certainly the one i go to has both as part of the multi disciplinary team and many years ago when i went to the rah pain unit they had both then too and it was the psychiatrist i had to see first then after that it was more contact with the pscyhologist but grappers would know more of their current structure. even now at my current clinicwith the major increase in pain i have at present due to the equipment problems - i rang telling the staff i was not coping well and the first suggestion was seeing the psychologist but he is on leave at present so i have an appointment with the psychiatrist instead- from past experience at this unit they work very closely together- of course the structure of some pain clinics may vary according to the resources available but the whole idea of the multi disciplinary team approac is to use each for there special expertiese and there is considerable difference between the 2- i think if they had a choice of only one it would be psychologists as the counselling and behavioural coping mechanisms they can teach are absolutely invaluable, they would also be able to recognize the need to medications such as antidepressants and refer to a suitable psychiatrist
obviously i can't speak of the structure of every pain unit in australia but my comments were based on my expereince of the ones i have attended and the literature i have read-i certainly would be looking for bothe as both have invaluable skills and expertiese to add to the pain management specialists.
even if money was no object and i could access a pain management specialist privately i would prefer to access one of the major multidisciplinary clinics that tend to be in the public system- simply because CP is such a complex issue that the skill of all are invaluable at some point
santosha. it does sound like you have had some very negative experiences to say the least, and i must admit that the reason i am so pro the multi d pain clinics is that before i got to them i had some pretty dismal treatment- that whole concept of a pain specialist (wether in in pain unit or not, lecturing you for using the medication (morphine) that was prescribed is a combination of bizarre and offensive! but just like in any profession you get the good and the bad! sounds like you have been unlucky to say the least- in another thread there is list of pain units around the country and i am sure someone here may be willing to comment on a clinic in brisbane that they are happy with- that may help - Grappers and i have both mentioned the units we attend here in SA but that does not help much
one thing does come to mind, all states have a variety of avenues to comaplain about the care they are recieving, at least in the public system usually through the states health commission and the states ombudsman- most hospitals also have a patient dvocate too and that may be an avenue for you to consider- i know some people fear they may be penalised in some way if they take these kinds of actions but i have had to resort to the equivalent in dsiability services in the past and it really helped - i am also going down that path at present to try to sort out the mess with my equipment at the present- so far with sympathetic ears, cetainly no hints i will be penalised in any way
you made one other comment that i had thought of but did not m ention, that perhaps that psychaitrist wanted you off the pain meds but then if that was the case he should have spoken to you about it , explained why etc rather than what he did- does not teach you trust others in his profession!
unfortunately, getting to the point where you feel happy with the pain management and support you are getting can be slow, i know in the early days i became very angry frustrated and defensive - but with perserverance it can work out well for you! in the meantime, as oxytotem said, if you need to vent eetc get you frustrations out- let it go! i don't think there would be any one here who would not have had some frustrations and problems getting adequate care at some point- CP is so poorly dealt with- i was terrified of being labled a chronic pain patient after what i had seen as a nurse! it was the help of peer support forums that helped me survive back then (quite literally) no one understands CP more than another with CP