Money, drugs, and power: The story of psychiatrists vs psychologists
Psychiatrist vs Therapist
A search of the internet reveals many people are interested in how psychologists differ from psychiatrists and other mental health professionals. Questions on salary differences, treatment approaches, ability to prescribe medication are common.
This article outlines the differences between mental health professionals and provides useful information on related topics. I’d add some jokes to prevent this topic from being too dry, but I don’t wish to cause offence. Instead, you have to settle for a clickbait-style title and the odd sarcastic answer in the FAQ below. I hope you find this article helpful nonetheless.
In this article
Psychiatrist definition
Psychiatrists undertake basic training as medical doctors. After completing a medical degree, they go on to specialist training. A key part of their role is to diagnose psychiatric conditions (e.g., schizophrenia, bipolar disorder). Psychiatrists focus on biological causes and treatments for these disorders.
Psychiatrists can perform or request various medical assessments and tests. They can and prescribe medication and recommend other forms of treatment (e.g., talking therapies, ECT).
A psychiatrist may also specialise in a particular type of problem area (e.g., substance abuse).
What is a psychologist?
This is actually a broad term, referring to various professions. But all are tied together by a grounding in psychological thinking and theory.
Some people hold academic positions teaching and researching topics within the field. Others apply their knowledge and skills supporting individuals and groups in public and private organisations (practitioner or applied psychologists).
Research psychologists usually teach and conduct research within universities. Practitioner psychologists work in various areas, many of which relate to mental health and well-being. There are exceptions; some psychologists are scientist-practitioners, or people involved in research and the application of findings to the psychological functioning of clients/patients.
A clinical psychologist undertakes training in the assessment and treatment of psychological difficulties. These problems range from diagnosable mental health conditions to issues such as stress and relationship difficulties.
What is the difference between a psychologist and a psychiatrist?
When comparing these two professions, we tend to focus on clinical psychology. Like psychiatry, clinical psychology focuses on the treatment of mental health conditions.
Sometimes this medical/psychological distinction is blurry. For instance, some psychiatrists offer psychological treatments in addition to prescribing medications for their patients. Both professional groups tend to work with other health professionals (e.g., social work). Groups of different health professionals are called Multi-Disciplinary Teams, or MDTs. You often find MDTs in the public health service.
Should I see a psychologist or psychiatrist?
The answer to this question depends on what causes psychological difficulties and the effectiveness of available treatment options. For example:
Medication is a primary way to stabilise people affected by serious psychiatric conditions such as psychosis and mania.
Psychological treatment may be preferred in a case of depression triggered by an ongoing medical condition.
What does a psychologist do?
This type of psychologist is interested in the application of psychological theory and research to treating mental illness and other serious forms of psychological distress. Training often involves the completion of a doctoral degree; an advanced university qualification that prepares people for practice.
Most clinical psychologists use evidence-based psychological interventions in their work. There are many types of therapy. One of the most well-known psychological interventions is Cognitive Behavioral Therapy (CBT). This is a type of ‘talk therapy’; an alternative or addition to treatment via medication.
The field of clinical psychology is diverse. Practitioners specialise in many areas. Sub-specialities include neuropsychology, child and adolescent mental health, physical/medical health, and forensics (amongst others). We can be found working in schools, clinics, hospitals, and commercial organisations.
Clinical psychologists work with other health and social care professionals in many settings. This collaboration typically takes place in Multidisciplinary Teams (MDT). These groups include (amongst others) social workers, occupational therapists and nurses.
Clinical psychologists seek to understand a person's difficulties through 'formulation'. This is an explanation of why and how a problem has developed. This approach to understanding mental health difficulties is a key tool used in clinical psychology.
A formulation is developed jointly with the clinical psychologist. It seeks to describe the problem(s) you want to address, and the reasons why (and how) your difficulties came about. We formulate to understand psychological difficulties, but also to indicate how we might treat the problem.
Clinical Psychologists base formulations on relevant theory and research. A clear, logical formulation leads to a specific treatment plan. A formulation may include clinical and non-clinical issues.
We treat problems with psychological interventions. These are talking theories shown to work through research studies. Treatment effectiveness is usually monitored by tracking changes to symptoms and other relevant factors.
Using evidence-based treatments is another key approach in clinical psychology. For example, Cognitive Behaviour Therapy (CBT) is well-validated for low mood, anxiety, and other common problems.
Clinical Psychology covers far more than mental disorders. We work with many other types of psychological problems, ranging from stress and relationship issues, to coping with big life changes.
Can a psychologist diagnose?
Clinical psychologists who complete specific training in the assessment of psychiatric disorders can diagnose these conditions.
Clinical Psychology in the workplace
Psychological thinking and skills are increasingly being applied at work.
