  • court922court922 Posts: 240Registered User Junior Member
    You both differ in the training required. I just wanted to know if the emphasis on psychiatry had changed.

    But I prefer to work with schizophrenics.
  • court922court922 Posts: 240Registered User Junior Member
    But I guess it has not changed so thank you.
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