Česky
If you think that depressive states are triggered by November, January or February, you are very wrong. Data from the Czech Statistical Office from the last ten years confirm the long-term trend that the spring months are the most critical for people at risk of suicide or severe depression. That's why we asked Marek Jančok, PhD, a psychologist at the Rehabilitation Hospital Beroun, about the differences between a psychiatrist and a psychologist and when it's time to seek professional help.
What is the difference between a psychiatrist and a psychologist?
A psychiatrist is a graduate of a medical school who has completed postgraduate certification in psychiatry. A psychiatrist mainly looks at the biological context of mental disorders from a medical perspective. In the treatment of mental disorders, a psychiatrist primarily uses biological means, especially pharmacotherapy. A psychiatrist with a certificate in psychotherapy can also carry out systematic psychotherapy and report it to the insurance company. Psychologists are graduates in the humanities with a degree in psychology, most often from the Faculty of Arts. Psychologists view mental disorders in relational, personality, psychosocial, and neuroscience contexts. Unlike psychiatrists, psychologists also conduct psychological examinations, given their specialty and area of expertise. In practice, we distinguish mainly clinical psychologists, counselling psychologists, school psychologists, police psychologists, traffic psychologists and sports psychologists. Some psychologists also act as forensic experts in their field of expertise. In the treatment of mental disorders, psychologists mainly use psychological means, especially psychotherapeutic interviewing, rehearsals, hypnosis, etc.
So being a clinical psychologist means "something extra"?
If a psychologist wants to become a clinical psychologist, he or she must complete a postgraduate specialisation in clinical psychology (the minimum length of this postgraduate study is 5 years) after completing a single-subject psychology degree; this specialisation training is completed by certification in clinical psychology. Until passing the attestation examination, the health care psychologist must perform diagnostic and therapeutic activities under the professional supervision of a certified clinical psychologist (supervisor and trainer). The psychologist in pre-attestation training is subject to statutory requirements for continuing education under the umbrella of the IPVZ. Unlike psychologists in other fields, a clinical psychologist (like a psychiatrist) can diagnose mental disorders according to the International Classification of Diseases.
What if a person does not want help and comes only on the basis of the wishes of others? Is it possible to help him?
You are right in that sometimes people come to a psychological outpatient clinic who consciously do not want the help of a psychologist, but have decided to comply with the wishes of their loved ones or the recommendations of a doctor. If a patient is referred by a doctor to a clinical psychologist for an assessment of his or her current condition, it is only a few visits for psychodiagnostic purposes. The patient's motivation is important, but the patient may not be motivated to work with the psychologist over the long term. A person's motivation plays an important role when psychotherapeutic rather than diagnostic care is sought. Those people who consciously do not want the psychologist's help may come in a defensive setting. In such a case, the psychologist can try - with an appropriately guided first contact - to weaken the defensive attitude and motivate the patient to cooperate. Sometimes, however, even with the psychologist's best efforts, this fails, and where the patient's motivation is lacking, even the best psychotherapist cannot help effectively enough. Therefore, we consider initial motivation to therapy as an important predictor of the effectiveness of the therapeutic process. From this point of view, the way in which the patient makes an appointment is already an important indicator for us. It often happens that parents of adult children or partners call psychological outpatient clinics and want to book their son, wife, husband. In this case, we always find out what the reasons are for the other person making the appointment and explain to the caller the importance of making a separate appointment. In most cases, they then make the appointment separately, which we consider to be an important step from a psychological point of view.
What do people most often come to you with?
People can come to us with or without a doctor's referral. However, most often they come with a referral from doctors, most often psychiatrists, general practitioners, rehabilitation doctors and neurologists. However, in my practice I have also encountered patients being referred by a dentist from an outpatient clinic. These patients usually suffer from some form of psychopathology, i.e. psychological disorders, of which anxiety disorders and mood disorders, especially depressive disorders, are the most represented. Often such anxiety or depression is masked by somatic manifestations. In this context, we sometimes speak of so-called psychosomatic disorders. Some people have more permanent and deeper difficulties in personality adjustment and functioning, and the term personality disorder is sometimes used in this context. Often we are also visited by people who do not suffer from any form of psychopathology, but who have got into a difficult life situation or are dealing with some inner conflict and need advice and help to overcome this more difficult period. In such cases, psychological intervention is a form of prophylaxis, i.e. a way of preventing mental health problems that could result from unmanaged stress. Thus, for example, Mrs. X is dealing with an internal conflict about whether to stay or leave the marriage. Mrs. X can seek out a psychologist, discuss the situation with the psychologist and clarify her needs, options, and possibly come to some form of resolution of this internal conflict. This reduces her emotional stress and reduces her risk of developing a psychological disorder. However, Mrs. X may also keep her inner conflict bottled up, struggling with it for the next 10 years until she eventually develops depression or some form of psychosomatic disorder. I would also like to point out an important point - in the case of dealing with personal problems and life crises, without the accompaniment of psychopathology, people can seek a psychologist (non-clinical) or sometimes consultation with a clergyman can be effective. In the case of children's difficulties at school, a school psychologist or a psychologist within the framework of a pedagogical-psychological counselling centre can work very effectively.
When is a good time to seek help from a psychologist or psychiatrist?
I believe there is no clear-cut answer. Each of us is different and therefore there will be considerable differences. However, in general, it is better to nip problems in the bud than to let them grow over a person's head. The point at which a person seeks a psychologist or psychiatrist is often a sense of hopelessness and loss of pleasure, a sense of enjoyment of things that used to give them pleasure.
You can make an appointment directly at the Clinical Psychology Office by calling 311 745 228 (Mon-Fri: 7:00 am-3:30 pm), or by e-mail: sabonova@nember.cz.
