What is the difference between a Psychologist and a Psychiatrist?
From the MindFit website:
First, let’s talk about the similarities between these professions.
Psychologists and psychiatrists both work to improve the mental health and overall well-being of individuals. In fact, they often work in collaboration to ensure you have more sources of support. They focus on prevention, diagnosis and treatment of mental health issues and often work with a wide variety of issues.
Although both do work with a variety of issues, they may also be more experienced or comfortable in working with certain issues. So it’s always a good idea to ask whether they can help with your specific goals.
The differences between these two professions come down to their education and training, and what specific services they can provide to help improve your mental health and well-being.
Psychologists need to complete a 4 year undergraduate course, followed by a minimum of 2 years of further training. After this, there is ongoing training and supervision to ensure they continually learn and refine their skills. Psychologists can’t provide medication and have to refer their clients to a GP or psychiatrist if they think medication would help. Importantly, psychologists can help you by using therapies that have been thoroughly researched to make sure that they’re effective. These include cognitive behavioural therapy (CBT), acceptance and commitment therapy (ACT) and many more.
Psychiatrists complete both medical and mental health training, which can take at least 13 years. In other words, psychiatrists are doctors who specialise in treating mental illnesses. This is good because physical and mental illnesses are often linked, and the combined training means psychiatrists can focus on both of these together. Unlike psychologists, psychiatrists can give you medication, which is often helpful for mental health issues.
Finding a Good Psychologist
The more support you have, the better the outcomes. So, even if a psychiatrist is better suited to your needs, also seeing a psychologist will help you further. They both have the same end goal, improved mental health and well-being.
How is my information handled?
Client files are held in a secure filing cabinet which is accessible only by your psychologist. The information on each file includes personal information such as name, address, contact phone numbers, medical history, and other personal information collected as part of providing the psychological service.
How clients’ personal information is collected?
A client’s personal information is collected in a number of ways during psychological consultation with your psychologist, including when the client provides information directly by using hardcopy forms, correspondence via email, when the client interacts directly with the psychologist and other staff/employees such as the receptionist, and when other health practitioners provide personal information to the psychologists or the practice via referrals, correspondence and medical reports.
Consequence of not providing personal information
Purpose of holding personal information
A client’s personal information is gathered and used for the purpose of providing psychological services, which includes assessing, diagnosing and treating a client’s presenting issue. The personal information is retained in order to document what happens during sessions, and enables the psychologist to provide a relevant and informed psychological service.
Disclosure of personal information
Clients’ personal information will not be disclosed except when:
1. It is subpoenaed by a court; or
2. Failure to disclose the information would in the reasonable belief place a client or another person at serious risk to life, health or safety; or
3. The client’s prior approval has been obtained to:
a) provide a written report to another professional or agency, e.g., a GP or a lawyer; or
b) discuss the material with another person, e.g. a parent, employer or health provider; or
c) disclose the information in another way; or
4. You would reasonably expect your personal information to be disclosed to another professional or agency (e.g. your GP) and disclosure of your personal information to that third party is for a purpose which is directly related to the primary purpose for which your personal information was collected; or
5. Disclosure is otherwise required or authorised by law.
A client’s personal information is not disclosed to overseas recipients, unless the client consents or such disclosure is otherwise required by law. Clients’ personal information will not be used, sold, rented or disclosed for any other purpose.
Requests for access and correction to client information
At any stage clients may request to see and correct the personal information about them kept on file. The psychologist may discuss the contents with them and/or give them a copy, subject to the exceptions in the Privacy Act 1988 (Cth). If satisfied that personal information is inaccurate, out of date or incomplete, reasonable steps will be taken in the circumstances to ensure that this information is corrected. All requests by clients for access to or correction of personal information held about them should be lodged with the practice directors. These requests will be responded to in writing within 30 days and an appointment will be made if necessary for clarification purposes.
If clients have a concern about the management of their personal information, they may inform the practice directors. Upon request they can obtain a copy of the Australian Privacy Principles, which describe their rights and how their personal information should be handled. Ultimately, if clients wish to lodge a formal complaint about the use of, disclosure of, or access to, their personal information, they may do so with the Office of the Australian Information Commissioner by phone on 1300 363 992, online at http://www.oaic.gov.au/privacy/making-a-privacy-complaint or by post to: Office of the Australian Information Commissioner, GPO Box 5218, Sydney, NSW 2001.
