Psychiatrist Vs. Therapist: Understanding The Differences

What is a Therapist?

What do you think of when you hear the word “therapist”? You might think of a patient lying on a couch, talking about their childhood to a stoic doctor with glasses and a notepad.

In a way, you would be correct. That is a therapist, and you might encounter therapists who like to practice like that. However, there are many ways to practice therapy, and that way of conducting a session only represents a small percentage of therapists. 

A therapist’s main job is to treat mental health conditions through interacting with their client. Most of the time, this interaction is verbal, a technique known as Talk Therapy. Talk Therapy can involve understanding and processing your emotions, thoughts, behaviors, and history. It can also look like learning new coping strategies, coming up with solutions to problems, and making plans for a healthier future. 

However, therapists can also be specialized in other, more unique forms of therapy. Behavioral therapy, for example, is focused on how our actions influence mental health and can involve working with a therapist in real-world situations or to help you break a habit. 

There are also mindfulness-based and skills-based therapy sessions using art therapy, music therapy, and play therapy, which can help a person work through harmful thoughts, emotions, and memories in means other than talking. 

Finally, there are specialized forms of therapy that use the brain’s natural mechanisms to help itself heal, such as EMDR, which is used to treat trauma.

In short, a therapist’s goal is to help you manage harmful symptoms of mental health conditions and to heal and recover using means other than medication.

Therapist vs Psychiatrist

The two most common mental health professional titles you’ll hear are therapist and Psychiatrist. While both therapists and psychiatrists practice in the mental health field, they perform different (but adjacent) duties. The main difference is this: 

A Psychiatrist can prescribe medication. 

A Therapist performs talk therapy and other forms of therapeutic interventions. 

Whether or not you need to see a psychiatrist or a therapist largely depends on your need for medication. Before you make your decision, let’s look a little closer into what each profession does.

Therapist Educational Requirements

The exact educational requirements for a therapist will depend on their license, which we’ll discuss in depth below. However, all therapists must have a master’s degree or higher and meet a certain number of in-field hours, usually around 2000, while working under a licensed therapist before receiving their own license. There are also ongoing educational requirements, ensuring therapists stay up to date on the newest science and intervention strategies. 

Some therapists may get their Doctorate or PH.Ds, in which case they will list their degree next to their license on their bio. For example, if you see someone with a bio that says “DSW, LCSW” that means “Doctors in Social Work, Licensed Clinical Social Worker”. This tells you that not only does this therapist have the license to practice therapy, but they have many additional years of schooling.

What can a therapist do?

A therapist is licensed to practice psychotherapy, under which many different types of therapy fall. The specific modality a therapist uses is based on their specialty and client interest. For example, Dialectical Behavioral Therapy is considered the best treatment method for Borderline Personality Disorder. Whereas Cognitive Behavioral Therapy is great for treating anxiety. 

Some therapists will get special certificates in their chosen modality. For example, a play therapy certificate ensures therapists are well-suited to perform therapy with children. 

In addition to conducting one-on-one therapy sessions, which usually last an hour, a therapist can organize and run group therapy sessions and diagnose mental health disorders.

Are therapists doctors?

No, a therapist does not need to be a doctor. Some may choose to pursue their doctorate, but because they did not go through medical school, therapists are not medical doctors.

Should I see a Therapist?

A therapist is recommended for almost anyone dealing with mental health struggles. Not only can they diagnose, they can treat most mental health disorders. Also, they can refer you to a psychiatrist for medication management if needed.

What is a Psychiatrist?

A Psychiatrist is a medical doctor working in the mental health field. They prescribe medication, manage medication, and diagnose mental health conditions. Some psychiatrists will also perform therapy, but that is rare. Instead, most psychiatrists will recommend you see a therapist in addition to receiving their medication management services.

What can a Psychiatrist do?

A Psychiatrist can prescribe medications. They can also diagnose mental health conditions. Their primary job is to prescribe the right medication and help manage it. This means checking in regularly with their patients to assess if the medication is working and if there are any unwanted side effects. They can change medication dosage and type until they find a suitable one for your needs, in which case they will continue to monitor your progress and refill prescriptions.

Psychiatrist Educational Requirements

A Psychiatrist is a medical doctor, meaning they graduated from medical school and completed a residency in the field. Because of this, they often have a much more rigorous understanding of the human body and the effects of medication on it.

Should I see a Psychiatrist?

It is recommended you see a psychiatrist if you need medication. Medication is used to treat mental health disorders and to provide relief from symptoms. For example, not everyone who struggles with anxiety or depression needs medication, but some find it very helpful.

In other psychiatric conditions, such as Bipolar Disorder or Schizophrenia Disorder, medication is part of the recommended treatment plan. 

