Psychiatrist, Psychologist, Counselor, Therapist: What’s the Difference?

In the field of psychology, there are many practitioners. It is important to find the practitioner that will best meet your needs. Here is a list of practitioners and a description of their training and the type of work they do.

Psychiatrist—A psychiatrist is a medical doctor. Psychiatrists typically get a four-year undergraduate degree following a pre-med track or majoring in biology or psychology. Then, they attend medical school. Med school programs usually take four years, two years of classroom work and two years of supervised clinical experience. Once medical school is completed, a four-year residency is required. During this residency, someone wanting to specialize in psychiatry will fulfill the number of required hours in that specialty. Upon successful completion of the residency, the doctor must sit for the licensure exam in each state and pass in order to practice and be able to bill insurance companies and Medicaid/Medicare. Psychiatrists prescribe medication, and therefore, must obtain a Federal Narcotics License and register with the Drug Enforcement Agency.  Psychiatrists most often manage psychotropic medications for their clients. Often the first meeting with the psychiatrist is 20-50 minutes long so that the psychiatrist can explore the patient’s family and medical history and decide which medication to prescribe. After that first appointment, subsequent appointments usually last approximately 15 minutes so that the psychiatrist can ask about any side effects and make any necessary changes in medications or dosages.

Psychologist—A psychologist is not a medical doctor. Psychologists usually have an undergraduate degree in psychology or social work, but this can vary. Psychologists then move into graduate school, with programs ranging from 4-6 years. There are many different kinds of psychologists, based on the types of specialties they choose—clinical, counseling, health, educational, industrial/organizational, and others. At this point in time, there are a limited number of states that will allow a psychologist to undergo more education and clinical experience in order to prescribe medication. Generally speaking, psychologists do not prescribe medication, but spend more time doing testing and therapy. Psychologists are qualified to administer IQ, achievement, personality and educational testing. Many psychologists are also involved in the supervision of master’s level therapists and case managers. Psychologists also sit for state licensure examinations in order to be eligible to bill insurance companies and Medicaid/Medicare. Sessions with a psychologist typically last 50 minutes and involve many different types of techniques (talk therapy, play therapy, art therapy, activity therapy to name only a few).

Counselor/Therapist—The words “counselor” and “therapist” often mean the same thing. Counselors/therapists are practitioners who have earned a 4-year undergraduate degree and a master’s degree in psychology or counseling. The master’s degree programs are typically 3-4 years in length. Counselors/therapists are not eligible to provide testing or medication and most often provide therapy and case management. The techniques used by counselors/therapists vary also. Folks in this category may also have varying types of specialties—social work, marriage and family, counseling, art, or music.

When selecting a psychiatrist, psychologist, or counselor/therapist, do your research. Do you need medication? If so, you’ll need to see a psychiatrist? Do you need to have testing done? You’ll need to see a psychologist. Are you interested in therapy? A counselor/therapist or psychologist can provide that service. Keep in mind that the more education the practitioner has and the more liability they have, the more expensive their services will be. Check your state licensing agency’s website to see if a practitioner you’re considering has a license and if anyone has filed a complaint against that practitioner. The best practitioner is someone that has a license in your state, does not have any complaints against them, and has a good reputation in your community. Don’t be afraid to ask around, just like you would for a family physician or dentist. Many times, the best referral is from someone you know who has used that practitioner’s services.



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