first therapy session is over

[michael 19 jones]

I feel so relieve to be talking to a real person about so many issues I face. She is going to be very helpful to help sort through all the crap that is in my mind. She wants me go once a week but I can only spend about 200 dollars a month right now so I can go only once every other week. The rest of the 200 dollars is going for car insurance.

My next session is on May 1^st. I'm going to buy a journal notebook to help keep track all of my thoughts, feelings and issues I still need to work on.

Amrisa

[Ms Jessica]

Good for you!  I just did my first therapy session this week, too. 
I know it's tough to divide time and money between necessities (like car insurance) and other necessities (like therapy)!  I think that keeping a journal is a really good idea.  Having a clear set of goals and a list of things to talk about is the best way to get your money's worth out of the time you spend with a therapist. 

[Berliegh]

Good for you!  I just did my first therapy session this week, too. 
I know it's tough to divide time and money between necessities (like car insurance) and other necessities (like therapy)!  I think that keeping a journal is a really good idea.  Having a clear set of goals and a list of things to talk about is the best way to get your money's worth out of the time you spend with a therapist. 

As we don't have therapists in the U.K....only psychiatrists..... what do therapists do or say at an appointment and what are the benefits?

[Ms Jessica]

As we don't have therapists in the U.K....only psychiatrists..... what do therapists do or say at an appointment and what are the benefits?

Therapist is a general term for any of the following: psychiatrist, psychologists, or licensed counselors.  The main difference between the three is education: psychiatrists have a medical degree and can prescribe medication.  Psychologists usually have either masters or doctorate degrees in psychology and can't prescribe medication.  A licensed counselor can pretty much have a degree in anything, but have passed some form of exam to obtain a license (think Dr. Laura Schlesinger-- she has a PhD in Physiology, but is a licensed marriage and family counselor).
So in the UK, you only have psychiatrists?  What about people with degrees in psychology?  Are they forbidden from entering into some kind of counseling practice? 
Anyway, from what I can tell, a session with any of the above would be very similar to a session with any other.  My wife and I have both been to see a psychiatrist before.  My current therapist is a psychologist, and honestly I can't say there's much of a difference. 

[Wing Walker]

Good going, Amrisa!  I see a therapist as a trained listener, someone who can help find out who you truly are within.

Journaling is a great idea.  Since you see your therapist every two weeks it can be useful to have notes on your thoughts.

IMHO, you're doing the smart things.

Wing Walker

[Berliegh]

As we don't have therapists in the U.K....only psychiatrists..... what do therapists do or say at an appointment and what are the benefits?

Therapist is a general term for any of the following: psychiatrist, psychologists, or licensed counselors.  The main difference between the three is education: psychiatrists have a medical degree and can prescribe medication.  Psychologists usually have either masters or doctorate degrees in psychology and can't prescribe medication.  A licensed counselor can pretty much have a degree in anything, but have passed some form of exam to obtain a license (think Dr. Laura Schlesinger-- she has a PhD in Physiology, but is a licensed marriage and family counselor).
So in the UK, you only have psychiatrists?  What about people with degrees in psychology?  Are they forbidden from entering into some kind of counseling practice? 
Anyway, from what I can tell, a session with any of the above would be very similar to a session with any other.  My wife and I have both been to see a psychiatrist before.  My current therapist is a psychologist, and honestly I can't say there's much of a difference. 

In the U.K the NHS Psychiatrists have a 'bully boy' approach and try and reduce the patient to breaking point and sometimes tears. Is that what they do in the U.S as well?

[Ms Jessica]

In the U.K the NHS Psychiatrists have a 'bully boy' approach and try and reduce the patient to breaking point and sometimes tears. Is that what they do in the U.S as well?

Only the bad and/or uneducated.  They do serve gatekeeper functions, but so far my therapist has been very nice.  She's asked some probing questions, but nothing mean-spirited.  I get a sense that she genuinely cares about me and is capable of helping me make some complicated changes in my life. 

[michael 19 jones]

 My therapist is kind, genuine, and a very good listener. She never did anything to upset me except having me talk about my past and on several times almost brought me to tears remembering all of the pain. I was surprised that I didn't stutter. Not one "da..da..da..dad" I've always stuttered especially when I'm nervous or excited. In recent years however I've been stuttering less but I still do stu... stu... stu... stutter. Just joking.