Mental health exists on a spectrum—you can have mild depression or severe depression—and medication is not required to treat every case of every mental illness. In general, the more severe the mental health issue, the greater need for medication there is.

Can a Psychiatrist provide therapy?

Yes, psychiatrists can legally provide mental health therapy. However, many choose not to or do so minimally. Most recommend seeing a therapist for non-medical interventions.

Should I see a Therapist or a Psychiatrist?

The big question is: who should you see first? 

In many ways, it doesn’t matter who you see first. Both will be able to diagnose and recommend a treatment strategy. In some ways, starting with a therapist is easier: they often have less of a wait time and can refer you to a psychiatrist for medication prescriptions if needed. 

In general, if your goal is to receive medication: talk to a Psychiatrist. If your goal is to start therapy and you are ready to commit to a regular session time working through a treatment plan, you should talk to a therapist. 

Most psychiatrists recommend receiving some sort of therapy offered by a Therapist in addition to their medication management services, which is why we recommend talking to a therapist first. 

Types of Therapists

“Therapist” is an umbrella term to describe many specific types of mental health professionals. All of these people can operate as a therapist, however, they may have unique education paths, training requirements, specialties, and extra duties they are licensed to do. Let’s break them down and go over what it means when you see their license in a therapist bio: 

• Licensed Professional Counselors (LPC): To become an LPC, candidates must graduate with their MA in counseling from an accredited university and must complete an in-field internship. From there, they must complete a written exam, and then receive around 2000 hours (varies by state) of licensed supervision. LPCs are most commonly found in private practices, schools, hospitals, and correctional facilities. An LPC can diagnose and treat mental health disorders. 
• Licensed Clinical Social Workers (LCSW): An LCSW must complete an MA in social work and complete an internship. If they wish to diagnose and treat clients using therapeutic methods, they must receive around 2000 hours of licensed supervision to get their clinical social work license. They are most commonly found in private practices, schools, correctional facilities, and hospitals. They can diagnose and treat mental health disorders and can conduct casework for families and individuals within the social work system. 
• Licensed Marriage and Family Therapist (LMFT): Becoming an LMFT is much the same as an LPC, except with a MA in Marriage and Family Therapy, and with internships and supervision hours in the same. LMFTs are well suited to work with couples and families, and are therefore commonly found in private practice, schools, and inpatient settings. 
• Psychologists: A Psychologist is different from the other three listed here because they require a doctorate. However, unlike a Psychiatrist, this doctor-level degree is not in the medical field but rather in Psychology (Psy.D or PhD). They will then have to complete around 2 years of supervision internship, and then pass the national examination. A Psychologist will work much the same as an LPC, but also have the option to work in research or teaching.

What therapist will be best for you largely depends on your needs. If you are a couple or a family in need of therapy, an LMFT might be best. If you have a complex diagnosis, a Psychologist, with their additional years of training, will be better suited for you.

What to consider when choosing a therapist and a psychiatrist

Even with all this information, there are many options out there. To help you narrow down who you want to schedule your first therapy session with, here are some factors to consider: 

• Do you want an In-Person or Online Therapy Session? Online Therapy has grown in popularity over the last few years, and researchers have proven that it is just as (if not more) effective than in-person therapy. Online therapy gives you the option to receive treatment from your own home.
• What insurance do they take? Most major insurance will cover mental health therapy and mental health medication. However, not every therapist takes every insurance plan. Be sure to check with the individual therapist or their practice before scheduling a session. Many practices also offer an affordable self-pay rate for those uninsured. 
• Do you have a treatment modality preference? Some people respond better to mindfulness therapy, while others want to try EMDR. It can help to do a little bit of research and see what you think will work best for you. Then, find someone who is qualified. 
• Can you connect with them? Many people find it’s easier to work with a therapist who understands where they’re coming from. Choosing a therapist who matches your gender, sexuality, race, ethnicity, language, background, or religion can help you feel more comfortable with them. 
• What are your goals? It is always helpful to write down what your goals are for therapy before you go. Some people want to start therapy to help them with a difficult life transition, and others need help navigating the onset of new, disruptive symptoms. What are you seeking therapy for? Most therapists will include a list of their specialties in their bio. If you’re struggling with trauma and PTSD, but your therapist only lists anxiety and depression, you might be better suited for someone who has experience working with survivors of trauma. 

Most therapists will have all the information you need to know about them on their profile. Here’s a breakdown of what a therapist profile looks like and how to best read it.

The mental health field can seem confusing at first, but everyone here is trained to help you. Take that first step today; if you end up in the wrong place, your therapist or psychiatrist will help you find the mental health professional best suited to help you.

Don’t let fear stop you from living your best possible life. Hope and healing is out there.