When it comes to getting an ADHD assessment, many people are confused about who can do what, a confusion I understand entirely. Two years ago, when seeking my own assessment, I spent a considerable amount of time trying to find the right professional—and I’ve worked in psychiatry for 35 years.
With a strong desire to make sure the person I was seeing was the right fit, my questions were wide-ranging. For example, it’s common for patients not to understand the differences between a psychiatrist, a psychotherapist, and a psychologist, so please allow me to break down the three Ps into bite-sized descriptions:
* Psychiatrist: A medical doctor who has completed a medical degree and then completed specialised training in psychiatry. Qualified to diagnose mental health conditions, they can also prescribe medication.
* Psychologist: Someone who completes a psychology degree and then does further training to become a clinical or counselling psychologist. They are experts in psychological assessment and therapy, but cannot prescribe medication.
* Psychotherapist: This is a broad term and not a legally protected title like the others. A psychotherapist can come from a variety of backgrounds and complete training in a specific type of therapy. Unlike psychiatrists or psychologists, a psychotherapist isn’t necessarily a mental health professional in the same sense.
Why I need to Explain My Background
Can a Nurse Practitioner or Clinical Nurse Specialist diagnose, treat, and prescribe for ADHD?
As a Clinical Nurse Specialist and a Nurse Practitioner with 37 years of experience in psychiatric and mental health nursing, fifteen years ago, I decided to train as a psychotherapist. I wanted to move beyond the limitations of the medical model and work with patients in a more holistic manner. I chose to train as a Cognitive Analytic Therapist (CAT), a field that is very human and relational. CAT training is rigorous and requires a background as a mental health professional, such as a psychiatrist, mental health nurse, social worker, or psychologist. This background is critical, I believe, as anyone performing an ADHD assessment needs a deep understanding of the full spectrum of mental health presentations, from personality disorders to bipolar disorder, cyclothymia, and dysthymia.
I’ve seen a dangerous trend recently involving people with no psychiatric background—such as general nurses or even teachers trained in dyslexia assessment—who are now offering ADHD assessments. How can you confidently diagnose ADHD if you don’t have the experience to differentiate it from conditions like Borderline Personality Disorder (BPD) or Bipolar Disorder? Short answer: you can’t.
Over my career, I’ve conducted thousands of assessments, and I’ve seen firsthand how easily patients with ADHD can be misdiagnosed with other conditions. The symptoms can be similar, but to an experienced eye, they are very distinct. My extensive experience allows me to see those nuances.
While I’m not a medical doctor, my training as a nurse practitioner required an additional year of university to become an independent prescriber. This allows me to diagnose, treat, and prescribe for my patients, ensuring a comprehensive approach. In total, my complete training in psychiatry is approximately ten years, including various courses and qualifications, making me a highly specialised practitioner.
I continue to take courses, as staying up-to-date is an essential part of my work. I am currently training in menopausal medicine, as I believe it is vital to keep expanding my knowledge to better serve my patients.
A Patient-Centred Approach
Recent documentaries, such as the Panorama program, have rightfully raised concerns about the quality of ADHD assessments. I understand the scepticism, as it seems many companies are operating like “sausage factories,” rushing through assessments to maximise profit. However, as someone with ADHD who had a less-than-ideal assessment experience myself, I’m passionate about providing a better alternative.
My goal is to provide a safe and reassuring experience for every patient; hence, any assessment undertaken by me is not only evidence-based but also strictly adheres to the NICE guidelines and the UK Adult ADHD Network guidelines. With a background as a CAT psychotherapist, my experience fits perfectly with my work in the field of ADHD.
CAT is a relational therapy, and people with ADHD can be hypersensitive to inauthenticity (put bluntly, we are masters at spotting bullshit). CAT helps patients understand what’s happening in their own brains through diagrams and collaborative work, which is especially useful for those with executive function and working memory challenges.
I don’t just put a list of my qualifications on a page. I want you to understand the experience and dedication that’s behind the face—or, as it were, behind the curtain. When it comes to getting an accurate and helpful ADHD assessment, I believe this deep, specialised knowledge is what truly matters. As for a late ADHD diagnosis and how it feels to have walked in your shoes, I’ve been there, and I understand.