How to decide between therapy or psychiatry?

6 Factors to Consider When Deciding Between Therapy, Psychiatry, Or Both

To help patients make an informed decision about their mental health treatment, we asked six licensed professionals, including a Clinical Director and a Medical Director, to share their insights. From understanding the importance of considering needs, severity, and goals to the suggestion to start with therapy and refer as needed, these experts provide a comprehensive guide to choosing between therapy, psychiatry, or both.

• Consider Needs, Severity, and Goals
• Holistic Approach: Therapy and Psychiatry
• Openness to Medication Matters
• Patient's Belief in Treatment Effectiveness
• Understand Your Mental Health Condition
• Start with Therapy, Refer as Needed

Consider Needs, Severity, and Goals

In making the decision between therapy and psychiatry, consider the specifics of your needs, the severity of your symptoms, and your treatment goals. Therapy primarily focuses on addressing emotional, psychological, and relational issues through talk-based approaches. It's a valuable resource for equipping you with tools to develop coping strategies, improve communication, and gain insight into your challenges.

The instances where a psychiatrist becomes essential are when you're grappling with severe or persistent mental health conditions necessitating medication or medical interventions. A psychiatrist's evaluation and medication management are crucial in these scenarios. While I, as a licensed therapist, can perform some evaluations under the supervision of a licensed psychologist, I do not have the credentials to conduct them independently. In such cases, I collaborate closely with your psychiatrist to ensure you receive comprehensive care.

Holistic Approach: Therapy and Psychiatry

In practice, I believe a holistic approach often yields the best results. Therapy covers the emotional and behavioral aspects, unravels thought patterns, and offers coping mechanisms tailored to the unique needs of the patient. On the other hand, psychiatry addresses the biochemical side, targeting chemical imbalances with medical treatment to restore mental and emotional balance. When combined, therapy and psychiatry can create a positive synergy, each filling the gaps of the other.

Openness to Medication Matters

Consider your openness to exploring medication as a part of your treatment. If you're hesitant about starting medication, seeing a therapist may be a better place to start. Your therapist may recommend you see a psychiatrist depending on the severity of your symptoms. There's really no wrong place to start. Often, psychiatrists will recommend you see a therapist for additional support. Many times, neither medication nor therapy alone are enough. Remember, it's okay to need help, and what each individual needs will look different. There's nothing wrong with needing both a therapist and a psychiatrist.

Patient's Belief in Treatment Effectiveness

As a practicing psychiatrist, I provide psychotherapy as well as treatments including antidepressant medication and TMS. This means that a patient doesn't necessarily need to have a separate therapist and psychiatrist. However, if a patient is trying to decide between "therapy, psychiatry, or both," they might be wondering whether they want psychotherapy versus medication, or both. One important factor to consider is what the patient thinks will work for them. Psychotherapy works best when the patient believes it will work, and a patient should never feel pressured to accept medication or other treatments such as TMS. Ultimately, what kind of professional to see is a personal decision for the patient.

Understand Your Mental Health Condition

One crucial factor for patients, when determining whether they need therapy, psychiatry, or both, is the nature of their mental health condition and its underlying causes. Therapy, typically provided by licensed individuals, is focused on addressing emotional and behavioral issues through talk-based interventions. It is beneficial for individuals dealing with conditions like anxiety, depression, relationship problems, or coping with life stressors.

On the other hand, psychiatry involves the medical evaluation and treatment of mental health conditions, including the prescription of medications. Patients with more severe or complex disorders, such as schizophrenia, bipolar disorder, or severe mood disorders with a biological basis, may find psychiatry an essential component of their treatment plan. It is important to note, collaborative care between therapy and psychiatry can be effective for comprehensive mental health management.

Start with Therapy, Refer as Needed

If a person is struggling with their mental health, therapy is a good place to start. A therapist can serve as the primary-care role who can then refer out to specialists, such as psychiatrists, as needed. If the person's symptoms are such that they are having difficulty actually engaging in therapy, then a referral to a psychiatrist for possible medication may be indicated. In my opinion, medication gives a person's nervous system a boost that is sometimes needed in order to benefit from therapy and can be removed later when the person has made progress in addressing the underlying issues in therapy.