What's the Difference Between a Psychologist and a Psychiatrist?

Psychologist or psychiatrist conducting therapy
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The terms "psychologist" and "psychiatrist" are often used interchangeably to describe anyone who provides therapy services, but the two professions and the services provided by each profession differ in terms of content and scope. 

Psychiatrists are medical doctors and are able to prescribe medications, which they do in conjunction with providing psychotherapy, though medical and pharmacological interventions are often their focus.

Psychologists hold doctorate degrees but are not physicians, and they cannot prescribe in most states. Rather, they solely provide psychotherapy, which may involve cognitive and behavioral interventions.

Education, Training, and Credentials

While psychologists and psychiatrists both conduct psychotherapy and research, there are significant differences between the two professions in terms of education, training, and approaches to patient treatment.

Educational Requirements for Psychologists

Psychologists receive graduate training in psychology and pursue either a PhD (Doctor of Philosophy) or PsyD (Doctor of Psychology) in clinical or counseling psychology.

Doctorate programs typically take five to seven years to complete and most states require an additional one or two-year long internship in order to gain licensure. Other states require another year or two of supervised practice before granting full licensure.

During their education, those pursuing either a PhD or PsyD doctoral degree take courses in personality development, psychological research methods, treatment approaches, psychological theories, cognitive therapies, and behavioral therapies among other topics. They also complete a one- or two year-long internship,  followed by a period of supervised practice.

The title of "psychologist" can only be used by an individual who has completed the above education, training, and state licensure requirements. Informal titles such as "counselor" or "therapist" are often used as well, but other mental health care professionals such as licensed social workers can also claim these titles.

The PhD degree option tends to be more research-oriented. Those who earn a PhD in clinical or counseling psychology receive extensive training in research methods and complete a dissertation. The PsyD degree option, on the other hand, tends to be more practice-oriented. Students who pursue this degree option spend more time learning about and practicing clinical approaches and treatment methods.

Like psychiatrists, psychologists utilize the DSM (or Diagnostic and Statistical Manual of Mental Disorders) to diagnose people who are experiencing symptoms of psychological illness. They often use psychological tests such as personality tests, clinical interviews, behavioral assessments, and IQ tests in order to get a better idea of how a client is functioning.

Educational Requirements for Psychiatrists

Psychiatrists are physicians that have specific training in the assessment, diagnosis, treatment, and prevention of mental illnesses.

In order to become a psychiatrist, students first earn an undergraduate degree before they attend medical school and receive an M.D.

After finishing their medical training, they also complete an additional four years of residency training in mental health. This residency often involves working in the psychiatric unit of a hospital. They also work with a wide variety of patients ranging from children to adults who may have behavioral problems, emotional difficulties, or some sort of psychiatric disorder.

During this medical residency, those specializing in psychiatry receive training and practice in how to diagnose and treat different psychiatric conditions such as PTSD, ADHD, schizophrenia, and bipolar disorder.

Psychiatrists receive training in different psychotherapy treatment modalities including cognitive-behavioral therapy, a popular treatment approach that has been shown to have a high level of effectiveness in the treatment of a wide variety of psychiatric conditions including anxiety disorders, somatoform disorders, stress, and anger issues. Some research suggests that combining CBT and medications may be more effective in the treatment of some conditions.

Some also receive additional training in a specific area of interest such as geriatric psychiatry, child and adolescent psychiatry, addictions, and other areas. Some may then choose to specialize further by completing a fellowship in an area such as neuropsychiatry, additions, geriatrics, adolescent psychiatry, or psychopharmacology.

The Ability to Prescribe Medication

A second important distinction between the two careers is that psychiatrists can prescribe medications, while, in most states, psychologists cannot. However, there has been a recent push to grant prescribing powers to psychologists. Some states such as New Mexico and Louisiana now grant prescribing privileges to medical psychologists holding a post-doctoral master's degree or equivalent in clinical psychopharmacology.

Kevin McGuinness, chairman of the Commissioned Corps Mental Health Functional Advisory Group, writes, "For those interested in a career in psychology as a prescriber, it is important to know that certain federal employees and uniformed commissioned officers (Army, Air Force, Public Health Service, Navy, etc.) that are licensed in one state as a medical psychologist may prescribe any other state to which they are assigned by the federal government."

How They Treat Patients

While the two professions are distinct, psychologists and psychiatrists both play important roles in mental health treatment. The two professions are often portrayed as being pitted against each other, but the reality is that they often work in collaboration with one another to provide the best possible treatment for patients.

Psychologists and psychiatrists often work in collaboration and contribute to an individual's unique treatment plan. In many cases, people with work with a psychologist in order to receive regular psychotherapy treatments and then see a psychiatrist on weekly or monthly basis in order to assess medication needs.

