um .. uh .. ok?
August 27, 2012 7:05 PM Subscribe
Can a psychiatrist, not a psychologist, give an ADHD diagnosis? My health insurance people really tried to steer me towards a psychologist and not a psychiatrist. Why might they do that? The cynic in me says it's cheaper for them and less likely to lead to a diagnosis.
Therapy visits to treat are probably a lot cheaper than daily Adderall. Psychiatrist office visits probably bill higher too.
posted by supercres at 7:11 PM on August 27, 2012
posted by supercres at 7:11 PM on August 27, 2012
Yes, a psychologist can diagnose you. They cannot, however, prescribe medication. You'll need a psychiatrist or a GP to do that if that's what you decide to do.
posted by cooker girl at 7:12 PM on August 27, 2012
posted by cooker girl at 7:12 PM on August 27, 2012
A psychiatrist is legally, clinically and ethically able to render a diagnosis, including ADHD. I am not sure why they might steer you towards a psychologist--It probably is less expensive per session and might be equally appropriate for assessment and ongoing counseling. I do not know whether your State permits psychologists to prescribe--if not, it would be best to see a psychiatrist to determine if medication is appropriate. If significant therapy is involved it might be appropriate to see both if the psychologist can not prescribe. I would strongly encourage you to see a psychiatrist, rather than GP if medication is involved.
posted by rmhsinc at 7:14 PM on August 27, 2012
posted by rmhsinc at 7:14 PM on August 27, 2012
I am married to a psychologist. Previous posters are absolutely correct that psychologists can diagnose ADHD, and that your insurance company is probably steering you that way primarily because it's cheaper. However, a psychologist will probably have more training and a better background in diagnosing this type of disorder. Psychiatrists do spend 8 years in med school, but much of that is not in psychiatry.
In most states, psychologists can't prescribe, but in some states they cn.
posted by gteffertz at 7:35 PM on August 27, 2012
In most states, psychologists can't prescribe, but in some states they cn.
posted by gteffertz at 7:35 PM on August 27, 2012
gteffertz: what? psychiatrists spend the same 4 years in medical school as every other M.D., but then they have a three-year residency in psychiatry. I am a psychologist and would say that *some* psychologists have a good background in diagnosing ADHD and some have no background at all in it.
Psychiatrists *always* are trained in the diagnosis of psychiatric disorders, and ADHD is a psychiatrist disorder.
I probably have more trust in psychologists than in psychiatrists, for various reasons, many of which probably overlap with your own, but please don't misrepresent the facts about psychiatric training.
posted by DMelanogaster at 7:51 PM on August 27, 2012
Psychiatrists *always* are trained in the diagnosis of psychiatric disorders, and ADHD is a psychiatrist disorder.
I probably have more trust in psychologists than in psychiatrists, for various reasons, many of which probably overlap with your own, but please don't misrepresent the facts about psychiatric training.
posted by DMelanogaster at 7:51 PM on August 27, 2012
woops, psychiatric disorder (obviously)
posted by DMelanogaster at 7:52 PM on August 27, 2012
posted by DMelanogaster at 7:52 PM on August 27, 2012
Response by poster: thanks everyone. i think i'll call back tomorrow and try to get some psychiatrist referals because i'm leaning towards the meds route. i think it will save me a trip and my precious PTO.
posted by cupcake1337 at 8:18 PM on August 27, 2012
posted by cupcake1337 at 8:18 PM on August 27, 2012
My guy is a neurologist AND a psychiatrist and I trust the first more than the latter and I would never trust a psychologist, MSW or anyone without the ability to write an Rx for meds.
posted by Ideefixe at 8:21 PM on August 27, 2012
posted by Ideefixe at 8:21 PM on August 27, 2012
I suspect cost is the main issue, but there's four times as many working psychologists than psychiatrists in the US, so you'll usually wait longer for an appointment with a psychiatrist.
In some states, psychologists can prescribe under the supervision of a psychiatrist.
posted by gingerest at 8:24 PM on August 27, 2012
In some states, psychologists can prescribe under the supervision of a psychiatrist.
posted by gingerest at 8:24 PM on August 27, 2012
You should be able to find a psychologist who will work with your GP to find the best medication for you.
posted by two lights above the sea at 8:47 PM on August 27, 2012
posted by two lights above the sea at 8:47 PM on August 27, 2012
Yep, a psychologist can determine if your child has ADHD. What they might not be able to do as well is rule out other physical ailments that might have many of the same presenting symptoms as ADHD. You might have a great primary care person who is seeing your child clinically, so this might not be an issue.
I can't speak to whether or not they are more or less likely to give ADHD diagnoses.
posted by anitanita at 9:04 PM on August 27, 2012
I can't speak to whether or not they are more or less likely to give ADHD diagnoses.
posted by anitanita at 9:04 PM on August 27, 2012
Response by poster: to be clear, i'm talking about adult ADHD, for ME.
posted by cupcake1337 at 9:09 PM on August 27, 2012 [1 favorite]
posted by cupcake1337 at 9:09 PM on August 27, 2012 [1 favorite]
It's getting difficult to find a psychiatrist who will actually engage in any sort of talk therapy with ADHD patients, especially adults. In my experience (which is apparently not unusual) it's more common to go to a psychologist for therapy/coping skills and have a cursory periodic check in with a psychiatrist who prescribes your meds.
posted by desuetude at 10:22 PM on August 27, 2012 [1 favorite]
posted by desuetude at 10:22 PM on August 27, 2012 [1 favorite]
A neuropsychologist diagnosed me and was very competent in doing so. I'm actually kind of shocked that people would dismiss psychologists simply because they can't prescribe. Hell, you don't even need to be a psychologist to administer the tests themselves; it's the interpretation of the results that requires the expertise of years of training. (Unless you're me, in which case all of your results end up super-obvious.)
