Frequently Asked QuestionsHow do psychologists function?Due to their doctoral-level training in research and their extensive clinical training, psychologists are held to high standards of practice. Psychologists are challenged to practice as advanced Clinical Scientists as well as compassionate Doctors. Due to their advanced training, Psychologists are trained to intelligently handle many “choice points” during the course of working with someone. The set of choice points including the following: One choice point is to decide how to comprehensively asses the presenting problems. Let’s say Mr. Jones comes in and reports “I am having problems with Anxiety”. Even seemingly simple problems (like Anxiety) are often poorly assessed by people who lack a comprehensive understanding of Anxiety or of what other problems may also be present. Anxiety is often the result ofna complex combination of genetic, medical, neurological, cognitive, emotional, and environmental factors. My experience in comprehensively assessment comes partly from my scientific work in developing a published multidimensional measure of anger. Go to the "In the News" section to review this measure. A second choice point is how to conceptualize the relationship between the problem (i.e., Anxiety) and Mr. Jones’ Personality. Since no one else has Mr. Jones’ personality, it is also fair to say no one else has the exact same problem with Anxiety that he has. To read more about this truism, go to the Personality-Driven subsection in the Unique Approach page. In other words, Mr. Jones’ problems do not exist completely separate from Mr. Jones’ Personality. Even common problems are never exactly the same in two people. The tricky challenge demanding high level training is to clarify how that problem is connected to your Personality. Now, Mr. Jones may take medication prescribed by a physician to treat his Anxiety. However, medication does not teach people skills, and effective treatment for many conditions (including Anxiety) would probably involve teaching Mr. Jones new cognitive-behavioral skills, for example. For many conditions, cognitive-behavioral approaches have been found to be as or more effective than using medication. A third choice point Psychologists handle competently is to consider what combination of treatments would be optimal for any given person. A major trend in Psychology is the idea that combinations of treatments are often better than simply using one approach only. A fourth choice point Psychologists regularly consider is whether they should consult Psychiatric and/or medical professionals if medication might be part of some optimal set of treatments. A fifth choice point is the issue of when and how to take advantage of a major trend in healthcare known as the Evidence-Based Movement (EBM). To read more about this movement, go to the Evidence-Based Resources section of this website. Amidst the reality that there are often over 50 treatments for any given psychological problem, there is an increasing focus on using the most evidence-based method. The difficulty is in deciding what literature to pay attention to at any given choice point. The most “evidence-based" method may not be the most effective method, and you need someone who can review the literature to make a plan with you of how to proceed. And even if there is a so-called Evidence-Based method available, 40 years of psychological research tells us that we must tailor our approach to a person’s Personality. There is as much complexity in finding the right treatment as in knowing how to apply that treatment. Questions about treatment selection and treatment application are very complex, and demand high-level training. Finally, a sixth choice point for the Psychologist is to determine how to measure Mr. Jones’ progress. Any high quality practitioner is outcome-based, and to assess outcome one must measure something. Psychologists, like physicians, develop simple ways to measure complex things. Return to the top of the page The Uniqueness of the Psychologist in the Field of PsychologyThe term “Psychologist” is legally reserved for those who have obtained a doctoral degree (those who have a “Ph.D.”, or “Psy.D.” after their name) in the field psychology. That is why they are considered “Doctors of Psychology” at the end of their uniquely extensive training. In contrast, the term “therapist”, “counselor”, “life coach”, and many other terms people in mental health use are often not protected terms in this country. This means anyone, regardless of education or training, can use these titles. Damage can be (and has been) done by people treating problems they are not trained to handle. Buyer beware! Educate yourself by interviewing the person you are thinking of using to get help. When I meet with people who interview me, I am excited because that tells me they really want to get the best help possible. And in today’s world, it is hard to find effective psychological help. The Psychologist’s doctoral level training is composed of uniquely rigorous scientific training. The Value of the Psychologist is evidenced by how business people, civic leaders, athletes, and governmental agencies are increasingly using Psychologists’ skills in assessment (e.g., evaluations), intervention (e.g., psychotherapy), and consultation (e.g., help from a problem-solving “confidant”). These advanced skills are forged from at least 5 years of graduate (i.e., post Bachelor's level) education, including a full year of internship. After this internship, the doctor must complete a year of postdoctoral study, then pass (at the doctoral level) a written national examination on psychological matters (i.e., the “EPPP”), and (in some cases) pass a state-specific examination related to the laws of that state. The licensed doctor is only then termed a "Licensed Psychologist". Psychologists (like myself) who obtain a Ph.D. must contribute an original research study to the field (i.e., a dissertation) of Psychology. This is a more extensive research project than a 'thesis', which is required of those who complete a master’s degree. Doctoral level Psychologists are generally required to complete both a thesis and a dissertation. Why should this uniquely rigorous scientific training matter to you? In a time when there are over 50 treatments for even the simplest problems, you want to find someone who can sift through all the options, many of which have some research behind them. You want someone who knows which research to look at, and how to evaluate the scientific value of competing opinions. We live in an increasingly complex world, a world where high level scientific thinking is needed to separate the “wheat from the chaff”. The scientific expertise of the therapist is as important as their character and desire to help. Even well-meaning people can do significant damage if they are not aware of the Science relating to your problem. It is important for you to know the experience level of the mental health practitioner you, your family, or your organization are thinking about working with. I invite you to explore his website (see About Dr. Brunner section). To understand more about how Psychologists function, continue scrolling down this page. Return to the top of the page Who seeks out a Psychologist?There is no one kind of person who seeks out a Psychologist. Quite simply, there are as many reasons to work with a Psychologist as there are individuals. Some people are already doing well, but they want to achieve Optimal functioning. I have worked with business executive, for example, who simply want to achieve their potential. On this note, one current survey suggested that less than half of the people who seek psychological services have diagnosable problems. People are recognizing Psychologists not only help get rid of symptoms, but also help people find meaning in their lives. This growing realization has probably contributed to the fact that (as suggested by a U.S News and World Report Survey) 1 in 3 people will seek some form of mental health assistance in their lifetime. Many more people than you may realize have benefited from work with a Psychologist, due to the confidential nature of the work. Return to the top of the page Dollars and sense value of a well-trained clinical PsychologistThis question must be addressed in terms of how Psychologists are unique. The prior section addresses this question. It is important to reiterate that doctors of psychology have 3-6 more years of education and professional training than master's-level therapists. Now, if you still think Psychologists are expensive, there are some mental exercises you can conduct: - Ask yourself how much you would (and have had to) pay for a dent in your car….a fun trip…a dental procedure. If you still think a Psychologist is expensive, then the problem is not in the price, but in how much relative Value your place on your, your child’s, or your organizations overall functioning. Some people are happier to accept a lower level of functioning than others.
