Shadowing a Doctor

January 9, 2015

Psychiatrists are highly trained physicians who specialize in the diagnosis and treatment of mental illnesses. Within the specialty of psychiatry, there are several different sub-specialties, which fall under two categories – adult mental illness specialties and child/adolescent psychiatry.

A student assisting with patients during ward rounds, Tanzania. Child & adolescent psychiatry

Child and adolescent psychiatry (CAP) deals with diagnosing and managing psychiatric disorders from infancy to mid-teens. With mental health problems in children show an increasing trend, CAP is considered to be a developing field. The approaches to treatment are many and varied, ranging from family therapy to psychodynamic psychotherapy. Child psychiatrists work in varied settings from private clinics and schools to hospitals.

Adult Mental Illness Specialties

There are several sub-categories of adult mental illness specialties. 

  • General psychiatry: General psychiatry encompasses the management of patients in hospital and community settings and may involve working with patients in one of the sub-specialties of general psychiatry – substance misuse, rehabilitation or liaison psychiatry. The work within general psychiatry is varied and challenging. It involves working with a range of other medical, nursing and paramedical staff, together with statutory and voluntary organizations concerned in the care of people with mental illness.
  • Learning disability: The psychiatry of learning disability deals with the assessing and treating emotional, behavioural and psychiatric disorders associated with learning disabilities such as mental handicap or mental retardation. Practitioners also offer advice and education about behavioural aspects of learning disability to parents and other carers and to other professionals such as teachers. The nature of problems dealt with is much broader than in other psychiatric sub-specialties and includes organic psychiatric disorders such as dementia and delirium, functional psychiatric disorders such as affective disorder, schizophrenia, autism and epilepsy. Advances in this field have dramatically increased the scope for improving the quality of life of people with learning disabilities through psychiatric intervention.
  • Geriatric or old age psychiatry: Geriatric psychiatry is a rapidly growing specialty that deals with the assessment, treatment and continuing mental health care in individuals over 65 years of age. This includes functional illnesses such as depression and schizophrenia as well as organic illnesses such as dementias. 
  • Forensic psychiatry: Forensic psychiatry deals with some of the most disturbed and difficult to manage patients in psychiatric practice. This sub-specialty primarily focuses on assessing and treating mentally disordered offenders and other patients with significant behavioural disturbance associated with severe mental disorder. Treatment settings vary from community forensic services through to medium and high security hospitals as well as prison settings. Knowledge of the law in relation to clinical practice is central to the work and there is regular involvement with criminal justice agencies.
  • Psychotherapy: Specialist psychotherapy is a significant part of all psychiatric services. A wide range of patients are referred to psychotherapy services, with the emphasis being on those with more serious mental illness such as personality disorders and co-morbid conditions. The time taken to assess the patient and also the therapy contact time is usually much greater in psychotherapy than in general psychiatry. Work is usually arranged within strict time boundaries, so the specialty is ideal for those who work part time.

Each of these sub-specialties requires their own Certificate of Completion of Specialist Training (CCST).