Therapy, Medication or Both (or Neither)?

June 30, 2015

I stumbled upon this brief piece in the Huffington Post about when patients should consider doing psychotherapy, trying medication, doing both at the same time or not doing anything at all.  I liked this article because it was short and to the point while giving some nice examples behind the answer to the question: “it depends.”

As a psychologist I have many patients ask for medications and I have many patients refuse my suggestion that they consider medications.  I work with only a handful of psychiatrists who I trust, and one of the things that I really like about them is that they don’t always prescribe medication on the first visit and sometimes they don’t prescribe at all.  Now days many psychiatrists have defaulted to the role of “prescription mill” and they just see patients on the quarter hour, back to back, writing scripts as quickly as they can.  I feel fortunate that I have good relationships with some very thoughtful and knowledgeable psychiatrists.

I also feel fortunate that as a psychologist I have the luxury of time to get to really know my patients, develop a strong therapeutic relationship with them and then help them improve various aspects of their lives.  One of my favorite things to do in therapy is to review my clinical notes with a patient when we’re close to terminating treatment.  I have found that when people are feeling better they often forget just how bad things were when they first came to me.  When we read through the chart together they are reminded of the incredible progress they made.

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