What can I expect on my first appointment?
From the MindFit website:
The idea of talking about your problems with someone you don’t even know yet can be scary. I’m going to provide you with some information that will hopefully make this beginning stage more comfortable.
What you should take to the first session
Most commonly, the only thing you’ll take along is a referral letter from your GP. The psychologist needs your Medicare number and the GP’s provider number to bill Medicare. If you don’t plan to claim the Medicare rebate you won’t need the letter. If you have a copy of a mental health treatment plan from your GP, take it along. It can save you having to give the same details twice. You could also ask the doctor’s office to send it to your psychologist for you.
What you should expect
The first consultation with your psychologist is often longer than a normal session. Find out before you go, so you can allow enough time. The psychologist wants to get to know what has happened, what is happening right now and what goals you would like to achieve. In return, they’ll explain how they work, what they expect of you, what the boundaries are and any limits to confidentiality. They may get you to sign an informed consent form that will outline all of this information. This first session is also a great time to determine whether or not you think you could have a good relationship with your psychologist. The therapeutic relationship is one of the most important factors in determining both your engagement in therapy and long-term positive progress. Pay attention to how you two work together and any “gut feelings” you may have about the psychologist.
What should I say?
Often, the psychologist will guide the conversation by the questions they ask. It may feel a little odd for the conversation to be focused on you. But remember, the psychologist is helping you to get through your concerns.
Having more information will help the psychologist to make a better treatment plan for you. If you can, go a bit outside your comfort zone in opening up and sharing what’s on your mind.
Finally, bring up any questions or concerns you may have. It is important that you feel informed and comfortable when seeing a psychologist.
The first session is the foundation for your treatment. If you feel like you don’t connect well with the psychologist, you don’t have to continue seeing them.
How to know if your therapy is effective?
From the MindFit website:
Therapy works. But did you know that about 50% of people drop out of therapy and more than 30% get no benefit from it? Make sure you’re one of the people getting effective therapy from a good psychologist.
The most important factors in effective therapy
You might think that the specific techniques your psychologist uses are the most important thing. They definitely play a part, and you should ask your psychologist why the treatment you’re getting is right for you. But there are two other factors that are even more important than technique. They’re the therapeutic alliance and early change.
Therapeutic alliance is the quality of the relationship between client and psychologist. Many studies have shown that it’s more important than technique when it comes to improvement. People often know whether or not they will have a good relationship with their psychologist from the first session, so don’t overlook this!
Changes or improvements that occur early in therapy also point to long term improvement in therapy. In fact, if you don’t see positive changes by your 6th session, more sessions with the same psychologist probably won’t work for you.
These two factors also affect each other. A better therapeutic alliance will lead to early changes and improvements. In turn, early improvements will make a better therapeutic alliance.
How to know whether you’re getting effective therapy
The way to see if you have early changes and good relationship is by measuring. Measuring therapeutic alliance and progress every session from the start is important. It lets you and your psychologist know whether things are working. Then you can work together to make changes if your situation isn’t improving or if the relationship isn’t great.
There is a quiz called the “Session Rating Scale (SRS)” that can quickly check the therapeutic alliance. It includes four questions that look at whether you feel understood and respected, whether you worked on your goals, whether the approach used by your psychologist is a good fit for you, and your overall rating for that session.
There is another quiz that can quickly check for improvements in your situation over time, called the “Outcome Rating Scale (ORS)”. This looks at your individual well-being, how your relationships are going, and your satisfaction with work or school.
Making sure that you have a good quality therapeutic relationship and you’re getting early improvements means you’re more engaged and reach your goals faster.
Am I entitled to a Medicare rebate?
From the MindFit website:
A mental health treatment plan (MHTP) can save you $1245 a year. If you are an Australian resident or citizen, you can get one from your doctor, or any GP. The plan lets you claim a Medicare rebate on your psychologist sessions, up to 10 a year.
What happens at the doctor’s
It will depend on the GP. Some doctors will collect a full history, give you a questionnaire, make a diagnosis, discuss your treatment goals, and talk you through the treatments they’ve planned for you. This is what they’re meant to do and it takes a bit of time, maybe 20 minutes. You will have to talk about your mental health stuff with the doctor, so be prepared.