A clinical psychologist’s expertise is directly transferable to workplace issues. I work with many difficulties including low confidence, anxiety, stress, poor work-life balance, barriers to promotion and more.
Strategies taken from evidence-based interventions like CBT are very useful in resolving these problems. For instance, people frequently assume that colleagues have negative thoughts towards them. Testing and re-evaluating these thoughts can produce positive results.
How long does it take to become a psychologist?
Clinical Psychologists are not medical doctors. Instead, most have earned a doctorate degree. This is from where the 'Dr' title comes. Clinical Psychologists may hold a PhD and/or PsyD. PhD is a research degree, and some complete people complete one during clinical training.
A PsyD is a ‘practitioner doctorate’ which is an advanced qualification that qualifies someone as a Clinical Psychologist. This degree usually involves research, academic classes and workplace (clinical) placements as part of a doctoral program.
The first step towards training is a degree in psychology. Some practitioners have completed masters degrees. However, clinical psychologists tend to train in a clinical psychology program (e.g., PsyD). In total, it can take anywhere between 6-9 years to complete clinical psychology training.
Counseling psychology
Related to clinical psychology, counseling psychologists tend to focus less on diagnosable mental health conditions, and more on general psychological issues (e.g., self-esteem). However, this distinction does not always hold up in reality. Counselors frequently complete a master’s degree (or another type of qualification) in preparation for client work.
Psychologist vs therapist
As described above, the term psychologist may refer to a diverse range of specialities. Therapist refers to a person who treats psychological and/or mental health issues. Some, but not all, psychologists are therapists. People who are both are most commonly clinical and counseling psychologists.
Most therapists would have studied psychology, at least to some degree. While there is some overlap in training, registration and practiting requirements do differ from one professional group to another.
Psychiatrist vs therapist
Having read the above sections, it’s probably not difficult to now guess the difference between a psychiatrist and therapist!
Can a clinical psychologist prescribe medication?
They cannot in most cases. Prescribing medications is the job of psychiatrists in nearly every country. Some clinical psychologists can prescribe in certain United States jurisdictions (e.g., New Mexico, the military).
Online psychiatrist
The pandemic has led to many psychiatric services moving online. Some mental health and cognitive conditions really do require medication management. ADHD is a good example here. Medication can help stabilise symptoms, allowing a clinical psychologist (or other talking therapies professional) to work with underlying issues. A psychologist can guide you on this topic, and help you determine whether a psychiatrist appointment is required.
Find a psychologist
Psychologists are often found in the public health system and private practice. There are lots of things to consider when choosing a psychologist to work with. I have written an article about starting therapy here.
Checking that someone is appropriately trained and has experience relevant to your issues is important. Feeling comfortable with the psychologist you are working with is equally vital.
Psychologist near me
Finding e-therapy services or an online therapist is easier than ever. It's the new 'therapist near me'. But the wide choice of practitioners can be confusing. Is BetterHelp legit? How do I find a therapist? How does online therapy work? What is Talkspace?
The pandemic has accelerated the availability of online therapy. Many more psychologists now offer their services online, including me. Working in this way is not for everyone, and I have found pros and cons of working online. There is convenience and increased choice, but sessions can get tricky with technical issues.
Many people are experiencing the benefits of improved access to online therapy. But be careful to ensure the practitioner is sufficiently trained and qualified. Whether using large online therapy platforms (e.g., BetterHelp), or working with an independent practitioner, you should always have ready access to a therapist's qualifications and credentials.
If you're looking for practical tools and strategies, my skills videos are an excellent place to start. In addition, my latest articles on mental health and well-being give you more tips and suggestions.
Free online therapy
In general, there is limited access to free therapy.
If you are looking for free therapy, you may have access to local public health services. These services are generally accessed through your GP. For instance, some people can access the IAPT (CBT) scheme. Many Clinical Psychologists now offer online services.
Summary
The topic discussed in this article is a confusing one. Not only are there lots of different job titles in mental health (e.g., psychiatrist, psychotherapist, counselor, psychologist), there is often some cross over and blurring of boundaries between these professional groups. If you are looking for someone to work with, solid training and experience are always going to be important.
FAQ
Which is better a psychiatrist or a psychologist?
No one profession is better than the other. The more relevant question is ‘Is a psychiatrist or psychologist more appropriate for this person at this time?’
Who earns more- psychologist or psychiatrist?
In most cases, psychiatrists earn more
Can a psychologist use the title doctor?
If a psychologist has completed a PhD or PsyD, they can call themselves ‘Dr’. This is not the same as a medical doctor who gains the title ‘Dr’ by completing medical training. This is where the confusion comes in- the title ‘Dr’ can be used by medically and non-medically trained mental health professionals.
How do you spell therapy?
You just did
How do you spell psychiatrist?
You just did
Can a PsyD prescribe medication?
The answer is no in almost all cases
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