A guide to combining counseling and psychiatric care
Therapy & Medication: How They Work Together
You don’t have to choose between therapy and medication. For many people, the most effective path is a combination: skills-based therapy to create lasting change, and when appropriate, medication to reduce symptoms enough to make that work possible. At Dimensions Counseling Center, we use proven methods like Acceptance & Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), and Eye-Movement Desensitization and Reprocessing (EMDR). We also collaborate with prescribing providers (psychiatrists, PMHNPs, primary care) when medication might help.
Care note: This page is educational and not medical advice. Decisions about medication must be made with a licensed prescriber who knows your history.
Medication doesn’t change who you are, it can adjust symptom intensity so therapy gains stick. Consider asking a prescriber about options if you’re experiencing:
Medication can also be a short‑term bridge during major life stressors, allowing you to benefit from therapy while symptoms settle.
Many people do well with ACT/CBT or other therapy skills, no prescription required. Therapy alone may be appropriate if:
If therapy alone isn’t moving the needle after a reasonable time, we’ll talk about adding a medication consult.
We don’t prescribe medication, but we partner closely with providers who do.
1. Screen & discuss (in therapy): We review symptoms, history, preferences, and concerns.
2. Refer (if desired): We can share a curated list of local/telehealth prescribers in Tennessee and Virginia or coordinate with your current provider.
3. Coordinate: With your consent, we exchange relevant info (diagnoses, goals, progress) to align the therapy plan with the medication plan.
4. Monitor & adjust: In therapy we track symptom changes, side‑effect concerns, and skill use; you bring those observations to your prescriber for fine‑tuning.
Step 1. Therapy intake.
We clarify goals, history, and what’s getting in the way. We start with small, doable actions and core skills (e.g., grounding, values‑based actions, thought tools).
Step 2. Medication consult (if you choose). You meet with a prescriber to review options, benefits/risks, and monitoring. Some medications may take time to reach full effect.
Step 3. Ongoing teamwork. We meet regularly to work on your skills while your prescriber manages dosing/adjustments. We’ll measure progress so decisions are data‑informed.
If you’re in crisis or thinking about harming yourself: Call 988 for the Suicide & Crisis Lifeline, go to the nearest ER, or call 911.
Therapy changes the habits of the mind, so practice matters.
Care note: This page is educational and not medical advice. Decisions about medication must be made with a licensed prescriber who knows your history.
When medication may help
Medication doesn’t change who you are, it can adjust symptom intensity so therapy gains stick. Consider asking a prescriber about options if you’re experiencing:
- Anxiety or panic so intense that it blocks sleep, focus, or daily responsibilities
- Depression with persistent low mood, loss of interest, or appetite/sleep changes
- PTSD symptoms (nightmares, hyperarousal) that make trauma work feel impossible
- Obsessions/compulsions (OCD) that consume hours of your day
- Severe insomnia or overwhelming irritability that doesn’t respond to lifestyle changes
- Thoughts of self‑harm (please seek urgent help—see the safety note below)
Medication can also be a short‑term bridge during major life stressors, allowing you to benefit from therapy while symptoms settle.
When therapy alone may be enough
Many people do well with ACT/CBT or other therapy skills, no prescription required. Therapy alone may be appropriate if:
- Symptoms are mild to moderate and primarily situational
- You’re sleeping adequately and can focus during sessions
- You prefer a non‑medication approach and are ready to practice skills between visits
If therapy alone isn’t moving the needle after a reasonable time, we’ll talk about adding a medication consult.
How we collaborate with prescribers
We don’t prescribe medication, but we partner closely with providers who do.
1. Screen & discuss (in therapy): We review symptoms, history, preferences, and concerns.
2. Refer (if desired): We can share a curated list of local/telehealth prescribers in Tennessee and Virginia or coordinate with your current provider.
3. Coordinate: With your consent, we exchange relevant info (diagnoses, goals, progress) to align the therapy plan with the medication plan.
4. Monitor & adjust: In therapy we track symptom changes, side‑effect concerns, and skill use; you bring those observations to your prescriber for fine‑tuning.
What to expect (step‑by‑step)
Step 1. Therapy intake.
We clarify goals, history, and what’s getting in the way. We start with small, doable actions and core skills (e.g., grounding, values‑based actions, thought tools).
Step 2. Medication consult (if you choose). You meet with a prescriber to review options, benefits/risks, and monitoring. Some medications may take time to reach full effect.
Step 3. Ongoing teamwork. We meet regularly to work on your skills while your prescriber manages dosing/adjustments. We’ll measure progress so decisions are data‑informed.
Safety, side effects, and informed choice
- Only a prescriber can recommend, start, or change medication. Never start/stop on your own.
- Ask about common side effects, how long benefits may take, and what to do if something feels off.
- If you’re pregnant, trying to conceive, or have medical conditions, raise these early so your prescriber can tailor care.
If you’re in crisis or thinking about harming yourself: Call 988 for the Suicide & Crisis Lifeline, go to the nearest ER, or call 911.
Your role between sessions
Therapy changes the habits of the mind, so practice matters.- Track: Briefly log sleep, mood, anxiety spikes, and what helped.
- Practice: Use the skills (breathing, grounding, cognitive de-fusion, exposure steps, values‑based actions) daily.
- Communicate: Share updates with your therapist and prescriber so your plan evolves with you.