Psychiatry is a specialty area of medicine that focuses on the assessment, diagnosis, and management of mental illness and psychological disorders of development. Psychiatrists have a medical degree (4-6 years) and work as doctors in hospitals (1-2 years at least) before applying to commence training in psychiatry (5 years).
Psychiatry training involves working in mental health services (hospitals and community clinics) over 5 years, while simultaneously studying at a tertiary level (in NSW this is currently via HETI – the NSW Government Health Education and Training Institute). All psychiatrists do a form of advanced training or sub-specialisation, for example, general adult, old age, or child and adolescent psychiatry.
The result of these years of training is that psychiatrists can assess patients in a way that integrates biological, social, and psychological perspectives. They are able to diagnose mental illness and neurodevelopmental conditions and provide management for patients which integrate the patient’s physical and mental health. Psychiatrists have training in a variety of psychotherapy (talking therapy) models and they also prescribe medication when required.
Child and Adolescent Psychiatrists can see patients of any age across the lifespan, although most will continue to sub-specialise in the 0-17 years age group.
A Child and Adolescent Psychiatrist may assess a child or teenager and refer them to a psychologist, psychotherapist, social worker, occupational therapist or speech pathologist as part of their management plan. They may also discuss aspects of care with schools or other medical specialists as well as the referring doctor, (usually a general practitioner).
Many psychiatrists will provide psychotherapy (talking therapy) as part of the care plan, depending on the needs of the individual patient. The model of therapy is often determined by the needs of the patient, but more often in psychiatry a combined model which draws from psychoanalysis, CBT, DBT, and ACT principles is used.
Working with parents and family members to increase their understanding of mental health conditions and how to support the person experiencing mental illness or neurodevelopment-related challenges also forms a significant part of a psychiatrist’s work.
Psychiatrists often work together with psychologists so that the talking therapy (CBT, ACT, DBT, EMDR etc) is provided by the psychologist, while the psychiatrist focuses on medication, education for family members and other aspects of care. However the process of assessment and diagnosis, and the regular followup with a psychiatrist includes a therapeutic alliance with the patient. The discussions that form part of the review of the patient’s progress, their response to medications, and their engagement with other therapies have their own therapeutic effects and are a chance for patients and families to reflect on their experience of receiving care.