For example, patients may begin by seeing their primary care physician about the psychological symptoms that they are experiencing. Their doctor may then refer them to a psychologist for further evaluation. That psychologist may observe, assess, and diagnose the patient before referring them to a psychiatrist who can prescribe and monitor medications. The psychologist and psychiatrist may work together, with the psychologist offering behavioral interventions and the psychiatrist providing medication, in order to best address the symptoms.

The type of approach needed often depends on the severity of the patient's symptoms and the needs and wishes of the patient. Some research has suggested that patients either tend to prefer psychotherapy alone or a combination of psychotherapy with medication. In such cases, patients may prefer to work with a psychologist if they wish to focus on psychotherapy or with a team that includes a psychologist and psychiatrist if they want to combine behavioral and pharmacological interventions. Some studies have found that combining treatment approaches may also be more cost-effective for patients.

Job Outlook and Pay

According to the Occupational Outlook Handbook published by the U.S. Bureau of Labor and Statistics, the job outlook for psychologists and psychiatrists is expected to grow at a fairly similar rate. They predict the demand for psychiatrists to rise at a rate of 15 percent between the years 2014 and 2024, amounting to an increase in around 4,200 jobs. The demand for psychologists is expected to grow at a somewhat larger rate of 19 percent between the years 2014 and 2024, amounting to an increase of about 32,500 more jobs.

The Bureau of Labor Statistics reports that the median salary for psychologists as of May 2016 was $75,230 per year. The median annual salary for psychiatrists in May 2016 was considerably higher at $245,673.

For Those Interested in Becoming a Psychologist or Psychiatrist

If you are considering a career as a therapist, you will need to determine which career path is best for you. Are you interested in conducting psychotherapy, administering psychological tests, and conducting research? If so, a career as a psychologist may be the best choice for you.

On the other hand, if you have an interest in medicine and want to be able to prescribe medications to your patients, a career in psychiatry might be your ideal choice.

If you do not want to invest five to eight years in graduate training, consider pursuing a career as a licensed social worker or counselor. These professionals are also qualified to provide mental health services depending upon training and experience. Both social work and counseling typically require two or three years of graduate study.

Psychiatric nursing is another great career option for students interested in medicine. Advanced Psychiatric Nurses hold a master's degree or higher in psychiatric-mental health nursing and are able to assess patients, diagnose disorders, provide psychotherapy, and prescribe medications.

What It's Like to Be a Psychologist or a Psychiatrist

Work/life balance and work settings are other factors that students should consider when choosing between a career as a psychiatrist or psychologist. Both medical school and graduate school are rigorous and require a significant investment of time, resources, and energy.

A medical residency can be grueling, and students should feel comfortable working in medical settings if they opt to enter the field of psychiatry.

After graduating, psychiatrists who choose to work in hospital settings may be required to work long hours or be on-call. Psychiatrists may work in hospitals, but they may also opt to work in community mental health centers, academic settings, or private practice. Those who choose to work in private practice may find that they have more control over their schedule and hours.

Psychologists also face similar demands. Some psychologists may also choose to work in hospital settings, while others can be found in mental health clinics, government agencies, academic settings, and private practice. Professionals in this field may find that they need to work evening and weekend hours in order to accommodate clients who work during normal business hours. Like psychiatrists, psychologists working in the mental health field may also need to be on call at times or be able to respond to emergency situations.

A Word From Verywell

Psychologists and psychiatrists represent distinctive professional designations, but both play a critical role in the field of mental health. Key differences between psychologists and psychiatrists come down to educational background and prescribing powers, but both share the important goal of helping patients feel better. 

There are many important differences between psychologists and psychiatrists and mental health consumers should be aware of the distinctions between the two professions. Despite these differences, both psychologists and psychiatrists are equipped to provide mental health services to people suffering from minor to more serious mental illness.

Both receive extensive training in psychology and mental health, so the type of professional you choose to see might depend on accessibility in your area and whether or not you need medications to treat your illness. Neither one is "better" than the other, but your needs and specific symptoms may play a role in which professional is best equipped to assist you in your treatment. Discuss your options with your doctor and seek references to find a mental health professional in your area who can help you deal with the issues you are facing.

Sources:

Capuzzi, D & Stauffer, MD. Counseling and Psychotherapy: Theories and Interventions. Alexandria, VA: American Counseling Association; 2016.

Hofmann, SG, Asnaani, A. Vonk, IJJ, Sawyer, AT, & Fang, A. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analysis. 2012;36(5):427-440. doi: 10.1007/s10608-012-9476-1.

McGuinness, KM. Personal communication. May 19, 2011.

Plotnik, R. & Kouyoumdjian, H. Introduction to Psychology. Belmont, CA: Wadsworth; 2014.

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