Should my brother see a psychiatrist or a psychologist?
Asked by
mramsey (
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October 5th, 2009
What is the difference between a psychologist and a psychiatrist? And which should my brother see? Do they take health insurance?
My brother is a freshman in high school and he is still afraid of sleeping alone. He often does my sisters chores so she will sleep in his room. My mom doesn’t allow him to watch scary movies because of how afraid he gets but when he does watch them he ends up in my parents bedroom. He even gets really mad if someone jumps out and scares him. He is convinced that our house (that we built and have been in for all of his life) is haunted even though the rest of do not think so. He is tired of always being afraid and really wants to talk to someone and get help. However, he will not talk to a school counselor or our pastor because he is to embarrassed to talk to someone he knows. Any suggestions?
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11 Answers
A psychiatrist typically isn’t needed in the beginning. The difference is that a psychiatrist can prescribe drugs and had a medical degree. A psychologist is a therapist and works on your issues by having you change behaviors or talk them through. Most people start with a therapist or psychologist and then if needed they will progress to a psychiatrist.
Nowadays a psychiatrist (who is an MD) largely consults with other psychotherapists, primarily in the area of psychopharmacology.
I suggest your brother look for an LCSW who has been trained in Cognitive-Behavioral therapy (there are many, many such people.) Anyone with advanced training in Dialectical Behavioral Therapy would be good to consider, simply because they have a different and effective set of tools in case they are necessary.
From your description of your brother’s concerns I would venture to guess that he can be helped a great deal, at not to great an expense, and over a relatively brief period of time. I wish him well.
A psychologist is the one who does the listening and talking these days, so I suggest he start there. If the behavioral tools the psychologist can teach him don’t help and it looks as though medication is necessary, then that would be the time to see a psychiatrist.
And yes, most insurance plans cover visits to both psychologists and psychiatrists but it may be at different levels. He needs to take a look at the policy that covers him to know what to expect. Typically, the psychologist and the psychiatrist will both file the insurance, leaving you with only the co-pay. Again, this may vary depending on your precise plan.
@pdworkin Now that’s twice you’ve suggested Dialectical Behavioral Therapy in one day. Is that your personal favorite or your area of training perhaps?
Oh and to add to what @Darwin said about the insurance, even if you cannot find one covered by your insurance there are typically counselors that offer sliding-scale fees. So don’t count it out due to money no matter what :)
No, not at all. It is being generally taught in most academic institutions that train clinicians, and I only mention it because there are some empirical data demonstrating its effectiveness, and it demands extra training so that leads me to assume that a therapist who is willing to do the extra work is highly motivated.
Other than that, it is, as I said, just another set of tools.
@mramsey, back of the insurance card, there should be a number for behavioral health services. Call the number, tell them what’s going on and they will provide authorization for visits. They will give you a list of covered providers, or if you have one that you would like to use, will tell you if that provider is covered. There were limits to how many behavioral health benefits your plan would pay for, but that’s going away with the Federal Mental Health Parity act as of health plan renewals after 11/½009.
@pdworkin Thanx, I was just interested in your thoughts on it since you had mentioned it.
@SarasWhimsy I assume that is from personal experience? :)
You can ask a social worker these questions. They know who you should be talking to.
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