Frequently Asked Questions about Psychological and Psychiatric Treatment:

My therapist referred me to a psychiatrist. Does that mean I need to take medications?

No. Seeing a psychiatrist is an opportunity to get a second opinion about your situation. The psychiatrist will review the reasons for the referral and make his/her own recommendations. Even though the therapist referred you for medication evaluation, the psychiatrist may not necessarily recommend medication.

My therapist referred me to a nurse practitioner instead of a psychiatrist. What's the difference?

Nurse practitioners, technically referred to as Certified Registered Nurse Practitioners (CRNP), like psychiatrists may prescribe medications. INTROSPECT hires highly qualified CRNPs who have special training in treating psychiatric illnesses. All of our CRNPs are supervised by Dr. Shanken, INTROSPECT’s Medical Director. If your therapist is uncertain about your diagnosis or believes your condition requires a different level of clinical experience, he or she may refer you to a psychiatrist. Psychiatrists are physicians and have more extensive experience and training in treating certain complex psychiatric illnesses.

After my initial appointment with the psychiatrist or nurse practitioner, my subsequent appointments with them are only 15 minutes. In such a brief time, how can he/she know what’s going on with me?

Our psychiatrists, nurse practitioners, and therapists practice in the same building. They communicate by using the same chart, by exchanging voice mails, or by talking face-to-face in consultation. Therefore, they are very familiar with your situation. Their primary focus when they meet with you is on making medication changes and adjustments rather than going over information you have already discussed in therapy with your therapist. Although you are only scheduled for 15 minutes for a follow-up, if more time is required to properly evaluate your situation, then your psychiatrist or CRNP will certainly extend your time as necessary.

I feel uncomfortable when my therapist does not start the discussion. Are they trying to make me uncomfortable?

No. This is a common refrain from patients and may occur for a number of reasons. Usually this is experienced at the beginning of the session because you therapist is waiting for your to talk about what is important to you. If your therapist were to begin the session he/she may bring up something less important to you at that moment.

My therapist is a psychologist and is referred to as 'Doctor.' Why can't my therapist give me medications if he/she is a doctor? Why must I see a psychiatrist or nurse practitioner?

Psychologists and Social Workers who refer to themselves as doctor, have a doctorate degree in psychology or social work. Psychiatrists have a doctor degree in medicine. Because psychologists, counselors and social workers are not medical doctors and have no special medical training like nurse practitioners, they may not prescribe medications. Even though nurse practitioners are not have the title of doctor, they are Advance Practice Registered Nurses who have special medical/psychiatric training allowing them to prescribe and diagnose.

How long will it take for me to feel better?

There is no hard and fast rule here because responses to treatment are dependent on many factors but especially your particular diagnosis and your unique response to medications and therapy. However, as a general guideline, for most moderate to severe mental health problems, fewer than eight therapy sessions are unlikely to be optimally effective. When combined with medication, often 10 to 20 sessions are needed for symptomatic relief and more for lasting change.

I'm not interested in talking therapy. Why must I see a therapist before I see a nurse practitioner or psychiatrist if I only want medications?

Because of the high demand for the time of psychiatrists and nurse practitioners their emphasis is on prescribing medications. Because taking a comprehensive history at the first visit with a patient requires approximately 45 to 50 minutes, seeing a psychiatrist or nurse practitioners would result in longer delays for patients to get an appointment with a psychiatrist or CRNP. And because approximately 50 % of our patients do not require medication, seeing a therapist first reduces the volume of patients that do not need to be seen by our medical staff.

How will I know that I have found the right therapist for me?

Our entire clinical staff is independently licensed by the state of Pennsylvania. Therefore, they have demonstrated to the State Licensing Board that they are qualified to administer mental health care. You should also look for a therapist who has experience in treating your specific problem. The first visit is the best time to ask about their experience and specific training. However, experience and licensing alone does not necessarily make the 'right therapist' for you. One of the best predictors of success in therapy is the level of comfort you have with your therapist. Because the objective is to create a safe and comfortable environment where you feel you can tell your therapist anything, it is essential that you find someone with whom you feel there is a fit. Sometimes that can take 3 or 4 visits to determine. However, if you continue to feel uncomfortable, or that your visits are unproductive, discuss that with your therapist. As therapists, we are trained to deal objectively with such situations and we do not take your feedback personally. Sometimes an interchange about your reaction to the therapist can resolve the discomfort. If not, your therapist will refer you to a colleague or assist you in finding a therapist elsewhere. If you feel you cannot discuss this with your therapist, you can also speak to the associate medical director who will assist you with a transfer to another therapist. INTROSPECT has a staff of close to 20 therapists. Usually we can find a good match for you.

What is Your Philosophy About Medication?

Many individuals in therapy at INTROSPECT are treated without medication. However, by working closely with our psychiatrists, therapists are alert to situations in which referral to our Nurse Practitioners or Psychiatrists for medication evaluation are necessary. Medications do not change one’s personality and make you a different person, but can help to bring out the best of who you really are. They can be useful in relieving uncomfortable feelings such as anger, depression and anxiety. Medications can improve concentration, sleep and help to generate feelings of well-being.

When medication is indicated, the combination of medication and talk therapy is generally more helpful than either one alone. INTROSPECT is NOT A MEDICATION MILL but a facility where the use of medication is carefully considered. We have found that many individuals benefit from therapy and/or medications within their first twelve sessions. When your throat hurts, you check it out with your family doctor and he/she often can reassure you that it is not serious, and then you proceed with relief. Or he/she may recommend some form of help and you are reassured that you have taken care of yourself and started on the road to recovery. Using the same analogy, a single consultation with our medication experts can often be useful in determining whether this form of therapy can prove beneficial.

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