Assessment & Confidentiality

Initial Appointment

The first time you meet with a psychiatrist, the appointment will usually last for up to an hour. The psychiatrist will need to do a full assessment. They will be trying to get a picture of the difficulties you are facing, how they affect your life, and what might be the causes and triggers of your problems.

This means they will listen to you talk about your concerns and symptoms, and ask you questions about your health in general and your family history. They might do a physical examination or ask you to fill out a questionnaire. They might also ask your permission to talk to other health professionals you’ve seen, or members of your family.

After getting all the information they need, they will tell you what they think your diagnosis is, and work out a treatment plan with you.

After the first visit, appointments will focus on checking your progress and adjusting treatments.

If you would like to have a family member or a friend with you in your appointments, you can discuss this with your psychiatrist.

How should I get ready for my first appointment?

It may be helpful to prepare for your first appointment by thinking about a few things:

• What symptoms do I have?
• Are there any particular stresses in my life that might be relevant?
• What other medical conditions do I have? (both current and previous)
• What medications, vitamins and supplements am I taking?
• What has helped/not helped in the past?
• What supports do I have in my life? (family, friends, colleagues, groups, etc.)

It might also help to think about questions you’d like the psychiatrist to answer.

What treatments might my psychologist use?

Psychologists help with a range of emotional, behavioural, developmental, circumstantial, and relational issues that influences a person’s mental health and psychological wellbeing in life, academia, and at work. The allied-health professionals may use an assortment of evidence-based ‘talk-therapy’ approaches such as cognitive, behavioural, interpersonal, humanistic, psychodynamic, neuro-linguistic, or a combination of skills from various therapy styles tailored to the individual’s needs and presentations that help people improve their functioning in life.

Psychologists are also trained to assess and diagnose psychiatric condition/s that meets its respective criteria in the Diagnostic Statistical Manual (DSM), and helps each client (or/and other stakeholders) understand their respective clinical presentation, predisposition, precipitating, perpetuating, and protective factors that explains the way he/she/other thinks, feels, and behaves when suffering from a mental health diagnosis/es.

Some of the most efficacious and effective psycho-therapy techniques among others are the cognitive-behavioural therapy (CBT), Positive Cognitive Behaviour Therapy, dialectical behaviour therapy (DBT), schema therapy, motivational interviewing (MI), interpersonal psychotherapy (IPT), emotion-focused therapy (EFT) and neurolinguistic programming (NLP). Research has found each of these therapeutic modes and its skills beneficial in managing a wide range of psychological conditions such as anxiety disorders, mood disorders, personality disorders, trauma-related disorders, and chronic pain. For some of these or other psychological/psychiatric conditions, therapy and medication may work best in combination.

Therapy can help an individual, couples, families, schoolteachers, academics, students, and for employers and employees ‘flourish’ significantly in life or/and in their respective areas of life.

Psychologists work holistically with the clients, and with their respective stakeholders such as their primary care physicians, psychiatrists and /or other specialists, rehabilitation consultants, legal representatives, probation & parole, educational representatives, human resources / return to work coordinators in their overall assessment, treatment, monitoring, reviews and relapse prevention programs. They can provide professional psychological reports upon stakeholder’s or client’s requests.

What treatments might my psychiatrist use?

Mental illnesses happen because of a combination of factors. These factors can be biological (the way your brain works), psychological (how you think), or social (your relationships with other people). The different psychiatric treatments available tackle these different factors.

Psychiatrists use a range of treatments, including

• medications
• Psychotherapy (also called psychological treatment or talking therapy)
• Practical advice about your lifestyle or behaviour.

Your psychiatrist will recommend the best treatment or treatments for you. They will recommend the treatments that are right for your mental illness, its severity, and your individual needs. They will only suggest treatments that have been proven to be safe and effective. In some cases, the proposed treatment might be a stay in hospital.

Your psychiatrist should explain the purpose, nature, possible side-effects, risks and costs of any treatment. It’s up to you whether you agree to have the treatment – and your psychiatrist must confirm that you want to proceed.

Any treatment recommended by your psychiatrist will be aimed at improving your symptoms. The psychiatrist’s goal is to help you improve your quality of life – that means improving your symptoms and helping you to have a fulfilling and healthy lifestyle, with a feeling of optimism for the future. This could include looking at home life, relationships, work, etc.

Your psychiatrist might be part of a team that works together with you to improve your mental health. Other members of the team might include GPs, psychologists, mental health nurses, counsellors, social workers and occupational therapists.

Confidentiality

Anything you talk about with your psychiatrist is confidential. You should feel that you can tell your psychiatrist anything.

Sometimes your psychiatrist may need to share some of your private information with other health-care professionals so they can assist with your treatment.

Your psychiatrist might suggest involving family members in your assessment, but will discuss this with you first.

Under special circumstances, a psychiatrist may be required to share a person’s private information with others, if it is related to your safety. Generally, your psychiatrist will tell you if they need to do this.

Clinicians are also required to engage in ongoing peer supervision to maintain their clinical registration. Peer supervision typically involves discussion of patient presentations although the information is shared in a way that does not identify the individual.

Peer supervision is very important for ensuring clinicians remain up to date in their knowledge and management skills and for obtaining extra support or advice regarding complex presentations.