Friday, July 22, 2011

Among Mental Health Professionals - What's the difference?

I am often asked about the difference between a psychologist and a psychiatrist or a social worker and a licensed counselor.  There are many different professionals who provide direct service to people seeking help from mental health professionals. The education, training and areas of expertise vary widely. This article will give a general explanation of the more prominent mental health professions, their educational and training backgrounds.

Psychologist (Ph.D.) - Doctorate of Philosophy, a clinical/research degree
The average length of a Ph.D. program is 6-7 years emphasizing psychological evaluations, theories and practice of psychotherapy, research and statistics, diagnosis and ethics, much more so than any other degree. Pre-internship training (practicum), internship and the completion of a dissertation are required for degree completion.  The differences between psychologists who graduated from a clinical program and those who graduated form a counseling program are minor. Clinical programs, which are greater in number, tend to focus more on serious mental illness such as depression, schizophrenia, anxiety, etc. Counseling programs tend to focus on change of life issues such as divorce, relationship problems, academic difficulties, etc.

Psychologist (Psy.D.) – Doctorate of Psychology, a professional degree
The Psy.D. was established in the late sixties and is more clinically oriented than the more traditional Ph.D. The average length of this degree program is 5-6 years. It requires more training and practicum experience instead of the research and statistic requirements of Ph.D. programs.  Most Psy.D. programs also require a dissertation, although some require an extensive research paper.  The degree focuses on psychological evaluations, theories and practice of psychotherapy, diagnosis and all forms of treatment delivery in a variety of clinical settings.

Social Worker (M.S.W.) – Master of Social Work
Social work programs generally last from 2-3 years. Degree attainment requires supervised clinical experience. Program emphasis is on psychotherapy and efforts to integrate people with available community resources.  Most social workers pursue careers as general psychotherapists, family therapists, case managers and/or EAP counselors.

Counselor/Therapist  (M.A., M.S.) – Master of Arts or Master of Science
The Master of Science is often a terminal degree meaning that the student plans to end their academic career with the Master’s degree, at which point they go on to become a general practitioner. The Master of Arts is a degree requirement necessary for admission to a doctorate program.  Both degrees are about 2 years in length, emphasize general psychotherapy techniques and require the completion of a thesis. There are few, if any, requirements for psychological assessments, theory and research.

Psychiatrist (M.D.) – Medical Degree
Psychiatrists begin their careers as general doctors and then complete a 3-4 year residency (training) in psychiatry. Residency training typically includes experience in medication management, diagnostic and crises evaluation in both inpatient and out patient settings.  Usually, psychiatrists receive no formal training in psychological assessment, research, or the practice and theory of psychotherapy.  Psychiatrists are the only mental health professionals that can prescribe medication and this is the mainstay of most who are in private practice.

Holly Houston, Ph.D.

Friday, July 8, 2011

Attention Deficit/Hyperactivity Disorder (ADHD) and Difficulties In The Classroom

What is ADHD?
Attention Deficit/Hyperactivity Disorder (ADHD), formerly known as ADD/ADHD, can be characterized as Inattentive Type, Hyperactive/Impulsive Type, or Combined Type (both).  Inattentive Type (formerly ADD), can affect a child by causing difficulty with staying organized, listening and/or concentrating for even short periods of time, and often leads to forgetting to do things such as chores and homework.  Children who are inattentive are often seen as daydreamers.  A child who is hyperactive often has trouble sitting still and remaining quiet, often causing disruption in the classroom.  They may seem fidgety or always on the go.  Impulsivity causes issues with taking turns with others.  Examples of this can be blurting out answers or not being able to wait their turn when playing a game.  This may be seen as annoying to other students and cause problems with peers.

Difficulties Associated with ADHD
Many daily demands can actually be unattainable for a child with ADHD, especially without the proper interventions in place.  Too often, a child with ADHD hears what they are doing wrong and what they need to change, without the child being given tools to make the necessary changes. The stressors that a child with ADHD face on a daily basis can be exhausting.  For instance, a child who is impulsive may have difficulty remaining quiet for any period of time, yet they consistently find themselves in trouble for talking out of turn.  It is not uncommon for the child who is hyperactive to become a disruption in the classroom by getting out of his seat without permission or by making noises by tapping their pen or speaking out of turn.  Impulsivity can make it difficult for a child with ADHD to wait his turn or follow rules that might otherwise seem simple for his peers.  Inattention can look like a child is lazy or does not care about what they are learning.  All of the above can lead to issues getting along with peers, and behavioral issues leading to disciplinary actions by your child’s school.

Undiagnosed and untreated, problems with ADHD can easily lead to your child feeling anxious, angry, and defeated. No matter how hard they try to do what is asked of them, they find themselves failing.  School can easily become a place where a child with ADHD feels they are seen as a “trouble maker.”  Difficulty with paying attention and remembering what assignments to complete often lead to academic underachievement and the belief that they are not smart enough to be successful academically.  All of the above can be very frustrating for a child with ADHD and can lead to low self-esteem and eventually lead to children giving up on themselves.

Ways To Start Helping Your Child
The good news is that there are ways to help your child if they are dealing with ADHD.   The first step is to take your child to a Child Psychiatrist or Child Psychologist/Mental Health Professional to get a proper diagnosis.  Once a diagnosis has been made, find out your child’s educational rights.  Contact your child’s school to discuss the possibility of what educational interventions and/or behavior plans can be put in place to assist your child’s learning in the classroom.  Work with school staff to find ways to help maximize your child’s academic success. Schedules and behavior management plans for school and home can help to keep your child on task and help your child to see the improvements they are making.  Seek professional assistance. Individual, Group, and Family Therapy can also be utilized to help you and your child learn about ADHD and how to build skills to deal with issues associated with ADHD.  Keeping yourself educated on ADHD and involved in your child’s education is a must.  Remember that you and your child are not alone and that there are effective supports.  The more advocates your child has, the greater their chances are of finding ways to help them become successful. 

Deanna Kozlowski, MSW, LCSW