PSYCHOLOGIST, PSYCHOTHERAPIST, PSYCHOANALYST, PSYCHIATRIST

WHAT DIFFERENCES?


The website nienteansia.it is an international website that provides general information concerning anxiety in particular and a very wide range of other psychological disorders and conditions. When seeking help from health-care providers for any form of mental distress, people may be uncertain as to which mental health-care profession they should first turn to.

The following basic notes are provided to clarify the differences between the categories of practitioners that are there to offer help. The situation in Italy is outlined on the corresponding page in the Italian-language area of the website.

At worldwide level, while psychiatrists and psychoanalysts undergo training and receive qualifications that are very similar in all countries, until quite recently the legislation or regulations concerning the educational requirements and qualifications of psychologists and psychotherapists have tended to differ to a certain extent. It should also be noted that in recent years European countries have begun to establish guidelines and directives increasingly aimed at standardizing the academic and training requirements for the latter categories.

In Europe, the scientific and practical training for psychologists should be at least six years and both the core training and advanced studies should be provided within a university or equivalent institution of higher education. Training undertaken in certain psychotherapeutic approaches will require further years of study.

Those wishing to identify in greater detail the scope of practice and qualifications of clinical psychologists, psychotherapists, counsellors and other health-care providers specialised in the various forms of therapy should refer to the websites of the national licensing bodies in their own country (such as the American Psychological Association (APA) in the United States or the British Psychological Society (BPS) in the United Kingdom) or consult Internet resources concerning professional licensing and regulation.


Psychologists

Psychology is a field of study which traditionally investigates how people think, act, react and interact. It is concerned with human behaviour and the thoughts, feelings and motivation that underlie such behaviour. However, outside the academic sphere, many psychologists are involved in the treatment of mental illness. Doctoral-level psychologists are also generally the point of reference for the administration and interpretation of psychological tests and assessment. In general terms, the work of a psychologist aims at the comprehension, prevention and relieving of psychological distress and dysfunction and the promotion of personal well-being.

Many people would normally associate this field of study with clinical concerns or counselling however many practitioners are involved in experimental psychology, industrial and organizational psychology, child psychology, educational psychology and sport psychology.

Clinical psychologists work in hospital and community settings or in private practice with people with health concerns, marital problems or learning difficulties. They practise a wide variety of techniques. For example, they train people in self-relaxation so that they can cope with their anxieties, and help children with learning difficulties to care for themselves. They also work with people who have eating disorders, sexual problems, phobias, head injuries, strokes, HIV/AIDS, and problems associated with age. Clinical psychologists often work as part of a team with social workers, medical practitioners and other health professionals.

Counselling psychologists help people improve their sense of well-being, alleviate their distress, resolve their crises and increase their ability to solve problems and make decisions for themselves. This is done through the application of psychological theories and techniques aimed at helping individuals deal with some of the inevitable difficulties of normal life. Counselling psychologists work in a variety of settings with individuals, couples, families and groups.

Educational psychologists deal with the problems presented by young people in scholastic settings. These may include learning difficulties and social or emotional problems. Their work involves working closely with teachers and parents.

A great deal of time is spent assessing the progress of schoolchildren, their academic and emotional needs and providing assistance and advice. Increasingly, educational psychologists work with teachers to improve the school environment.

Health Psychologists work in a relatively new field of applied psychology. They are represented in a number of settings, such as hospitals, academic health research units, health authorities and university departments. Psychological principles are used to promote changes in people’s attitudes, behaviour and thinking about health.



Psychotherapists

A psychotherapist treats a wide range of mental and also physical disorders by a number of different methods, each of which has been developed in terms of its own theoretical framework. Such treatment is carried out with individual patients or clients, with groups of patients and with children and adults. Methods will vary and the duration of treatment will range from just one or two interviews to a long series of in-depth discussions extending over two or three years. Group treatment may consist in facilitating the verbal expression of problems or inhibited emotions within a therapeutic group.

As in the case of hypnosis, psychotherapy is a post-qualification specialisation for medical practitioners, general psychologists or licensed social workers.  A psychotherapist specialised in one of the therapeutic theories and techniques may therefore be a medical doctor, a psychologist or may have basic training in one of the other mental-health professions. Some mental-health nurses and social workers also undertake this form of postgraduate training. It has been recognised that some mental disturbances can also be effectively treated by combining psychotherapy with the administration of certain drugs (e.g., severe depression or anxiety). In this case, a psychotherapist who is also a physician may prescribe such medication directly. If the psychotherapist is not a physician, then the patient might be required to seek the support of a psychiatrist or other physician for full coverage. Many psychotherapists adopt an integrated approach whereby techniques from various psychotherapeutic approaches are used. Some of the more common approaches are Cognitive-Behavioural Therapy, Behaviour Therapy, Psychoanalysis, Cognitive Analytic Therapy, Schema Therapy, Systemic and Family Therapy. Some of the techniques most suitable for anxiety disorders are described in the ‘Psychotherapies’ section.


Psychoanalysts

A psychoanalyst is a psychotherapist (medical doctor, psychiatrist, psychologist or other health-care professional) whose clinical methodology and theoretical points of reference derive from the original teachings and theory of Sigmund Freud and the related ‘post-Freudian’ developments and techniques, including the Jungian and Adlerian approaches (see ‘Psychotherapies’). These alternative psychoanalytical therapies developed by members of the original Viennese group of psychoanalysts and also other closely-related later schools of thought attribute a greater or lesser degree of importance to the various tenets of the original theory (including those relating to the psychosocial development of children) and introduce other new elements that were not considered by Freud himself. On account of the particular methodology and therapist-patient relationship employed in this kind of treatment, in order to become a psychoanalyst, student practitioners must necessarily undergo personal analysis, which may last for a few years. The aim of ‘didactic’ therapy and analysis is to identify and resolve any traces of unresolved personal conflict and ensure the acquisition of solid professional competence. While in its original format, psychoanalysis tended to be a long form of treatment (lasting from many months to years), in recent decades briefer forms of treatment have been developed.


Psychiatrists

Psychiatrists are medical doctors who, following their basic training at medical school, have specialised in the field of mental disorders. Following their specialisation in psychiatry, they may also acquire further training in one of the specific psychotherapies or in psychoanalysis.

It may be said that psychologists and psychotherapists would tend to adopt a more holistic approach, simultaneously taking into consideration various aspects of the life of an individual and avoiding solely focusing on a particular disorder itself. Unless psychiatrists adopt one of the psychotherapies in their treatment – as may occur in private practice – they generally utilise a more strictly ‘medical’ approach (especially in hospital settings), whereby diagnosis and treatment tend to be more standardised and attention will tend to focus more on the presenting problem itself rather than on other possible intervening ‘social’ aspects or personal situations that may to a greater or lesser degree also contribute to the problem. In this way, psychiatrists tend to adopt a more strictly ‘medical’ model typical of physicians who treat organic disorders. They treat psychic disorders by application of the methods available to psychiatry, and this may include the use of anti-depressants and/or anti-anxiety medication, mood stabilizers and other drugs when these solutions are considered useful. Psychiatrists will often limit their intervention to administering and monitoring the effects of medication, however it frequently occurs that psychologists and psychotherapists collaborate with psychiatrists in order to ensure results better than those that might be attained through the exclusive use of only one of these approaches.

Psychology and psychotherapy
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