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

The office receptionist knocked on my door saying, “We’ve a prospective client on the phone saying they need to make an appointment with a psychologist. We don’t have a psychologist on our staff, do we?”  “No,” I said, “not in the official sense. But lots of people use the term as a generalization for any kind of behavioral health professional.”

While it varies from state to state, there are three general designations for helping professionals in the behavioral health field. Let me offer some clarification.

Psychiatrist

A psychiatrist is a medical doctor. This means he or she has completed medical school, residency, and has chosen psychiatry as his or her specialty. He or she is licensed by the state to practice medicine, and can legally prescribe medication. He or she may or may not have privileges which allow him or her to admit patients to the behavioral health unit at a local hospital. Many times, they will have their own practice and may or may not have a psychologist or therapist working in the same office. They usually know comparatively little about doing counseling or psychotherapy and rely on the therapists on their staff to accomplish this. They generally see their patients to evaluate the effectiveness of medication. Some psychiatrists will have a social worker and/or a pastoral counselor on their staff, in addition to a psychologist and other therapists.

Psychologist

A psychologist’s primary role is to conduct psychological testing and evaluation.  He or she has accomplished seven or eight years of college and often is referred to as “doctor.” The initials behind their name are typically PsyD or PhD. In recent years, they have come to prefer the title “neuro-psychologist.” When an individual is ordered to undergo and “psychological evaluation,” that person is generally evaluated by a psychologist. The psychologist is schooled in a wide variety of testing and evaluation instruments. The most popular of which include the Minnesota Multiphasic Personality Inventory (MMPI), the Milan Clinical Multiaxial Inventory (MCII), and the Wechsler Intelligence Quotient (IQ test) — there are many others.  In some states, the psychologist is the only behavioral health professional who is legally qualified to administer and interpret these instruments, and diagnosis mental illness.  Many psychologists are also trained in providing talk therapy and counseling, but their primary focus is on psychological testing and evaluation.

Therapist or Counselor

The therapist is the behavioral health professional who spends the most face-to-face time with the client or patient. He or she is trained in listening and intervention skills. The therapist has usually completed six or seven years of college, which includes some type of internship — many states require up to two years of additional training.  During the internship, the therapist gains experience working with clients while under the careful and watchful eye of a clinical supervisor. A therapist may work in the same office as both a psychiatrist and psychologist, but typically, he or she will have their own practice or separate office or practice. The therapist will ask the client to talk at length about their issues or problems, take the time to explore thoughts and feelings, and work with the client to find solutions that lead to growth and change.

Most individuals have no idea about the differences among these professionals. I hope now you have some clarity.

© 2019 by Roger Daniels

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