Suggestions for Accessing ADHD Medication
Suggestions for accessing medication
Humans are complex. Sometimes, issues that bring you to therapy may be best treated using a Integrative Mental Health treatment approach. Integrative Mental Health treatment pulls from a variety of potential treatment options including: traditional talk therapy/psychotherapy, pharmacological treatments (medication), acupuncture, dietary adjustments, herbal remedies, lifestyle changes, meditation, and other forms of traditional and non-traditional healing. For this reason, your therapist may suggest exploring medication as a supplement to your work together in the therapy room. Unfortunately, navigating the medical system can be overwhelming, confusing, and often frustrating.
To help with this process, we have summarized how most people are able to work with their medical provider to be prescribed medication for their mental health concerns.
Generally speaking, in order to get a prescription, a medical provider with the authority to prescribe medication must make a diagnosis and determine if medication is an appropriate treatment option. Then a discussion of types of medication and dosage normally follows.
As a first step in this process, it is important to get a diagnosis. Various providers in the mental health and medical fields are able to give a mental health diagnosis. Different providers have different areas of focus and different training which allows them to provide different services. The providers and their roles have been summarized below:
Counselors/Therapists
Providers at this level usually have a masters degree, have completed a supervised internship, and have years of supervised practice. Some providers are interns or candidates which indicates they are still working towards their own independent license and likely have a supervisor who is independently licensed.
Examples at this level include: Licensed Marriage and Family Therapists (LMFT), Licensed Professional Counselors (LPC), Licensed Clinical Social Workers (LCSW)
Providers at this level specialize in providing talk therapy. Each license group carries unique specializations and emphasis. LMFTs focus on relationships and often see couples or families together, LPCs focus on individuals and often focus on specific mental illness concerns like trauma or eating disorders, LCSWs focus on providing social support and connecting individuals with their community while working with individuals or relationships, PMH-RNs combine their medical knowledge with psychotherapy techniques and can provide informed suggestions about the interactions between biology and psychology. Some providers at this level specialize by getting additional degrees or certifications such as Certified Sex Therapist (CST), Eye Movement Desensitization and Reprocessing (EMDR) certifications, or Licensed Addiction Counselor (LAC).
Providers at this level cannot prescribe medication but can provide a mental health diagnosis as well as support getting connected with other providers including prescribers.
Psychologists
Providers at this level have doctoral degrees, have completed internships, and have years of supervised practice. Some providers are interns or candidates which indicates they are still working towards their own independent license and likely have a supervisor who is independently licensed.
Licensed Psychologists (LP) can work in a variety of capacities including clinical work, school psychology, or forensic psychology. In clinical settings, psychologists can provide talk therapy but are often focused on providing diagnostic assessments.
Providers at this level cannot prescribe medication but can provide mental health diagnosis as well as support getting connected with other providers. In order to access certain government programs and certain types of insurance funded services a diagnosis from a Licensed Psychologist is required.
Prescribers: Medical Doctors and Psychiatric-Mental Health Nurse Practitioners
Providers at this level have advanced medical training and are either medical doctors or Nurse Practitioners with specialty training in Psychiatry. Medical Doctors (MDs) and Psychiatric-Mental Health Nurse Practitioners (PMHNP) have completed internships, residencies, and have years of supervised practice.
MDs and PMHNPs typically focus on diagnosing, prescribing, and managing medication. Two kinds of MDs that you are likely to interact with include Primary Care Physicians (PCPs)- who generally diagnose and treat common medical issues- and Psychiatrists- who have specialized in the diagnosis and treatment of mental health issues. Psychiatrists and PMHNPs can provide talk therapy in addition to diagnosing, prescribing, and managing medication.
Providers at this level have the authority to prescribe medication. To receive a prescription for medication, a provider at this level must determine that a diagnosis is warranted based on the symptoms being presented. Some providers at this level will want to undertake a formal – and sometimes lengthy – assessment process to determine an appropriate diagnosis. Other providers at this level will want confirmation or collaboration of a potential diagnosis from another provider. For example, a MD may ask to speak with a client’s counselor/therapist to get more information about what diagnosis they have given the client.
Being on medication is often a lengthy process that can sometimes require multiple attempts at trying different medications in order to find a type of medication that is effective at reducing symptoms while also mitigating unwanted side effects. Sometimes adjusting dosage of a medication is also a necessary step to achieve symptom relief. Some medications require blood tests, urine analysis, or other medical tests to ensure that they are safe to take and are having the desired effect on the biological and chemical processes in the body. Being on medication also often requires follow-up with your prescriber at regular intervals.
Path to Medication
The steps to getting a prescription for medication are summarized below:
When exploring the possibility of adding medication as a part of your treatment approach, it is important to speak with a provider who has the authority to prescribe medication (MD or PMHNP).
In order for them to prescribe medication, a diagnosis must be made regarding what the provider believes may be happening and they must determine that medication is an effective treatment for that diagnosis.
Prescribers may want to complete their own assessment or may ask for documentation from other providers (therapists/counselors or psychologists) to confirm or support a diagnosis.
If a prescriber determines that a diagnosis is warranted, and that the diagnosis they make has medication as an appropriate treatment, medication may be prescribed
Finding a medication that is effective at reducing symptoms and limits unwanted side effects can require trying different kinds of medication or different doses of medication
In addition to receiving talk therapy, working with a therapist/counselor or a psychologist can create a space to explore additional treatment options including medication, help you to get connected to other community resources including prescribers, and get an initial diagnosis which can be communicated to prescribers and other providers.
Continue working with your treatment team of providers to determine the effectiveness of your current treatment approach and continue tracking progress towards personal goals and symptom reduction
Getting on medication can be a confusing and complex process. Speaking with a therapist can be a helpful, first step in order to explore potential treatment options, including medical and non-medical options. If you have questions about effective treatment options for what you are experiencing, feel free to give us a call!
References
Duffy, J. D., Cohen, L., & Chaoul, A. (2016). Integrative medicine in mental health. Encyclopedia of Mental Health, 384–389. https://doi.org/10.1016/b978-0-12-397045-9.00132-4