EXcellent thread - right up my alley. S/F!!
I am a retired clinical social worker - mental health therapist. I spent oodles of money getting an advanced degree toward that end at the turn of
the century, and learned a whole bunch about how society uses tools like the DSM. My copy of the DSM IV-TR (Diagnostic Statistical Manual, Fourth
edition, text revision is the long name) is dog-eared, paper-clipped, highlighted, bookmarked, and ratty.
First I want to address your personal experience within the mental health system; you are obviously a very astute "consumer", and have done the work
required (yep,
required) to improve your own functioning. Most people who seek mental health treatment are either coerced into it by others,
or forced into it. Oftentiimes it is at "rock bottom" that people will seek help.
There is too much of a stigma on "Behavioral Health", and you are absolutely SPOT ON that
everyone can beneft by entering willingly into
a partnership with a professional trained to help develop introspection and self-management skills -- either to identify and learn to change
counterproductive skills, or to learn productive ones. The skills that a person develops to cope in the world are a direct result of their
environment and the conditions in which they find themselves. No life is perfect. No parent or family is perfect. No person is perfect either, and
each of us has an individual temperament and response to the world in which we find ourselves.
Therefore, mental health counseling is an ART as well as a SCIENCE. It depends MOSTLY on relationship and trust, communication skills, and the
willingness of both parties to be honest.
That said, there are difference between the three different "Mental Health Professional" titles.
The types of professionals' educations depend on where they went to school. I went to a very well-respected Public University, which has its own
hospitals and School of Medicine (teaching hospitals), as well as a School of Social Welfare; and studied under Psychiatrists, Psychologists, and
Social Workers. I learned a great deal about how the system works. Keep in mind that every school has their own "curriculum", and not all schools
teach the same philosophies.
My academic institution turns out these styles:
A
Psychiatrist is an M.D. A medical doctor. They got the same early training as doctors like your family practitioner or oncologist or
phlebotomist, etc. They may OR MAY NOT have received indepth training for what we call "bedside manner" or empathy.
They are the ONLY ONES who
can prescribe.. Their mindset is to see clients as SICK, as PATIENTS, and their job is to CURE the ILLNESS and be the EXPERT. Telling the
person what is wrong with them, and handing out pills (or shock treatments or blood-letting or whatever is in vogue) is how they operate.
Some schools are beginning to integrate actual "therapy" more into their residents' training, but not all.
A
Psychologist may or may not achieve a PhD (Doctor of philosophy), but will have a Masters Degree in Clinical Counseling (or be interning
under the supervision of one toward that degree). They are NOT ALLOWED to prescribe. They work as therapists on the behavioral level, and are
trained to see themselves, again, as EXPERTS treating a sick PATIENT.
Then there are
Clinical Social Workers, who also may or may not achieve a PhD, but will have a Masters Degree in Clinical Counseling equal in
credentials to the above Psychologist, and also are NOT ALLOWED to prescribe. Their style is different from Psychologists, though. The Social Worker
is trained to build a rapport with the
CLIENT (as opposed to "patient"), and to hold that the CLIENT is the EXPERT on their own lives, and are
capable of DETERMINING THEIR OWN GOALS. Their job is to help the client determine and achieve those goals, not to treat them as "sick".
So, whether you're seeing an intern, a PhD, or a MSW, they will ALL have a partnering PSYCHIATRIST who is often itinerant and sees clients
periodically to adjust prescriptions. The docs rely on the clinicians to keep them up to speed on progress in the behavioral aspects. And
ALL
THREE types of practitioners USE THE DSM, for billing purposes and uniformity of communication.
EVERY PERSON ON EARTH has moments or spells or days, or even years, of uncomfortable moods, emotions, thoughts, etc. EVERYONE can benefit from a
professional screening or conversation. It is empowering if done well, and can be devastating if done poorly. Nevertheless, prescriptions are
various. Some are short-term to alleviate symptoms until firmer footing is found by the client. Others are long-term to "correct" unusual
bio-chemical imbalances. Without THERAPY, though, scrips alone often will do little.
Finally:
The DSM is a DIAGNOSTIC TOOL only. Its purpose is to give CODE numbers for BILLING to INSURANCE. While it has a lot of stats and
lists of "clusters of behaviors", it is NOT A CURE HANDBOOK. It's your practitioner's skill that makes the difference.
Anyway, just wanted to pitch in here.
edit on 8-12-2012 by wildtimes because: i'm nitpicky about my prose.
