1. Q-Should I see a psychologist or a psychiatrist? What is the difference between the two?
A-Psychologists and psychiatrists are both trained to treat mental health conditions. Psychologists and psychiatrists assess, diagnose and treat mental illnesses. In this regard, there is often overlap between their clinical responsibilities, particularly within the domain of assessing and diagnosing mental disorders, however, more differentiation is noted when it comes to the treatment approach of the two practitioners. There are differences in their training, which leads to different approaches in the management of mental health problems. Psychiatrists are medical doctors and can prescribe medication. Often their focus is on medical and pharmacological treatment. Psychologists focus on treating patients with psychotherapy (talk therapy) and behavioural interventions. Psychiatrists and psychologists often collaborate as part of a mental health team with the aim of providing the best possible treatment for an individual.
2. Q-How long will I be in therapy?
A- The therapeutic journey is a collaborative one and usually the length of the therapy is decided by both the therapist and the client. Solution focused therapy tends to have a shorter span lasting anything between 6 to 20 weeks. While longer term insight orientated therapy can span over years. Treatment duration will differ depending on the presenting problem and the agreed upon treatment plan. In this regard, it is always best to discuss this with your treating practitioner after they have assessed and conceptualised the presenting problem comprehensively.
3. Q-Do psychologists use different therapy modalities?
A- This depends on the training and focus of the psychologist. Some psychologists work primarily from one therapeutic modality and have dedicated their time in practicing that craft. While other therapists may practice more integratively using different modalities. There are a number of different psychological treatment modalities such as CBT, DBT, and psychodynamic treatment approaches. The modality that is utilised depends on the presenting problem and other factors discussed between you and your treating practitioner.
4. Q-How do I determine if the psychologist is the right fit for me?
A- Finding the right psychologist can be its own journey and one which should not discourage you from persevering. Usually, the right person will allow you to feel comfortable, welcome and safe to speak about whatever is on your mind.
5. Q-What can I expect from the first session with my psychologist?
A- The first session normally entails a gentle space to meet the other person and for your psychologist to get a sense of your history and challenges. This could include them asking questions about current and past experiences in order to help understand what your specific needs of therapy. The first consultation is used to establish rapport between you and your treating practitioner and discuss limits to confidentiality as well as other administrative matters. This is usually followed by a clinical interview during which basic demographic information is obtained, as well as a comprehensive outline of the presenting problem and other clinical history.
6. Q-How do I know if I need medication?
A- Usually medication is initiated when symptoms have become distressing and impact negatively on quality of life. Not all conditions require medication and sometimes other treatment modalities may be recommended. A mental health care professional can guide you in the decision of whether to take medication or not. Often medication has the most benefit when it is used as a part of an overall treatment plan which may also include psychotherapy, support groups or rehabilitation programs.
Research indicates that mental health conditions are in part caused by chemical imbalances in the brain. Medication works on these chemicals to alleviate symptoms. Some serious mental illnesses such as schizophrenia or bipolar disorder require long-term maintenance treatment so as to minimise the risk of relapses. Other conditions, such as depression or anxiety, may be treated with a shorter duration of medication.
7. Q-What can I expect from my first session with my psychiatrist?
A- Your first appointment with your psychiatrist will usually be 1 to 1.5 hours long. During this time the psychiatrist will explore your concerns and symptoms and ask about your medical and family history. There are usually a lot of questions aimed at getting a full picture about what has lead you to seek help. This first appointment lays the groundwork for establishing a diagnosis and formulating a treatment plan. At the end of the appointment, your psychiatrist may recommend medication, therapy or possibly further tests that may need to be done.
8. Q-Can I contact my psychiatrist/psychologist between sessions?
A- Contact between sessions should typically only occur in emergencies. Admin related queries are normally managed by the admin team and other queries can be discussed with your therapist during your session time. If communication does occur, it typically occurs during work hours and for a specific reason. If you have any concerns or questions regarding your medication you may contact your psychiatrist via email or telephonically. However, they may not be able to respond straight away as they are usually in consultation with patients. Your psychiatrist will get back to you as soon as possible. Some queries may be resolved during a phone call or via email. However, some issues may require more in-depth discussion (such as changes to medication) and then an in-person consultation may be recommended.
9. Q-Is my depression Chemically induced or environmental?
A- Depression has multiple possible causes which usually interact to lead to the development of the condition. The possible causes include an imbalance in brain chemicals (such as serotonin), faulty mood regulation in the brain, genetic vulnerability (can run in families), stressful life events, medications or drugs and medical illnesses. Therefore, even though people may have similar symptoms of depression, they may have different underlying causes of the depression. Depression and mental illness in general, is complex. The interplay between chemicals and environment usually gives rise to depression and other illnesses. Discuss your presenting problem and symptoms with your treating practitioner and query if your depressive symptoms may be chemically-induced or stem from environmental factors. A thorough assessment is often required to make this distinction.
10. Q-What are the limits of Confidentiality?
A- Confidentiality refers to the ethical duty of clinicians not to disclose any information about a patient without permission from the patient to do so. All patients have the right to confidentiality and privacy. The ethical rules of the Health Professions Council of South Africa state that information about a patient may only be disclosed with consent of the patient, if instructed to do so by a court, or if the patient or another person are at risk of serious harm. It can be very important that certain information be discussed with any other members of a health care team. However, this would be discussed with you beforehand. Confidentiality may be breached in three instances: (1) if there is a risk to yourself; (2) if there is a risk to others; or (3) if instructed to do so by a court of law/legislation. When you are a danger to yourself or someone else however this is an extreme and psychologists usually exhaust all other possible options before opting to break confidentiality. In the rare case that this does occur, the client must be given a heads up before the break in confidentiality occurs. Thus, as a client, you should never be unaware of a confidentiality break.
11. Q-What would be the benefit of attending Occupational Therapy?
A- OT focusses on providing practical support to enable you to implement changes in your life that you know needs to be done, but you cannot seem to implement/ sustain effectively. OT provides a platform for identifying the barriers/ obstacles that you face in getting the life that you want and equips you with practical strategies and techniques to achieve your goals.
12. Q-What can I expect from the Occupational Therapy process?
A- The first session with an OT takes the form of an interview in which we discuss your habits, routines and life responsibilities. Thereafter, an assessment is conducted to determine your areas of strengths and difficulties, as well as to gain a better understanding of your unique profile. A feedback session is scheduled to discuss the assessment findings and set collaborative goals. Therapy sessions usually occur once weekly to practice skills/ techniques and jointly determine how best to implement the skills/ techniques into your routine. You are encouraged to implement the skills/ techniques in the interceding week and the following session reviews whether the suggestions were suited to your lifestyle and bringing you closer to your identified goals.
13. Q-Are there specific things about myself that an OT assessment can help me discover?
A- An OT can provide you with an understanding of your Sensory Profile, i.e. what sensory information in your work/ home/ social environments may cause you to become overwhelmed, and how you use your senses to activate yourself or calm yourself down. This can have a significant effect on your productivity, interactions with people and your general coping skills. Work assessments can also identify your specific skills and difficulties in relation to work tasks, which can guide the implementation of practical techniques or accommodations to improve your work performance and efficiency.
14. Q-How long will I be attending Occupational Therapy?
A- The process depends very much on what type of skills you are looking to improve and on how diligently you try to apply the techniques/ skills into your daily life to make sustainable changes. However, OT intervention is usually not a long-term process. The aim is to guide you in understanding yourself better, impart knowledge and skills to equip you with practical strategies to address difficulties, and to support you in the initial phases of making changes to ensure that you succeed and remain motivated.