Re: PTO, if you go through a battery of testing, you'll still be out of the office for the same amount of time. Maybe you might have to come back for another visit, but that's the responsible thing to do: the prescribing physician can look over the results of your testing AND the rest of your chart to figure out what type of medication could work best for you.
Either way, you want the person with the most experience in diagnosing and evaluating people who may have ADHD. In my case, the neuropsychologist -- and his experienced technician -- handled these cases almost exclusively for the practice of ~15 psychiatrists and therapists of various stripes.
posted by Madamina at 5:49 AM on August 28, 2012 [2 favorites]
Re: PTO, if you go through a battery of testing, you'll still be out of the office for the same amount of time. Maybe you might have to come back for another visit, but that's the responsible thing to do: the prescribing physician can look over the results of your testing AND the rest of your chart to figure out what type of medication could work best for you.
Either way, you want the person with the most experience in diagnosing and evaluating people who may have ADHD. In my case, the neuropsychologist -- and his experienced technician -- handled these cases almost exclusively for the practice of ~15 psychiatrists and therapists of various stripes.
posted by Madamina at 5:49 AM on August 28, 2012 [2 favorites]
Psychology is unique in the mental health field in their extensive training in assessment and diagnosis. This is not to say that others cannot diagnose. But if you, for example, want intelligence testing or formal testing of ADHD/learning disorders, you'll (99% of the time, I have never heard of otherwise) see a psychologist. In part because the psychiatry programs I've seen don't include training in formal assessment, and probably because they could bill so much for their time it would be astronomical to get a couple hours of testing done.
Psychologists can't write you a prescription (in most states) and I'd definitely go to a psychiatrist for my meds. If you're looking for coping skills to assist you in working around your challenges with ADHD more effectively, I'd say a psychologist is the way to go. If I were to find I had ADHD, I'd have a psychiatrist and still see a psychologist to get some skills training too.
posted by gilsonal at 6:03 AM on August 28, 2012
Psychologists can't write you a prescription (in most states) and I'd definitely go to a psychiatrist for my meds. If you're looking for coping skills to assist you in working around your challenges with ADHD more effectively, I'd say a psychologist is the way to go. If I were to find I had ADHD, I'd have a psychiatrist and still see a psychologist to get some skills training too.
posted by gilsonal at 6:03 AM on August 28, 2012
I think part of the divide in this question is because most people see "psychologist" and replace it in their mind with the word "therapist". I do it myself, and I've been seeing multiple professionals in the mental health field since I was 16.
If your insurance company is trying to steer you towards a therapist instead of a different kind of psychologist, then probably no, that's not what it seems like you want. A psychiatrist is much more likely to get down to brass tacks and test you, maybe write some prescriptions, then done. A therapist type of psychologist is going to want to talk to you, do multiple appointments.
If your insurance company, however, is directing you towards a psychologist who is not acting as a therapist, in other words strictly for testing purposes, this may be entirely valid. For example, the Social Security Administration hires some psychologists on a contract basis to do outside testing on people who are trying to get Social Security Disability Income to correlate or disprove their diagnos(is/es). That's basically what you want, and if it's going to be a hassle to see a psychiatrist, I would recommend going to the testing psychologist first, getting your Dx, and then seeing one.
Good luck navigating the minefield of healthcare insurance! (Plus, you know, I hope the Dx/Rx results are what you would prefer, of course.)
posted by saveyoursanity at 9:24 AM on August 28, 2012
If your insurance company is trying to steer you towards a therapist instead of a different kind of psychologist, then probably no, that's not what it seems like you want. A psychiatrist is much more likely to get down to brass tacks and test you, maybe write some prescriptions, then done. A therapist type of psychologist is going to want to talk to you, do multiple appointments.
If your insurance company, however, is directing you towards a psychologist who is not acting as a therapist, in other words strictly for testing purposes, this may be entirely valid. For example, the Social Security Administration hires some psychologists on a contract basis to do outside testing on people who are trying to get Social Security Disability Income to correlate or disprove their diagnos(is/es). That's basically what you want, and if it's going to be a hassle to see a psychiatrist, I would recommend going to the testing psychologist first, getting your Dx, and then seeing one.
Good luck navigating the minefield of healthcare insurance! (Plus, you know, I hope the Dx/Rx results are what you would prefer, of course.)
posted by saveyoursanity at 9:24 AM on August 28, 2012
Response by poster: i'm not looking for therapy or coping skills. i already have coping skills, and they've gotten me this far, but it's not really enough.
posted by cupcake1337 at 5:42 PM on August 28, 2012
posted by cupcake1337 at 5:42 PM on August 28, 2012
> 'm not looking for therapy or coping skills. i already have coping skills, and they've gotten me this far, but it's not really enough.
Drugs aren't magic, they're a tool. It can be awfully difficult to get someone to prescribe a schedule 2 drug for you without some other sort of therapy.
posted by desuetude at 11:19 PM on August 28, 2012
Drugs aren't magic, they're a tool. It can be awfully difficult to get someone to prescribe a schedule 2 drug for you without some other sort of therapy.
posted by desuetude at 11:19 PM on August 28, 2012
This thread is closed to new comments.
posted by Aquifer at 7:08 PM on August 27, 2012 [4 favorites]