It’s a common question people have, understanding the distinction between these two common types of mental health professionals. What’s the difference between a psychologist versus a psychiatrist? Is there one? Should you prefer going to see one over the other? What kinds of things do they treat?
And if you want a specific type of treatment — such as psychotherapy vs medication — which one should you go see first?
Psychologists are professionals who have an advanced educational degree called a doctorate. A doctorate takes most people at least five years to complete after undergraduate studies at a college or university. We call psychologists who study and specialize in helping people with mental illness, personality, family, relationships, and psychological concerns clinical psychologists, because their education and training is focused on helping people with these issues. (Full disclosure: I was trained as a clinical psychologist.)
Psychologists’ educational training is focused on learning about mental illness, the various theoretical approaches to understanding and treating them, and psychological assessment. During their education, clinical psychologists engage in hands-on training called practicums. A practicum gives the student a chance to put their education into direct practice, by seeing clients for psychotherapy and conducting psychological assessments. Practicum students are supervised by faculty, and often the sessions will be videotaped or recorded for further training purposes (with the client’s knowledge and consent).
Psychologists earn either a Ph.D. or a Psy.D. degree. A Ph.D. is a traditional doctoral degree. Most clinical psychology Ph.D. programs focus a little bit more on research methods and the scientific study of psychology, rather than hands-on training and practical experience. A Psy.D. is a professional doctoral degree. Most clinical psychology Psy.D. programs focus a little bit more on practical experience and hands-on training, rather than research methods. Both types of psychologists are well-equipped to provide psychotherapy services in the real-world. For most psychologists, there’s no discernible difference in the degree earned after a few years in practice and either degree is equipped to provide clinical services to people, or to conduct research.
Clinical psychologists who go into practice must be licensed by the state they practice in. Psychologists who enter into research, academia, or education do not need to sit for licensure. Licensure is maintained by taking continuing education courses on an annual basis. As with most healthcare professions, if a psychologist moves to a new state, they need to sit for licensure again.
Clinical psychologists focus on the practice of psychotherapy, psychological assessment, or research into the underlying mechanisms and theories of psychology. In most countries and in most states in the U.S., psychologists do not have the training or certification to write prescriptions for psychiatric medications. In five states (Iowa, Idaho, Illinois, New Mexico and Louisiana), some psychologists do have prescription privileges; but this is the exception, not the norm.
Psychologists can further specialize in a specific type of treatment, disorder, or population they treat, such as children, women, or only treating those with depression.
Because of clinical psychologists’ unique, intensive combination of training and education into mental illness, they are generally the best-equipped professionals to diagnose and treat most mental disorders today, although their treatment usually focuses on psychotherapy methods and techniques.
Psychiatrists are physicians who have specialized in the study of psychiatry and generally hold either a traditional medical degree (M.D.) or an osteopathic degree (O.D.). A medical degree usually involves four years of medical school where a person learns the basics of medicine, how the human body works, the different kinds of laboratory testing, and how to diagnose disease.
Psychiatrists then typically complete another three or four years of residency, learning more specifically about mental illness, medications, and various psychotherapy techniques. The residency period includes classroom instruction as well as intensive hands-on training in a hospital or other facility that regularly sees and treats people with mental illness.
Psychiatrists who see patients are licensed by the state they work in. Most psychiatrists also complete a comprehensive examination at the end of their training to become “board certified.” Such certification simply means that they are proficient in the field they’ve taken the certification in, and it must be renewed every 10 years in order to maintain the certification.
Psychiatrists can further specialize in a specific type of disorder or population they treat, such as children, women, or only treating those with depression.
Because psychiatrists are medical doctors, they can prescribe and administer psychiatric medications. Indeed, most modern psychiatric practices in the U.S. are focused on solely prescribing psychiatric medications; very few psychiatrists practice psychotherapy any longer (with one notable exception, psychoanalysts). Psychiatrists are one of the lowest paid of physicians. Because of this, there has been a growing shortage of psychiatrists in the U.S.
The primary difference between a psychologist and a psychiatrist is that a psychiatrist is a medical doctor who can prescribe medications, whereas a psychologist is not and instead offers assessment and psychotherapy. Psychologists focus on the treatment of mental illness through psychotherapy and other techniques, while psychiatrists focus on the treatment through medications.
Research has demonstrated time and time again that for most disorders, a combination treatment approach works best — psychotherapy and medications. So rather than these two professions being in competition with one another, they actually nicely complement one another since in many cases, a person who is being treated for mental illness would go see both.
Psychologists and psychiatrists also approach mental illness from very different paradigms. Psychologists are trained from a scientific model based upon over a century of research into different psychotherapy techniques, psychological theories, and personality theories. Psychiatrists are trained from a medical model that emphasizes medical and biological knowledge over psychological theory.
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Learn more: Types of Mental Health Professionals