Psychiatrists and Psychiatry
How do psychiatrists differ from psychologists and other mental health counselors?
A popular but simplistic explanation is that psychiatrists prescribe drugs while psychologists and counselors do talk therapy. Since there are many more psychologists than psychiatrists, it isn't surprising that psychiatrists, who are trained as physicians before learning to do talk therapy, are viewed as medication consultants. Some of this misinformation is designed to place psychiatrists into a box where they do not present a threat to non-physician therapists while the remainder stems from choices many psychiatrists have made in recent decades to confine themselves to the practice of psychopharmacology in order to distinguish themselves as "medical specialists" similar to cardiologists, orthopedic surgeons, and others. While we are indeed medical specialists (contrary to the opinion of many psychologists, who have attempted through state legislative fiat to obtain the "right" to prescribe psychiatric medication in various states without medical training and supervision) it requires a great deal of medical knowledge and extensive supevised experience in the nuances of psychotherapy in order to provide quality psychiatric care.
I want to assure you that I do not believe most mental health and substance abuse problems result entirely from the currently popular but unproven myth that they result from a mysterious chemical imbalance. However, I have also seen through my 25+ years of practice experience the occasional benefits of medications when utilized in conjunction with individual and family therapy. This balanced perspective is different from professionals without medical training, who often glorify medications, or many psychiatrists who limit their focus exclusively to medication therapy and therefore have little understanding of the complexities of the human mind and psychotherapy. Research continues to demonstrate that, for most emotional and behavior problems, the best results are obtained from an approach that integrates multiple therapies, but that medications alone are often no better than sugar pills (often because the majority of antidepressants are prescribed for symptoms of general unhappiness that do not meet criteria for either Major Depressive Disorder, among other reasons). This is why for many years I conducted individual and family therapy with all my patients and did not restrict myself to the "medical model" of practice, in spite of the urging of my non-medical colleagues and questions from befuddled managed care plans that wished to only authorize brief "medication management" sessions. It is not that I don't believe in medications - in some situations, they have been very useful - I just choose not to utilize them as my exclusive treatment.
That having been said, as our group practice has developed over time, and given the limited psychiatric resources in the local area, I have had to relinquish some of my psychotherapy work to trusted associates in order to meet the increasing needs for quality therapy services here. These clinical associates have been hand-picked because they share my philosophy and have been under my mentorship since. Consequently, much of the patient care work I currently do consists of clinical, disability, juvenile court, and Bariatric (Gastric Bypass) Surgery evaluations as well as therapy I provide in my areas of clinical expertise. These include work with two groups often thought of as difficult to treat - preschool and teenage boys. However, for all cases I supervise the care done here and all of our cases are reviewed 2-3 times per month in group consultation meetings we hold behind the scenes. We maintain the philosophy that ongoing individual and family therapy in our professional work with clients and patients is the cornerstone of our work, and those who do not wish to participate in therapy and prefer a purely medication approach are generally referred to other area providers. We hope you will find our approach refreshing and that you will derive important benefits from our work together!
Founder and Medical Director
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| Gregory P. Barclay, MD |
