Thursday, August 25, 2011

What To Expect From An Initial Consultation With A Psychiatrist

By Stephen Daniels


The old stereotype of a silent bearded man seated behind you taking notes as you lie on a couch discussing your childhood is long gone. These days, your first visit with a psychiatrist, who may be either a man or a woman, will more likely be conducted in a comfortable office where a friendly face-to-face conversation will ensue. Since psychiatrists are MDs, a large portion of the initial meeting will involve discussing your medical history. It is important that the doctor be aware of any medical conditions you are currently being treated for, as well as any that could be affecting your behavior and issues currently. Because medical issues, such as hormonal imbalances can cause mental illness types of symptoms, it is important that any medical conditions be ruled out before any treatment begins.

Psychiatrists will definitely want to know about any medications you are currently taking, not just because the addition of psychotropic prescriptions might be indicated, but again, to preclude any medications as being the cause of or exacerbating current symptoms. After the history taking, the discussion will largely be about you, and especially your reason for the visit in the first place.

If you were referred by another physician for whatever reason, the psychiatrist most likely will have been briefed on your case and will not need as much medical information from you. Additionally, his approach could be different than if you come to him with a psychological or emotional problem. If you're uncomfortable with the idea of seeing a psychiatrist for the first time, you are always free to take a friend or relative who is familiar enough with you to answer questions that might be difficult for you to handle alone, or just for emotional support.

For the first visit, most psychiatrists will spend an hour to an hour-and-a-half with a patient, which should give both parties enough time to evaluate each other. Above all, feeling comfortable enough with a therapist to disclose your innermost thoughts is a most important element in successful treatment.

It's helpful to take a list of questions to ask on the first visit. You need to know such mundane things as cost and insurance coverage as well as information pertaining to the psychiatrist's background and experience in your particular ailment. For example, if you have a substance abuse problem or have already been diagnosed with a named disorder, specific questions regarding his familiarity with these subjects should be broached. Age is also a factor; young patients sometimes feel more comfortable with a parental type of figure, while others might find their level of comfort with someone closer to their own age. This is also your opportunity to interview the doctor to make sure that you like him/her and want to work with this individual.

Different doctors have different, individual approaches in working with their patients. One style may work better for some patients than others. Keep in mind that, aside from some major breakthrough you might experience down the road, the initial consult may be the most important meeting you have with your new psychiatrist. It sets the tone for all future interactions and makes a lasting impression on both of you. The most important things to remember are to be as open and honest as you can and to trust your gut reaction to the doctor. There is no law that says you must like or trust any particular therapist. If for any reason you feel uncomfortable or react negatively to him, you are always free to ask for a second opinion or simply tell the truth and say you'd prefer to consult with someone else.

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