What To Expect From A Psychiatrist

Deciding to go to a psychiatrist can be a big decision. While it may be a hard decision to make, depending on what you are dealing with it may also be one of the best decisions you can make. It is important to find a psychiatrist who is clinically competent and respectful of your Christian beliefs and values. The information in this handout is designed to help you find a good psychiatrist and know what to expect during your course of treatment. If you have additional questions after reading this information, please call ACCFS. We are glad to assist you in any way we can.

Finding A Psychiatrist

How do you find a good psychiatrist in the first place? It is usually best to go to a psychiatrist who is recommended by someone you trust or by someone who would have information about qualified psychiatrists in your area. Below are some suggestions that you may find helpful.

• Your local elder/ministers may be able to help you find a good psychiatrist in your area as well as provide you with spiritual guidance and support.
• Your family physician or your counselor may be able to help you find a competent psychiatrist in your area as well as provide you with a referral to that psychiatrist.
• ACCFS maintains a database of counselors, psychiatrists, and specialty clinics located across the country. We would be glad to assist you in locating a psychiatrist in your area.
• Your medical insurance carrier can provide you with a list of psychiatrists they have in their network.

Understanding The Psychiatrist’s Qualifications

Below is a broad outline of the types of medical and mental health professionals.

Psychiatrists
Psychiatrists have been through medical school and thus hold a MD or DO degree. They have completed a four-year residency after medical school focusing in psychiatry. Psychiatrists approach mental illness primarily through a medical and biological model and therefore tend to utilize various types of medications (such as antidepressants, etc.). Most of the appointments with psychiatrists will focus on medication management. While psychiatric training includes different types of therapy, psychiatrists do not generally provide therapy but have a basic understanding of the principles of therapy used by different mental health care providers.

Primary Care Physicians, Physician’s Assistants, and Nurse Practitioners
These medical professionals treat people for a wide variety of physical and emotional issues. Many people seeking medication for a mental health condition (e.g., depression, anxiety) often start by having an appointment with their healthcare practitioner. If you have not had a physical checkup with bloodwork done recently, it is wise to do so as some aspect of your physical health may be affecting your mental health (e.g., hypothyroidism, etc.).

While your family practitioner may be helpful in prescribing medication for emotional health issues in some circumstances, other times, they will not feel comfortable prescribing medications for mental health concerns and will make a referral to a psychiatrist. Also, if your family practitioner has prescribed you a medication(s) for a mental health condition, but it has not seemed to work as hoped, they may make a referral to a psychiatrist.

Psychologist, Counselors, Social Workers, and Marriage and Family Therapists
All of these mental health professions focus on providing counseling and cannot prescribe medication. It is common for individuals receiving counseling to also be working with one of the medical doctors listed above who prescribe medication.

Expectations Of Sessions With The Psychiatrist

When going to a psychiatrist, you should have certain expectations for how you will be treated. At the same time, your psychiatrist will have expectations for you.

Feel free to ask your psychiatrist questions.

1. Inquire about different medication treatment options.
2. Ask about and discuss potential side effects of various medications and what steps will be done to address these potential side effects.
3. Ask about any fears or concerns that you have about medications (e.g., addiction potential, length of time you may need to take a medication).
4. Request that a family member(s) attend the appointments with you.
5. Understand how medications and therapy work together.
6. Request a second opinion from a different psychiatrist if you have been working with a psychiatrist for a while and you aren’t sure the treatment approach is working.

Your psychiatrist’s expectations for you

1. Arrive for your appointments on time.
2. Ask questions if you have them. You may want to have with you a written, prepared list of questions.
3. Discuss any and all side effects you have, including sensitive topics.
4. Take your medications as prescribed and contact your psychiatrist before making any changes (including stopping or decreasing your medication).
5. Have blood work done, if needed.
6. Allow the psychiatrist to communicate with your therapist.

Understanding the psychiatric approach to treatment

Every psychiatrist has a different style; the following questions may help you learn about your psychiatrist’s approach to treatment.

1. What are your thresholds for prescribing medication(s)?
2. What are your goals for medication(s)?
3. How will you work with my therapist?
4. How long do you want people to be on medications?
5. What role do you think that Christian beliefs fit in with medication(s)?

Logistics

1. How often do you expect to meet?
2. How long do appointments usually take?
3. How can I communicate with you outside of the appointments?
4. What should I do if an emergency arises?

Phases of treatment

1. Phase #1: Assessment

a. Typically the first appointment lasts one hour; during that hour your psychiatrist will:

i. Review potential past and/or current symptoms of anxiety, depression, mania, and psychosis.
ii. Discuss current and past medication trials (if any) and the response to those treatments.
iii. Review past and current alcohol and drug use (if present).
iv. Discuss past family psychiatric history.
v. Review counseling you are currently engaged in.
vi. Complete a mental status exam including basic questions that assess memory capabilities and abstract thinking.
vii. Review medical conditions that may impact psychiatric stability.

b. A treatment plan will be established at the conclusion of the initial evaluation.

2. Phase #2: Treatment

a. These sessions typically last 15-30 minutes.
b. The frequency of the sessions will be determined based on the level of stability present.
c. Sessions will focus on specific psychiatric symptoms and how they are being impacted by medication(s).
d. Medication changes will be made if there are intolerable side effects, or the medications don’t appear to be working.
Note: Depending on the medications being used, it may take days to weeks to notice changes.

3. Phase #3: Conclusion

a. When stability has been reached, medications may be discontinued with follow-up appointments as needed to ensure that symptoms do not return.
b. Your care may be transferred to a primary care provider who can continue to prescribe medications.
c. If symptoms return after the conclusion or transition of care, a new initial evaluation can be scheduled.

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