For many, this is a thoroughly unpleasant topic. But it really does happen that therapy alone may no longer be nearly enough.
Our responsibility as therapists — to provide the best possible help.
The client’s health and wellbeing are our priority.
And therefore, when one or several of the symptoms listed below appear, a psychologist is simply obliged to recommend that the client consult a psychiatrist!
Signs that a client in therapy may need a psychiatric consultation:
Possible psychotic symptoms:
If the client shows signs of psychosis, such as hallucinations, delusions or severe thought disturbances — this may indicate a need for psychiatric help.
Suicidal thoughts or attempts:
If the client expresses an intention to harm themselves or speaks about suicidal plans — this requires an immediate referral to a specialist.
Severe affective disorders:
If depression or a manic state becomes very pronounced and interferes with the client’s normal life, medication under a psychiatrist’s supervision may be needed.
Uncontrolled behavioural disturbances:
Aggressive behaviour, outbursts of anger, impulsivity that become dangerous for the client or for those around them.
Eating disorders:
Severe forms of anorexia or bulimia in which the client’s health is at risk.
Addictions:
If the client has a strong dependence on chemical substances or medication that is difficult to manage with psychotherapeutic methods.
A sudden deterioration of the mental state with no evident cause.
The presence of somatic symptoms:
If psychological difficulties are accompanied by physical symptoms for which there is no medical explanation — this may be a sign of a psychosomatic disorder.
Insufficient response to psychotherapy:
If, despite long and intensive therapy, no progress is observed, a psychiatric consultation can help to determine whether some medical aspect of the problem has been missed.
The client’s own wish:
If the client themselves expresses a wish to see a psychiatrist for medication or for additional diagnostic assessment.