Anxiety is a complex combination of the feeling of fear, apprehension and worry often accompanied by physical sensations such as palpitations, chest pain and/or shortness of breath. It may exist as a primary disorder or may be associated with other medical problems including other psychiatric disorders.

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The presence of an infectious agent on a body surface, in clothes, bedding, toys, surgical instruments or dressings, or other inanimate articles or substances including water and food

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To counterbalance or counteract the effect of; render ineffective.

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A specific behavior therapy approach called “exposure and response prevention” is effective for many people with OCD. In this approach, the patient is deliberately and voluntarily exposed to the feared object or idea, either directly or by imagination, and then is discouraged or prevented from carrying out the usual compulsive response. For example, a compulsive hand washer may be urged to touch an object believed to be contaminated, and then may be denied the opportunity to wash for several hours. When the treatment works well, the patient gradually experiences less anxiety from the obsessive thoughts and becomes able to do without the compulsive actions for extended periods of time.

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Physician, dentist, or other healthcare professional, usually with special advanced education and training.

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Your Family Doctor (GP) is often the first person you will seek help from. He/she will assess the problem and may either provide medication and monitor your condition or may refer you to a specialist, e.g., psychiatrist, psychologist or counsellor, if necessary. Your GP may be able to recommend a support group for the particular problem. Where others are involved in the patient’s care (e.g., psychiatrist, social worker, family members, etc.) your GP may liaise with them in order to provide you with the best overall care.

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A Psychiatrist is a medical doctor that specialises in mental health. Psychiatrists are responsible for the medical care of psychiatric patients (medication, physical symptoms, etc.) and are also involved in counselling. A Psychiatrist usually works in a psychiatric hospital or unit or as part of a community care team but he or she can also be part of a private practice. In most cases, your GP will refer you to a Psychiatrist if he or she considers it necessary or if you request a referral. A psychiatrist will assess the person, usually at a hospital out-patient clinic, form a diagnosis and treat the person accordingly. This may involve treatment with medication or referral to a member of the mental health team. If a psychiatrist thinks it necessary, he or she may suggest that a patient be admitted to hospital.

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A Psychologist is trained in the study of human behaviour and tries to explain feelings, thoughts and behaviour. Psychologists can provide assessment and treatment of a psychological nature that includes personality assessment through a structured interview, assessment of a wide range of psychological problems – anxiety, depression, self esteem issues, psycho-sexual and marital problems. They can also help patients examine the effects their illness is having on their lives and methods of coping with those effects. Bringing a patient closer to an understanding of his or her illness is a key aim of a psychologist. When involved in the area of mental health, the Psychologist usually works as a clinical, community or counselling Psychologist, and unless also medically qualified, does not prescribe medication. Most Psychologists are members of the Psychological Society of Ireland. This professional body provides accredited training and ongoing professional development for its members prescribe to. It outlines a Code of Ethics and also monitors the standards of practice of its members. If you have any questions or complaints about any members of the Society, you should contact the Society directly. In order to qualify as a Psychologist, he or she must obtain a honours Degree in Psychology and additional postgraduate qualifications, in a chosen area, at the Masters or Doctorate level. Some Psychologists are also members of the Irish Association for Counselling & Psychotherapy (IACP), which itself outlines professional training and a code of ethics. You can obtain a referral to an appropriate Psychologist through your local health board, Psychiatrist or GP.

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The Clinical Psychologist has a specialist qualification in mental health and works as part of the mental health team in a unit or hospital and is involved in assessment and counselling therapy. Family therapy may be provided where appropriate and a particular approach may be used for specific problems, such as a cognitive-behavioural approach for phobias. Referral is often through a GP or Psychiatrist, but self-referral is possible.

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The Community Psychologist has a clinical qualification and works as part of a community-based team with individuals such as social workers, speech therapists and Community welfare officers. The community psychologist is involved in assessing and working with those with a wide range of problems, including children with behavioural, educational and other difficulties.

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A Counselling Psychologist has a postgraduate qualification in counselling-psychology and often works privately, offering help for a wide range of problems such as relationship difficulties, anxiety, poor self-esteem, etc. Not all Counsellors are Psychologists.

