The Role of Medication in Therapy

For the past twenty years and more, filmmakers have depicted various types of therapy situations.  From the comedy Analyze This starring Robert De Niro and Billy Crystal to the provocative HBO series In Treatment, the role of a Psychiatrist has captured the fascination of the general public. Probably the most recognized image of a Psychiatrist was seen in The Sopranos with Lorraine Bracco playing Dr. Jennifer Melfi, the doctor treating Tony Soprano, a middle-aged New Jersey mobster suffering panic attacks. Throughout the show, Dr. Melfi provides in-depth psychotherapy to Tony, as well as prescribes him medication to ease his symptoms. Although this situation can, and does exist, it is not as common as you might think.

The terms Psychologist and Psychiatrist are often used interchangeably to describe anyone who provides therapy services. However, there are significant differences between the two professions:

1. Psychiatrists can prescribe medications, Psychologists cannot
2. Psychologists typically provide talk therapy, whereas the majority of Psychiatrists do not

Psychiatrists

A Psychiatrist has attended medical school and received a Doctor of Medicine (M.D.). After completing their medical training, Psychiatrists complete an additional four years of residency training in mental health and receive additional training in a specific area of interest.  Although Psychiatrists can provide therapy, many do not, primarily because if the provider participates in a health insurance plan, the plan’s fee structure may discourage time spent on therapy. In addition, Psychiatrists complete their residency in hospitals and clinics where the focus is on medication management and not therapy.

Psychologists

A Psychologist received graduate training in psychology and earned a Doctor of Philosophy (Ph.D.) or a Doctor in Psychology (Psy.D.)  Doctoral programs typically take five to seven years to complete and an additional one or two year-long internship in order to gain licensure. The title of ‘Psychologist’ is used by an individual who has completed the above education, training and is licensed by the state. Informal titles such as ‘counselor’ or ‘therapist’ are often used for masters-level mental health providers.

Is there a place for prescription drugs alongside therapy?

A common misconception about Psychiatrists is that they only treat people with severe mental illness. In fact, Psychiatrists provide much-needed help to high-functioning individuals who are suffering from the effects of depression and anxiety. When a Psychologist sees a person who could benefit from medication, they refer that person to a Psychiatrist for a consultation and possibly a prescription.

If a person is continuing to do well in therapy, and can attend work or school and have relationships with family and friends, therapy alone can be very effective. In fact, research has shown that Cognitive Behavioral Therapy (CBT) can be more effective than medication for treating a variety of mental health concerns. However, there is a role for medication in therapy for certain situations. Medication can sometimes be necessary for a person in crisis to get to the point where he or she is able to engage in therapy. Examples include difficulty getting to therapy, engaging in healthy-enhancing behaviors, panic or anxious symptoms that make it difficult to stay focused and maintain attention, sleep problems, poor appetite, and thoughts of suicide. Specific conditions that often lend themselves to a combination of talk therapy and medication include Attention Deficit Hyperactivity Disorder (ADHD), Obsessive Compulsive Disorder (OCD), Bipolar Disorder, Eating Disorders, and severe Post Traumatic Stress Disorders (PTSD).

But what is important to remember is that medications do not help a person develop the strategies necessary for dealing with life’s problems. Without therapy, once medications are discontinued, the problems often still remain – or may return. Therapy will teach you new strategies and problem-solving skills that will help you better address future problems that arise in your life.

How can I get medication if I need it?

If you believe that you could benefit from medication, talk to your Psychologist. Your Psychologist will work with you to refer you to a Psychiatrist who specializes in your area of need and ensure a coordinated approach to treatment that is in our best interest. You should feel comfortable talking with your therapist about medication and asking questions. At Therapy Changes, we honor your decision whether or not to pursue medication alongside therapy. We will never push you toward a direction that you do not feel comfortable and support you in your journey of recovery.