Understanding Psychiatrists, Psychologists and Therapists - How to Choose

Understanding the Differences Between Psychiatrists, Psychologists and Therapists

Mental health is an important component of overall health and well-being. However, navigating the mental health system can be confusing, especially understanding the differences between the various providers. Psychiatrists, psychologists and therapists all work in mental health, but have different roles, expertise and approaches to care.

What is a Psychiatrist?

Psychiatrists are medical doctors who specialize in the diagnosis and treatment of mental illnesses. After medical school, psychiatrists complete four years of additional training in mental health, including one year focusing on diagnosing and treating mental illness and three years of specialized training in psychotherapy and other therapeutic approaches.

As medical doctors, psychiatrists can prescribe medication and have an in-depth understanding of how mental illness impacts the body. They have extensive training in differential diagnosis, meaning they can help distinguish mental illness from other potential causes. Psychiatrists often serve as a patient's primary mental health provider, coordinating care with therapists, psychologists and other specialists as needed.

Psychiatrist Expertise

Psychiatrists can provide treatment for a wide range of diagnoses, including:

• Mood disorders, such as depression and bipolar disorder
• Anxiety disorders, including panic disorder, phobias and PTSD
• Personality disorders, like borderline personality disorder
• Psychotic disorders, such as schizophrenia
• Substance abuse disorders
• Eating disorders
• Trauma and abuse

In addition to psychotherapy, psychiatrists may utilize other treatments like:

• Medication management
• ECT or electroconvulsive therapy
• TMS or transcranial magnetic stimulation

Since they are medical doctors, psychiatrists can also order lab tests or medical exams to rule out other conditions that may be contributing to mental health symptoms, like thyroid disorders, brain tumors or vitamin deficiencies.

When to see a Psychiatrist

You may benefit from seeing a psychiatrist if you:

• Need an expert diagnosis, especially for complex, severe or unfamiliar symptoms
• Require medication as part of your treatment
• Have co-occurring physical health concerns
• Need evaluation or treatment for conditions requiring ECT or TMS
• Want support managing medications from a provider who can prescribe

What is a Psychologist?

Psychologists have doctoral degrees, either a Ph.D. or Psy.D, and are experts in the science and practice of psychology and human behavior. They have extensive training in evaluating mental health concerns, providing therapy, and conducting psychological testing.

Psychologists can not prescribe medication. They provide psychotherapy and have training across therapeutic approaches including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and other evidence-based modalities. Some specialize in specific diagnoses or populations such as children, families, athletes or veterans.

Psychologist Expertise

Psychologists are trained to treat many conditions including:

• Depression
• Anxiety
• PTSD
• ADHD
• Autism spectrum disorders
• Eating disorders
• Obsessive compulsive disorder
• Bipolar disorder
• Schizophrenia
• Personality disorders
• Sleep disorders
• Chronic pain
• Neurological disorders
• Trauma and abuse

They provide services like:

• Individual therapy
• Group therapy
• Couples counseling
• Family therapy
• Testing and assessment
• Specialized approaches like CBT and DBT

When to See a Psychologist

Seeing a psychologist may be a good option if you:

• Want therapy without medication
• Need counseling with an expert in human behavior and psychology
• Want specialized therapy approaches like CBT or DBT
• Require psychological testing or assessment
• Prefer a nontraditional provider to psychiatrists and therapists

What is a Therapist?

There are many different types of therapists who provide mental health care and counseling. Some common examples include:

• Psychotherapists - Provide talk therapy and psychotherapy, trained at masters or doctoral levels.
• Clinical social workers - Have a MSW masters degree in social work with specialized clinical training.
• Marriage and family therapists - Treat relationship issues and family dynamics, require a master's degree.
• Counselors - Have master's degrees and provide general counseling services.

Therapists typically take a holistic approach, viewing clients in the context of their relationships, environment and broader lives. They focus on clients' strengths and abilities to foster growth and healing. Most provide psychotherapy but do not prescribe medication.

Therapist Expertise

Therapists have wide-ranging expertise in common concerns like:

• Anxiety
• Depression
• Grief
• Self-esteem
• Trauma
• Life transitions
• Stress
• Relationships and family
• Life balance and satisfaction
• Coping skills

Services often include:

• Individual counseling
• Couples therapy
• Family therapy
• Group counseling

When to See a Therapist

Seeing a therapist may meet your needs if you:

• Want to develop self-awareness and emotional skills
• Need support and guidance through major life changes
• Require couples counseling or family therapy
• Have everyday stresses, relationship concerns or generalized symptoms of anxiety or depression
• Are unable to access or do not need psychiatric services

How to Choose Between Providers

With overlapping services and expertise, choosing between these mental health professionals can be challenging. Consider the following to guide your search:

Identify Your Main Concerns

Make a list of your symptoms, struggles and goals for treatment. Are you experiencing specific psychiatric symptoms? Do you know you need therapy but are unsure what type? This will help narrow your search.

Consider Medication Needs

If you know you need medication management or may want to try psychiatric medications, you will need a provider able to prescribe, like a psychiatrist or psychiatric nurse practitioner.

Think About the Type of Therapy You Want

Do you think you would benefit most from specific approaches like CBT or DBT? Consult with a psychologist. More interested in everyday counseling and growth? A licensed therapist often provides this support.

Ask for Referrals and Recommendations

Talk to your primary care doctor, friends and family to get recommendations of providers that fit your preferences and offer the services you are looking for.

Check Credentials and Experience

Make sure any provider you consider has the appropriate training, education, credentials and background treating issues similar to yours.

Trust Your Gut

Pay attention to how comfortable you feel interacting with the provider during your initial consultation. The therapist-client relationship is so important, so go with your gut.

Questions to Ask Potential Providers

Speaking with potential psychiatrists, psychologists or therapists can help you determine who is the best fit. Here are some questions you can ask during initial consultations:

• What is your experience treating clients with concerns like mine?
• What are your areas of specialty and expertise?
• What therapeutic approaches do you use?
• How will we evaluate my progress and adjust treatment over time?
• Do you take my insurance? What are your fees?
• What is your availability for appointments?

Being prepared with questions can help you get a sense of each provider's background, expertise and how well your needs align with what they offer. Pay attention to how comfortably you communicate with them as well.

When to Get a Referral Between Providers

Collaborating with both a therapist and psychiatrist is very common. The prescribing expertise of a psychiatrist combined with the counseling of a therapist can provide comprehensive care. Here are some signs it may be time to request a referral to a psychiatrist or therapist:

• Your symptoms are not improving with therapy alone.
• You develop medication needs your current provider cannot meet.
• You need specialized care like family therapy or CBT.
• Your diagnosis is unclear and you need an expert evaluation.
• You require coordination of care for both physical and mental health concerns.

A good provider will never hesitate to refer you to another specialist if they feel it is in your best interest. Being open about your symptoms and treatment goals can help facilitate appropriate referrals.

Working with Your Mental Health Team

Navigating multiple providers does add complexity, but with good communication it can be very effective. Some tips for success:

• Sign consent forms allowing them to share information and coordinate care.
• Provide each provider a list of your medications.
• Give regular updates about medication changes, symptoms and treatment progress.
• Ask providers to be in touch directly if needed.
• Tell them if you feel pulled in different directions about your care plan.
• Check in to make sure each fully understands your goals and perspective.

While psychiatrists, psychologists and therapists have differences in their roles, the most important thing is finding the provider that best fits your individual needs. Being open about symptoms, asking questions, and clearly communicating your treatment goals can help you successfully navigate the mental health system.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.