Information for Psychologists
Collaborative psychiatric support to enhance ongoing psychological therapy.
Collaborative Psychiatric Support
At Alexandra Specialist Clinic, psychiatric care is designed to support, not replace, ongoing psychological therapy. Many patients benefit from combined treatment, particularly when medication optimisation or diagnostic clarification is required.
When Psychiatric Input May Be Helpful
You may consider suggesting psychiatric referral when:
1. Therapy programs have plateaued
- Persistent depressive symptoms despite engagement
- Anxiety not responding to structured interventions
- Emotional dysregulation limiting therapeutic work
- Recurrent relapse despite appropriate therapy
Medication optimisation can sometimes unlock therapy progress.
2. Diagnostic clarification is needed
- Bipolar spectrum vs recurrent depression
- ADHD with comorbid mood instability
- OCD vs trauma-related symptoms
- Complex trauma presentations with affective instability
Clarifying diagnosis often improves therapeutic direction.
3. Medication concerns arise
- Multiple failed antidepressant trials
- Intolerable side effects
- Polypharmacy concerns
- Questionable long-term benzodiazepine use
- Suspected mood destabilisation
Psychiatric review may provide structured adjustment rather than repeated GP changes.
4. Risk Is Escalating
- Emerging suicidality
- Marked functional decline
- Increasing impulsivity or agitation
- Possible hypomanic or mixed features
Early intervention reduces crisis presentations.
Treatment Philosophy
Psychological therapy remains central.
Psychiatric input is typically focused on:
- Diagnostic formulation
- Medication review and optimisation
- Risk assessment and stabilisation
- Clear communication with GP and therapist
The goal is to stabilise and return patients to effective therapy.
Communication and Shared Care
Where appropriate (with patient consent):
- A written report is provided to the GP.
- Collaborative updates can be provided to treating psychologists.
- Treatment planning aims to support therapeutic continuity.
The therapeutic alliance with psychologists is respected and maintained.
Areas of Clinical Interest
- Treatment-resistant depression
- Bipolar spectrum disorders
- Complex anxiety and OCD
- Trauma-related presentations
- WorkCover and occupational stress injury
Referral Process
- Patients require a valid GP referral for Medicare rebate eligibility.
- Psychologists may encourage patients to discuss psychiatric referral with their GP if medication review or diagnostic clarification appears indicated.
- Urgent cases may be considered at the discretion of the practice.