What is the difference between a psychiatrist and a psychologist or psychotherapist?
A psychiatrist is a physician trained in mental health, including the prescription of medicines. Some psychiatrists do psychotherapy as well. Psychologists and psychotherapists are trained in mental health, from the perspective of psychological theories about human behavior. Their training is most heavily focused on psychotherapy.
Where do my records go/who has access to them?
We do use an electronic health records system called Epic. Records are securely stored there. Your other health-care providers within the Froedtert/MCW system do have access to these records. However, faculty members should not access students’ health records. Information from your health record will never find its way onto your academic record unless you consent to do so, or if some legal procedure is enacted such as a fitness-for-duty evaluation.
What is the first session usually like?
The first session does involve an interview which touches on your health history as well as the history of your presenting complaint or concern. Your provider will work with you to describe and define your concerns so that a treatment plan with goals can be developed. Often, your therapist will have some helpful strategies to offer in that first session.
How much does it cost?
For students, MCW offers the first five sessions free. For residents and fellows, MCWAH offers the first three sessions free. Post-doctoral (PhD) fellows receive the student benefit (5 free sessions). Following these unbilled sessions, you may use your health insurance. A clinic representative will help you to understand what your benefits are under your plan.
What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy (CBT) is a powerful treatment which is grounded in the notion that it is our thoughts and perceptions of events happening in our lives that determine our emotional reactions to them. It begins by examining what these thoughts are and whether or not there are any distortions in them (which we are all prone to have under stress). It is an active therapy which involves not only coming to understand these distortions, but how to dispute them. Other aspects of CBT involve examining core beliefs which are often the result of early life experiences and homework assignments which may involve the practice of a new skill or the exposure to an avoided (stressful) stimulus so as to reduce the distress surrounding the stimulus.
What other kinds of therapy are there?
Another type of therapy is psychodynamic therapy and this is based on the psychoanalytic theory that early life experiences determine our emotional make-up. Through talking about these experiences and working through the emotions with the therapist, corrective emotional experiences can be had. True psychoanalysis is a much more formalized approach to this sort of insight-oriented therapy and often involves several sessions per week. It is a long-term therapy. There is also marriage (couples) therapy and family therapy. Of course, there are other types of therapy not mentioned here, but your therapist would be happy to discuss as you wish.
How often are the appointments scheduled and how many sessions do people typically come for?
Appointments are usually scheduled once per week to begin with, and then may be tapered down to every other week or so. The majority of our medical students attend just a couple of sessions, although for those who go over the 5 free sessions, the average number is around 8. The numbers are similar for residents and fellows.
How do I know if I need medicine or counseling?
You will usually meet with a therapist first who will help you decide if medicine is appropriate or needed for you. Or, if you have already been prescribed a psychiatric medicine and are seeking a provider to continue those prescriptions, then you would see a psychiatrist first. Many treatment guidelines for depression and anxiety recommend that psychotherapy can be a first line treatment and that if there is minimal to no progress by the sixth session, a medication consultation may be sought.
What if I find myself in a class being taught by my doctor?
We comply with LCME and ACGME guidelines prohibiting treating faculty from being in a position to evaluate a learner who is his/her patient. The faculty member will immediately recuse him/herself from being responsible for evaluating or grading you.
What are the implications of receiving mental health treatment for licensure and/or privileges?
Most states, including Wisconsin have changed the language for such questions from, “Have you ever been treated for a mental health condition?” to “Are you currently impaired by a mental health condition?” This is a welcome change as you can still be a great doctor even if you are struggling with depression or anxiety - patient safety depends on the level of impairment. If you know you are going to a particular state in the future, check the language on Its applications.
What should I do if I don't experience a good fit with my provider?
Your comfort level with your provider is important for your treatment. If you feel that your provider is not a good fit for you, talk to him or her about this. All providers are trained to deal with this issue. If you are reluctant to do that, call the Intake Coordinator or the Director of Student and Resident Behavioral health.