[sarahxxkristine]

i been reading on here that people have hour long sessions with the Pdoc..i was just wondering what goes on when u talk to ur Pdoc...ive never had one but i thought theyd just ask how the meds are working and stuff like that? do they actually counsel u?

[ECHOES]

Yeah, most psychiatrists (pdocs) don't provide therapy. They are medication specialists and those visits are like what you describe--a short visit to see how the medications are working.

Some do provide therapy also but usually therapy is provided by therapists (T's). Sometimes both a pdoc and a T work for the same agency or group and might coordinate treatment.

[KUREHA]

I've only been twice but the second time, the nurse was there.
He said they'd be 40 minutes though - so I'm not really sure what we'll talk about, he does ask some of the same questions my psychologist asks though.

[splitimage]

I see my pdoc once a month for an hour. It's mostly meds management that I see her for, and I consider my psychologist to be my primary mental health provider. But my pdoc and I do talk about stuff - like how I'm doing with managing my alcoholism, are my meds working, have I had any depressive symptoms, just in general terms how I'm functioning / enjoying life, managing at work. We also talk about other treatment options that might be open to me through the hospital that would compliment the meds in managing my depression. I've been seeing the same pdoc for about 7 years now and we've always met for an hour. This came in super useful a couple of summers ago, when I had a major crash and was really in trouble. She'd been off on medical leave so hadn't seen me in a while, but as soon as she saw me, she said - this is the worst I've ever seen you, would you consider inpatient treatment. I did, and since she's the clinical director of women's in patient programs at the hospital she got me in within a week. Best thing I ever did for myself.

--splitimage

[emilyjeanne]

Originally Posted by sarahxxkristine

i been reading on here that people have hour long sessions with the Pdoc..i was just wondering what goes on when u talk to ur Pdoc...ive never had one but i thought theyd just ask how the meds are working and stuff like that? do they actually counsel u?

Hello,

I see my Pdoc for meds and therapy. It is true that most Pdocs only do medication management. But I happened to really like my Pdoc and decided to do therapy with her. But a Pdoc will talk to you about how you are feeling and how the medication might be working.

[deliquesce]

i've been seeing my pdoc for 4 years now. initially, we just did med management - so our sessions would be maybe 15mins to 1/2hr. as he got to know me, he realised there was a lot more on my plate than a simple 'biological' depression, so we started talking about a few of those issues and how to manage them - just simple stuff like uni, time management, making sure i don't isolate myself etc.

around this time he also referred me to a T, so the T could help me manage my uni stuff (i'm a student, but due to the depression, hadn't been passing very many subjects at all).

then about 2 years ago, i had a major meltdown due to some PTSD stuff. i was still trying to build up trust with the new T, so pdoc stepped in and said he was willing to do therapy with me if i wanted to. so that's how our sessions became one hour.

obviously, he is not as well trained as a T is, but i like that in a way, because his responses seem a lot more 'genuine'. he really listens to me. my T might have more useful ideas about moving on, but my pdoc is the one i turn to if i need emotional support.

i recently stopped with my T, and am seeing only pdoc now. atm, i am seeing him every week for about an hour (it depends on what we need to talk about - i'm starting new meds, so lately the sessions have been a bit shorter and just discussing how the meds are going).

[sunrise]

My PNP, who prescribes my meds, is also a licensed therapist, and I kind of like that. Although I have a different therapist, when I go see my PNP monthly for meds, sometimes we talk about other things going on in my life and she does do a bit of therapy. If I stay a long time, she will sometimes charge it to my insurance as a pschotherapy session. If I stay a shorter time, she charges it as medication management. I like the fact that she is trained for therapy as well as meds. She has a different viewpoint from my therapist (he's male, she's female, for one thing), and I think that can be valuable.

[possum220]

I see my P'doc for at least an hour every week. He can do meds and is certified in a number of areas of counseling. Mostly the sessions go for one hour some times a little more.

I don't think I could cope with seeing another therapist on top of that. Couldn't afford it either.

Possum

I can only speak for the USA, but here it is pretty rare that a psychiatrist also does psychotherapy. This was very common a long time ago. My psychiatrist (who, incidentally, I am seeing tomorrow morning) is in charge of medication only. Our sessions typically last for about 15 minutes, and he pretty much asks the same questions every time.

[deliquesce]

^ i'm actually quite curious about what a pdoc who doesn't do therapy actually does?

pdoc checks my meds are going ok, but really, if there is a problem with them i just make my own changes. i would hate to have to wait for his ok on everything. that said, he is happy for me to do so (knows i research everything properly, run things past him if i'm unsure), so i guess i have his blessing.

it must be so boring being a pdoc who only does 15min intervals (but $$$-making, so i guess it evens out ).

Originally Posted by deliquesce

it must be so boring being a pdoc who only does 15min intervals (but $$$-making, so i guess it evens out ).

I don't think it's particularly boring, as a lot of pdocs work privately, as well as in the hospitals. Also, many of them are doing research and publishing journal articles. I know that my pdoc is doing research in regards to alternative treatments to ECT. A lot of pdocs are also involved in research that goes into medication trials for new psychiatric medicines that will be approved (or not) in the future.

[deliquesce]

^ aah, thank you .

my pdoc just works privately and at the attached private hospital.

i think in australia we might have a different set up in that there seems to be a divide between 'research' and 'practicing' psychiatrists. obviously there are a number who would do both, but i gather they are in the minority.

[sunrise]

Originally Posted by deliquesce

it must be so boring being a pdoc who only does 15min intervals

I actually think it would be really interesting, and challenging. I'm a scientist, so I view each patient who presents as a bit of an experiment. The pdoc listens to their symptoms, tries to think what is going on in their body and brain, at the molecular level, and then uses their experience and knowledge of drug action to try to come up with the best drug solution. Then the patient returns a month later and reports the results of the experiment (how they are feeling, their symptoms, side effects), and the pdoc changes some of the variables (drugs, dosages) and tries again. With each cycle the pdoc gets closer to getting it right and learns something about that individual's biochemistry. I think it would be quite a fascinating job.

My pdoc also is involved in research (but not on her clients) and I expect that does give her week variety.