Other doctors will quickly fill out a plan template with the minimum required information. This is bad if you’re relying on the GP for care, because they don’t understand your needs and their plan won’t be very tailored for you. It’s not so bad if you’re taking more responsibility for your own care, because now you’ve got your plan so you can get your Medicare rebates. You can do all the goals and treatment planning with the psychologist.
Almost certainly you’ll get a referral to a psychologist. If you already have one in mind, you can ask for the referral to be written to that psychologist. The doctor is allowed to give you a blank referral to “any psychologist”, but they probably won’t.
What if I don’t like the plan or the psychologist?
Your MHTP lets you get Medicare rebates for 6 sessions with any registered psychologist. If you don’t like the psychologist named on the plan, you can choose a different one. You still get your rebate, and you don’t need a new MHTP or updated referral letter.
If you don’t like one of the goals or treatments on your MHTP, discuss it with your psychologist and do something different.
How much is the rebate?
The rebate amount varies, depending on whether the psychologist is a “general psychologist” or a “clinical psychologist”.
General psychologist: $84.80
Clinical psychologist: $124.50
Psychologists set their own fees. When you’re choosing between psychologists or booking a session, make sure you ask how much it will cost and which rebate amount you’ll get.
How do I get my rebates?
You’ll need to pay the full fee for the session on the day. If your psychologist has electronic claiming you can then get your rebate on the spot. If not, you need to send your receipts to Medicare.
If your psychologist bulk-bills, you don’t have to pay anything. Hardly any psychologists bulk bill.
How many sessions do I get?
Your MHTP gives you 6 sessions. When you’ve used them you can go back to the doctor and get another 4 sessions. Then that’s it for the year. You can still have sessions with your psychologist, but Medicare won’t give you any money back for them. On January 1 each year you’re eligible for 6 sessions again. You don’t need a new MHTP each year.
What makes me eligible for an MHTP?
Most MHTPs are for depression or anxiety. Here’s the full list of conditions that are eligible:
- Anxiety disorder
- Adjustment disorder
- Conduct disorders
- Bereavement disorders
- Post-traumatic stress disorder
- Sleep problems
- Attention deficit disorder
- Obsessive Compulsive Disorder
- Co-occurring anxiety and depression
Do I have to see a doctor to access psychology services?
No, but you can’t get a Medicare rebate without an MHTP.
(Technically you can get a Medicare rebate if you have a referral letter from a psychiatrist or paediatrician. But if you had a psychiatrist or a paediatrician you probably wouldn’t be reading this.)
Can I meet with my psychologist before getting an MHTP?
Sure, but you can’t get rebates for sessions that happened before the date your MHTP was filed with Medicare. (Your GP does the filing.)
Why does my doctor need to be involved?
People have different opinions about this. On the one hand, your GP might be familiar with your medical and personal history which can be useful.
They can help manage your medication, and prescribe things for you, which your psychologist can’t do. So if you have a good doctor they can be part of your mental health care team.
On the other hand, all the stuff the doctor does to prepare an MHTP probably gets re-done by the psychologist. You might decide to make the psychologist a more important part of your care, and just get through the MHTP formalities.
Note that psychological services under Medicare are specified as ‘professional attendance’ and as such require face-to-face attendance with the client that was referred under the Better Access scheme. Other methods of service delivery, such as providing psychological services over the telephone, internet, or via video link, are not allowable under the MBS psychology items.
Can I see a Psychologist through my Private Health Insurance?
From the APS website:
Clients cannot use their private health insurance ancillary cover to pay the gap between the Medicare rebate and the charge for psychological services. Clients need to decide if they will use Medicare or their private health insurance ancillary cover to pay for psychological services they receive. Clients with this insurance can either access rebates from Medicare by following the claiming process or claim where available on their insurer’s ancillary benefits. It is the client’s choice, not that of the health insurance company or the psychologist.
Where the client chooses to claim against their health insurance (gets a better rebate, has exhausted the 10 sessions, or does not have a specified mental health disorder), the psychologist can assist the client and the health insurance company by not using the Medicare item numbers and marking on the account ‘Not claiming under Medicare’. Such a process will ensure that any confusion will be removed for the private health insurance company and the client’s claim will be processed promptly. No such confusion will arise where electronic claiming (HICAPS) is being utilised, as the very act of claiming against one of the collaborating health insurance companies electronically should make the client’s intentions clear.