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

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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 they provide differ in terms of content and scope. Psychiatrists are medical doctors who 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 may have some overlapping responsibilities, such as conducting psychotherapy and performing research, the background they need to perform them differs.

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 Diagnostic and Statistical Manual of Mental Disorders (DSM) 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.

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 MD.

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 (CBT), 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 than medication alone in the treatment of some conditions.)

Psychiatrists 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 like neuropsychiatry, geriatrics, adolescent psychiatry, or psychopharmacology.

Prescriptive Authority

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 in 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. Very often, they work in collaboration with one another to provide the best possible treatment for an individual.

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 or adjusting medication, in order to best address the patient's symptoms.

The type of approach needed often depends on the severity of the symptoms and the needs and wishes of the patient. According to research, patients differ as to what is preferred— psychotherapy alone or in combination with medication—which, therefore, can affect what professionals they see. Expense can also be a mitigating factor; some studies have found that combining treatment approaches may also be more cost-effective for patients.

Your Career Path

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 for you.

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 on 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.

Life As a Psychologist or Psychiatrist

Work/life balance and work settings are other factors that students should consider when choosing between a career as a psychologist or psychiatrist. 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 typical 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.

Job Outlook

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 of 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.

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. 

Neither one is "better" than the other, but one's needs and specific symptoms may play a role in which professional is best equipped to assist with treatment.

View Article Sources
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