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There are many forms of Counselling/Psychotherapy available for a wide range of problems and many counsellors/psychotherapists specialise in particular areas such as addiction or bereavement. All approaches emphasise non-judgemental, attentive listening and respect for the client. Psychotherapy/Counselling aims to enable people to take control of their own lives, and the counsellor may not adhere to one particular theory. Self-referral is the usual route to counselling, although a GP, psychiatrist or trusted friend may be able to recommend someone suitable. Some counsellors/psychotherapists are qualified psychologists, but many are not. Those who are not may have a basic degree or training in other areas and/or relevant work experience (e.g., teaching, nursing, etc.) plus a counselling qualification. These qualifications can vary from Masters degrees to short-term courses. It is important to make sure you are happy with the training and qualifications of any counsellor that you choose. You can check that your counsellor is registered with the Irish Association for Counselling and Psychotherapy. This is a national body that operates accreditation schemes for individual counsellors and therapists and maintains a national register of IACP accredited counsellors and psychotherapists. The IACP has also developed a Code of Ethics and Practice for counsellors and therapists. If you have any complaints to make about therapists or counsellors, you should contact the IACP. Counselling is often one session per week and tends to be short-term rather than longer-term, although this can vary. Additionally some Counsellors/Psychotherapists obtain additional postgraduate or professional training in order to qualify for entry to a branch of the Irish Council for Psychotherapy  i.e. the Irish Association of Humanistic and Integrative Psychotherapy.

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Behavioural therapy works on the premise that the therapist can change what people do by teaching them to respond to things in a different way. Behavioural therapy aims to help the patient control undesirable habits or irrational fears and can be used in the treatment of behavioural conditions like eating disorders and phobias. In many cases, behaviours can be learned or unlearned through basic conditioning techniques. Behavioural therapy uses such techniques as aversive conditioning, where unwanted habits are paired with unpleasant stimuli, and systematic desensitisation, where a stimulus that causes anxiety is paired with a pleasant one. Some behavioural therapists may also be psychiatrists or psychologists but this is not necessarily the case. They may be people like psychiatric nurses or social workers who have received the relevant training to work in this area. While this kind of therapy is frequently used in the treatment of behaviour disorders, it may not be available in all regions.

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Cognitive behavioural therapy (CBT) aims to reduce distorted cognitions, emotions and behaviour by changing behaviour and thinking patterns. Professionals who specialise in this kind of therapy believe that a change in symptoms and behaviour follows a change in thinking. They have often obtained additional postgraduate level training or professional training in cognitive behavioural psychotherapy. This change can be brought about in a number of ways, including the practice of new behaviours and analysis of faulty thinking patterns. The purpose of CBT is to reduce distress or unwanted behaviour by undoing this learning or by providing new, more adaptive learning. Again, cognitive behavioural therapists may not all be psychologists or psychiatrists and you should check with your health board to see if the service is available in your area. CBT therapists are often members of the British Association for Behavioural & Cognitive Psychotherapists (BABCP), which maintains its own Irish Division.

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The psychiatric nurse plays a central role in the care of the psychiatric patient, both in a hospital setting and in the community. He or she works within a psychiatric service as part of a health care team. Nurses provide both physical and psychological care to their patients and can also provide essential support and encouragement to the patients’ families. The nurse’s activities are varied but can include:

• Day patient care
• Detoxification programmes
• Education of student nurses and community groups
• Family education and support
• Group therapies, individual counselling
• Acting as a liaison with in-patient services, GPs, strategy and voluntary organisations
• Organisation of admissions to hospital and reception
• Initial assessment of referrals from GPs

The community psychiatric nurse usually follows up patients on discharge from hospital, calling to their homes and attending out-patients’ clinics and day care centres. Community psychiatric nurses are now becoming involved in patients’ re-housing needs.

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A mental health social worker is involved in the provision of a direct social work service for patients who are under psychiatric care and for their relatives. The mental health social worker liaises with members of the various services involved in the care of patients (e.g., GPs, public health nurses, Community Welfare Officers and voluntary bodies) and also with relatives and employers. They are also involved in team discussions, policy development and research. The range of possible services provided can include help with accommodation, work link programmes, appropriate rehabilitative help, social and community skills, loss and bereavement work, work with people who have been sexually abused and with sexual abusers. Social workers will be able to help people who need information about the social welfare benefits, such as medical cards and rent allowance, to which they may be entitled. They can also advise on family law, including marital breakdown, family violence and child protection issues. You will not automatically be assigned a social worker if you are receiving treatment for mental illness, but one will be available to you if it is considered necessary.