Well I'm off to do some Sudoku and make a few notes in my first journal in over 7 years. Now why did I ever give it up?

Amrisa

[Ms Jessica]

Funny.  I think your post planted a subliminal thought that I should start keeping a diary.  So I started one today.

[Berliegh]

In the U.K the NHS Psychiatrists have a 'bully boy' approach and try and reduce the patient to breaking point and sometimes tears. Is that what they do in the U.S as well?

Only the bad and/or uneducated.  They do serve gatekeeper functions, but so far my therapist has been very nice.  She's asked some probing questions, but nothing mean-spirited.  I get a sense that she genuinely cares about me and is capable of helping me make some complicated changes in my life. 

I think it makes a difference if you have a therapist who is female. I was speaking about the male NHS U.K Psychiatrists....

[tekla]

In the U.K the NHS Psychiatrists have a 'bully boy' approach and try and reduce the patient to breaking point and sometimes tears. Is that what they do in the U.S as well?

Oh god no.  They are all about being client centered.  And in the US, where therapy of some sort is almost a given in some places and in some lifestyles, there is a huge split between those who do phych. classical Sigmund and prescribing meds, and those who are there to help you, to talk with you, to help guide you to a place where you are accepting and happy, or some such.  At any rate, its very patient centered.

[Kate]

what do therapists do or say at an appointment and what are the benefits?

I've seen two psychs now, and one therapist... although the psych visits were only for one or two sessions each.

Everyone has their own style or "method" of treatment, so even amoungst psychs or therapists there's a lot of variation. But between the people I've seen, the pyschs were much more clinical and straight-forward about the GID, asking very specific and pertinent questions to focus on the GID. Friendly and kind, but to the point.

My therapist on the other hand took a more "holistic" approach and tended to view my GID as *part* of my treatment, but didn't focus on it. She tried to see how it fit into my life as a whole.

~Kate~

[joannatsf]

A licensed counselor can pretty much have a degree in anything, but have passed some form of exam to obtain a license (think Dr. Laura Schlesinger-- she has a PhD in Physiology, but is a licensed marriage and family counselor).

"I'm sure it varies from state to state but in California an LMFT must complete a Masters level course in clinical psychology from a school that is accredited by the state.  Included in that program is 600 hours of supervised internship at least part of which is in a MH clinic.  Then the candidate can take the test.  Only when one has completed all the above can they be licensed to practice.  The requirements for an LCSW are similar but the focus of the program are different."  she said as she fills out another grad school application.

The academic programs are very competitive.  The MSW program at SFSU has 500 applicants for 60 open slots.


Posted on: 23 April 2008, 08:17:23

In the U.K the NHS Psychiatrists have a 'bully boy' approach and try and reduce the patient to breaking point and sometimes tears. Is that what they do in the U.S as well?

Oh god no.  They are all about being client centered.  And in the US, where therapy of some sort is almost a given in some places and in some lifestyles, there is a huge split between those who do phych. classical Sigmund and prescribing meds, and those who are there to help you, to talk with you, to help guide you to a place where you are accepting and happy, or some such.  At any rate, its very patient centered.

Few psychiatrists practice Freudian psychoanalysis any more.  For more recently trained shrinks the focus is on psychopharmacology and neuropsychiatry, things that utilize the MD part of their training.  Insurance won't pay for psychoanalysis which requires 5 - 10 years of therapy.  Much of what Freud said was based on personal observations and has since been discredited by emperical research.

Cognitive or Cognitive Behavioral Therapies are probably the most used therapies now and you don't need an MD to practice them.  Both are client centered approaches and usually yield fast results (the client feels better).  They are commonly used to treat mood disorders like depression and anxiety which account for a huge portion of mental illness.  Psychotic disorders such as schizophrenia, bi-polar and personality disorders require a collaberation of a case manager and a psychiatrist.

If you have a problem that requires medication SEE A PSYCHIATRIST not your primary care doctor.  It can take several tries to find the right medication and dosage for YOU!  You need a specialist in those meds meds, not some one who may throw a Prozac 'script at you and consider you treated.