- Consider the cost of not taking care of the problem. Most psychological problems, if they are significant, cause physical problems as well. So, not receiving psychological treatment can also cause your medical costs to rise. Proof of the relationship between “mental” and “physical” problems resides in how psychological treatment has been tied to medical savings. For example…
- A three year study of over 10,000 Aetna beneficiaries showed that after the initiation of mental health treatment, client medical costs dropped continuously over the next 36 months. The health costs of one mental health intervention group fell from $242 the year prior to treatment to $162 two years post-treatment. Other subject groups demonstrated similarly dramatic offset effects, leading the researchers to conclude that a decrease in total health care costs can be expected following mental health interventions even when the cost of the intervention is included. Holder, H.D. & Blose, J.O. (1987). Changes in health care costs and utilization associated with mental health treatment. Hospital and Community Psychiatry, 38, 1070-75.
- When the Utah division of Kennecott Copper Corporation provided mental health counseling for employees, its hospital and surgical costs decreased 48.9%. The company's weekly claims costs dropped nearly 64.2%. In all, for every dollar spent on mental health care, the company saved $5.78. Lechnyr, R. (1993). The cost savings of mental health services. EAP Digest, 22, 23.
- A study of Kaiser Permanente patients who received psychotherapy showed a 77.9% decrease in the average length of stay in the hospital, a 66.7% decrease in frequency of hospitalizations, a 48.6% decrease in the number of prescriptions written, a 48.6% decrease in the number of physicians seen for office visits, a 47.1% decrease in physician office visits, a 45.3% decrease in emergency room visits, and a 31.2% decrease in telephone contacts. Lechnyr, R. (1993). The cost savings of mental health services. EAP Digest, 22, 23.
Return to the top of the page What Myths are out there about Psychologists?Psychologists are shrinks; they “shrink” people down to their problems Well-trained, compassionate Psychologists never shrink people down to their problems. For example, I emphasize helping people explore and utilize positive parts of themselves that they may have forgotten about. Great psychologists help people re-discover personal resources they instinctually have, and in that way help people find a new sense of depth and breadth. Psychological treatment does not shrink, it helps people feel more powerful, more in control of their lives. In short, I do not shrink, I help a person expand themselves! Do I need to be crazy to see a Psychologist? To the contrary, seeing a Psychologist simply means that you have the courage to address issues that most people sweep under the rug. The problem is most problems do not magically go away. Contrary to the old saying that “you will grow out of it”, many psychological problems – although minor at first – often fester and worsen if not treated properly. Some studies suggest that most people who go to see a Psychologist do not have a diagnosable condition, because they realize Psychologists also can help you clarify your Values, and find more meaning in your life. Boredom is a common complaint of some people I have worked with, and together we have developed a way for them to find more meaning in Life. …I will be adding more to this section I proceed along with my work here in Tucson. Return to the top of the page How are Psychiatrists and Psychologists similar and different?You may think the difference is that Psychiatrists use biological approaches, and psychologists do things that are not “biological”. This is an outdated assumption. Why? Because the behavioral methods Psychologists employ are increasingly shown to have biological effects on the brain. For example, a growing number of fMRI studies (where blood flow in the brain is recorded through snapshots of the brain) indicates that psychological approaches (like “talk therapy”) have biological effects. Moreover, these effects at times are similar to the effects of medication. Medication may be warranted, but medication does not teach you skills, and Psychologists do. - Many people confuse the definition of Psychologist with that of a Psychiatrist.
- Both Professionals work in mental health
- Both have received Doctoral Degrees; Psychologists have a Ph.D. (or Psy.D.), and Psychiatrists have an M.D.
- Both professionals are granted the right to make diagnosis while most other health care providers cannot.
- Psychologists and Psychiatrists both work together for the good of patients, since each has particular kinds of expertise.
- The primary difference is that psychologists obtain more training in the combined use of an interview and sophisticated measures to assess personality, as well as the complexity of emotions and behavioral linked to the problem. Psychologists also tend to have greater expertise in conducting comprehensive evaluations using these behavioral measures.
- In contrast, Psychiatrists primarily treat through medication management based on their specialized physiological education. There are exceptions, in that some psychologists (nationwide) are trained in medication management and some psychiatrists are trained in psychotherapy.
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