The titles of psychologist and psychiatrist are confusing to the general public. Unfortunately, people not in the mental health field often use the terms interchangeably, not realizing there are essential differences.
If you are considering starting mental health treatment for your child (or even yourself), it is important to know how these two professions differ. Once you have an understanding of what each has to offer, you may want to start treatment with only one or both.
This article is part two of a five-part series about everything you need to know before getting mental health assistance for your child. You can read an overview and introduction for the series here. If you are unsure if it’s the right time to start treatment, you can read the previous article in the series here.
Once you have decided to start mental health treatment, a whole other set of other questions comes up:
· What kind of treatment should I look for?
· Who do I see?
· How do I find the right person?
This article will attempt to answer these questions and more.
What Psychologists and Psychiatrists Have in Common
Both professionals have doctoral-level degrees and are qualified to diagnose and treat mental illness. Generally speaking, it cannot be said that one is superior to the other. Rather, they have different approaches that, in many cases, work together to provide the optimal treatment for a given person.
Education and Training: Psychologist = PhD or PsyD
While certain psychology positions (those in schools and some other organizations) only require a master’s degree, the Bureau of Labor Statistics (BLS) states that most clinical, counseling, and research psychologists need a doctoral degree.
An individual can become a psychologist by following different paths, but these are the usual steps:
1. Study for a bachelor’s degree by enrolling in psychology courses or related disciplines like social work.
2. Earn a master’s degree. Some schools encourage students to first earn a bachelor’s degree in psychology, while others will accept degreed applicants in other subjects with certain prerequisites.
3. Enroll in a doctoral degree program. Practicing psychology in most states requires a license, and a doctoral degree is necessary to get one.
4. Gain field experience. Students pursuing a doctoral degree must complete an internship in a relevant area (required to become licensed).
5. Obtain a license. Each state has its own specific licensing requirements.
It generally takes four years to complete a bachelor’s degree program, and a master’s degree might take between 18 to 27 months. A doctorate can usually be acquired in four to six years.
Education and Training: Psychiatrist = MD
A psychiatrist first needs a bachelor’s degree, which can be in any subject as long as specific prerequisite courses and MCAT (Medical College Admission Test) are taken. Budding psychiatrists then enter a four-year medical school program to study anatomy, neuroscience, pharmacology, and physiology. They also participate in rotations through all the major medical specialties.
After graduating from medical school, psychiatrists begin a residency program. General psychiatry training is four years, with subspecialty fellowships adding an additional one to two years of residency training.
The Difference in Treatment Approaches
Psychologists use psychotherapy when treating patients with mental health concerns. This is commonly referred to as “talk therapy,” but many types of therapy can be used. (You can read about the different types here.) Some psychologists will specialize in one area, and others will use a combo tailored to an individual patient.
Psychiatrists come from medical backgrounds and use medication treatments that target the biological bases of mental illnesses.
What a Typical Psychotherapy Appointment Looks Like
Psychotherapy typically consists of weekly sessions of about 50 minutes each. During each session, the psychologist meets with the patient and sometimes also with family members.
The patient guides some types of therapy, and others are led more by the therapist. Topics of discussion include both current life circumstances and early life experiences, but different therapy types may focus on one more than the other.
What a Typical Psychiatric Appointment Looks Like
Psychiatric treatment usually starts with an extended intake session, typically 60‑‑90 minutes in length. Most follow-ups are shorter (about 30 minutes). The frequency of appointments varies widely but is often monthly while medications are being adjusted during early treatment. Then, appointments decrease to once every few months as symptoms stabilize. Appointments will review physical symptoms, medical issues, medication responses, and possible medication side effects.
· You can read more about psychiatric evaluations here.
What Is a Therapist?
Another confusing term that people ask about is “therapist.” “Therapist” is a more general term describing someone who offers therapy. When referring to mental health treatment, it refers to someone who is licensed to provide psychotherapy.
The word “therapist” can include psychologists (PhD or PsyD), psychiatrists (MD), social workers (LMSW or LCSW), counselors (LPC), and marriage and family therapists (LMFT).
Should I Look for a Psychologist or a Psychiatrist for My Child?
The answer to this depends on several factors. There is no one-size-fits-all answer because each child is unique.
If your child has any physical symptoms, is suffering from a chronic illness, or is taking any medications, then a psychiatric evaluation may be the best first step to take.
It’s important to recognize that mental health and physical health cannot truly be separated because your brain is an organ in your body. The health of or illness in any bodily system will affect your mental health, and vice versa. Being a medical doctor gives psychiatrists the ability to understand and provide education, treatment, and referrals when necessary for general health conditions and overall physical health.
Many non-psychiatric illnesses or medications can cause symptoms that mimic a psychiatric illness. With their medical backgrounds, psychiatrists are ideally suited to evaluate these possible contributions to your child’s symptoms. Psychiatrists are medical doctors, so if your child has symptoms of fatigue or heart palpitations, for example, they have training in differentiating when these symptoms may be part of a medical condition that requires further evaluation or treatment.
Sometimes, specific illness symptoms present a challenge to participating in therapy. For example, social anxiety or panic disorder can make the idea of therapy so overwhelming that affected individuals never seek care. However, sometimes getting medication started can provide some relief and make therapy possible.
If a mental illness is severe enough to affect several areas of a person’s life (school, friendships, family relationships, etc.), then medications may be an important tool for recovery.
· More severe illness often requires a combination of treatments.
How Psychologists and Psychiatrists Complement Each Other
Both psychologists and psychiatrists have extensive education and training and have dedicated their careers to helping people who are suffering from mental health issues. Both are taught when to refer to the other and when alternative or additional treatment may be advisable. This is very helpful and important for you to know.
Most psychiatrists focus primarily on medication management. This is not because psychiatrists think that medications are the only or even necessarily the best treatment for every person. However, individuals who can prescribe medications are extremely limited in number compared to the many people needing this service.
Think of it like surgeons and physical therapists. If you need a knee replacement, you go to a surgeon. After your surgery, the surgeon will recommend you do physical therapy and will send you to a physical therapist.
The surgeon doesn’t do your physical therapy. Not because they don’t think it is important. But because they are a surgeon, and if surgeons are out doing physical therapy, then there will be no one to do surgeries. The surgeon and physical therapist are a team that helps you recover, and neither is more important; they just have different roles to play.
Similarly, a psychiatrist may prescribe medications and monitor responses to them, but they will almost always also refer the patient to a psychologist or other therapist for concurrent psychotherapy.
Finding the Best Way to Proceed – How We Can Help
This article contains a lot of information to process at once, especially if you or your child are currently suffering from depression or anxiety. Both of these states can make it difficult to make decisions. However, more important than finding the perfect first step is to make a call and ask questions. In the mental health world, we are used to taking calls from people with a wide range of concerns. If we are not the best place to give you the help you need, we are happy to point you in the right direction.
· At Austin Child Psychiatry, Dr. Larson provides a limited number of spots for patients who wish to do both therapy and medication management with one provider. If there is no availability for combination treatment with Dr. Larson, she is happy to provide referrals and coordinate with outside therapists.
If you or your child need help, then see someone. Just start somewhere.
Information presented on this site is for information and education purposes and is not intended to be medical advice. It is not meant to be a substitute for your own doctor’s advice. Please review our site's Disclosures and Terms of Use here: austinchildpsychiatry.com/blog/site-terms-conditions-and-disclaimer