Looking through my insurance plan’s provider book and I see that they list both psychologists and psychiatrists. From the little I remember, being told back in the day and all, the difference is that psychologists are not MD’s and therefore are not able to prescribe medicine… but I don’t even know if that’s true anymore (assuming it was true at one point).
Other than that, are there any other differences?
As far as I know, that’s it. Psychologists have studied psyvhology, which is a social science while Psychiatrists have been to med school (that’s at least the way it is done here in Holland). There are appearantly ways for Psychologists to follow med school programs that qualify them as Psychiatrists.
FWIW I second that.
Agree as well. Also, many psychiatrist do not conduct therapy. Some do, but the majority do not. Their primary purpose will be to gain information of your symptoms to treat with medication.
There are a bunch of practical differences. Psychiatrists tend to be more often diagnosticians, while psychologists tend to be therapists; psychiatrists often work in crisis conditions (e.g., attempted suicide, life-threatening eating disorders, delusions/hallucinations, etc.) while psychologists may focus on long-term follow-up treatment.
But those are more determined by the job than the actual degree.
The majority of psychiatrists do not do therapy. They diagnose illnesses, or work in conjunction with a psychologist (who may know a lot about the patient if they have a long history together) to diagnose. Usually, at least from my experiences, visits with a psychiatrist involve the patient being asked how the medications are working, if the side-effects are disabling or tolerable, and the doctor making a judgement call about what drug to add or take away, or if things have “stabilized” and no modifications are needed. These visits are relatively short and there isn’t a whole of lot of idle chitter-chatter. You may see the psychiatrist every two weeks in the very beginning, if your problems are serious, and then go down to once every other month or so, just to get a reneweal on a prescription. Often, if the doctor has a brisk business and you’re in a stable condition, they will have you make appointments with their nurse practioner, who also has the power of the prescription pad. But she or he will consult the doctor before making any major decisions. Some people might prefer to see the MD, but from my experience, the nurse practioner is just as good, if not better. There are different types of psychiatrists, too. If you’re dealing with any kind of neurological issues that have psychiatric components (like schizophrenia or Asperger’s Syndrome), you would consult a neuropsychiatrist.
A clinical psychologist does therapy. There are states that will allow psychologists to prescribe drugs, but they have to be certified before they can. Psychologists come in many stripes and have specialities. Some specialize in fears and anxieties, while other specialize in chronic depression or personality disorders. Their modalities differ–some do only cognitive behavioral therapy while others do psychodynamic therapy (think Freud). Many will say they are “eclectic”, meaning they don’t have a particular approach that they always take. But they’ll still have leanings towards one approach more than another. In contrast with psychiatrists, visits (or sessions) with a psychologist last longer (50-55 minutes). They’re a lot less informal than you would have with a psychiatrist, as you would expect with someone you might visit once or twice a week over a course of a long period of time. Because they aren’t medical doctors, they are cheaper than psychiatrists. Like, a co-pay with a psychiatrist with my insurance is $35, but just $25 for the psychologist.
If you aren’t sure what’s troubling you or a loved one and it’s not an absolutely urgent situation, I would recommend going to a clinical psychologist first before going to a psychiatrist. It may take weeks before someone can figure out what the problem is. The psychiatrist will have a tendency to go after the problem with a hammer in the form of drugs (many of which will not be helpful) while the psychologist will take the first few sessions to draw up a rough sketch of what the problem is. Their picture may be missing some details, but they’ll be able to share this sketch with a psychiatrist (they usually have a couple of names on hand), who will then have a better idea of what approach to take medically. Also, a good psychologist can act as your “hook-up” in case the best psychiatrist in town is not taking any new patients.
A psychiatrist is a doctor. A psychologist is a scientist.
In addition to what others have said already, psychologists are the ones that come up with (and conduct, of course) those cool experiments that become so famous. Stanford prison? Milgram shocks? Little Albert? All done by psychologists.
Not in America. In a couple of states there are ways for psychologists to take some additional training to be given limited rights to prescribe some medications however that does not make them physicians. Even those psychologists don’t go through the whole medical school training process that psychiatrists go through.
To be a psychiatrist, you also have to have an MD. The same is not true for a psychologist.
There you go. Psychiatrists have an MD. That’s the salient difference.
Incidentally, psychiatrists also tend to focus primarily on the actual physiology of the brain – the meat itself – the chemistry, pharmocology, neurology – rather than talk therapy and the like.
Where does a “psychotherapist” fit into all of this?
I’m not sure anybody has explicitly answered the OP’s question… A psychiatrist is a medical doctor who has some specialized training in behavioral health. A psychologist has a graduate degree in psychology (typically a doctorate) and has been licensed by their state. As far as the differences between what they can do, only the MD can prescribe medicine and perform other regulated medical procedures.
Psychotherapy is a type of counseling, which could be done by a psychologist , a psychiatrist, a scoial worker, or someone else. Someone who calls themselves a psychotherapist could have a number of different educational backgrounds.
In the USA and Canada a psychiatrist can also be a D.O. (Doctor of Osteopathy). In the US and Canada, D.O. are equvilent to MDs and both are physicians.
This isn’t true everywhere else where a an osteopath isn’t necessarily a physican.
American here. I’ve been taught that a DO is equivalent here to an MD for virtually all legal purposes regarding practice (i.e. what they can do, e.g. prescribing drugs, billing insurance/medicare/etc as a practitioner, evaluating and testifying about competency in court,etc.), but I’ve never heard of a psychiatrist who wasn’t an MD.
In some areas of the US, a properly licensed physician (MD or DO) may be able to legally practice any type of medicine regardless of what specialty certificates they hold, though for liability purposes you would probably face difficulting in getting a psychiatrist with no surgical training beyond med school to give you laser eye surgery, even though in many places there probably isn’t anything per se illegal about it assuming that they doctor didn’t lie about their qualifications and you freely consented.
Here, a psychologist has an academic research degree (minimum of an MS, probably a PhD) in psychology or possibly a closely related discipline. There are two types of psychologists, clinical and research. Clinical psychologists give talk therapy and whatnot to patients. Research psychologists are often attached to a university and do research and experiments on people (e.g. the people who did the famous “Milgram experiment”) and write academic papers on what they find.
My understanding is that “psychotherapy” means talking therapy of whatever form (e.g. Freudian psychoanalysis, cognitive-behavioral therapy, Gestalt therapy, etc). Either a psychologist or a psychiatrist can give it, but I associate it more with the psychologist.
I have. They’re fine (or at least about as f**ked up as MD psychiatrists, by and large.)
DOs are eligible for just about any residency training program in the US that MDs are eligible for. I know DO urologists, OB/GYN, orthopods, neurologists, physiatrists, etc.
This is a complicated topic and it gets more complicated because some of it depends on state you are in. Psychiatrists are medical doctors and they tend to operate like it. Some work in hospital emergency rooms, inpatient wards, or do outpatient work but it is usually in only 15 - 30 minute intervals. They tend to triage and prescribe drugs quickly because that is their primary job. They aren’t usually interested in your life story. The answers before are correct for that.
However, a doctorate in clinical psychology is mainly a research degree so that is what some psychology professors have and as well as the people that run clinical psychological studies. They can see patients as a practitioner but that degree tends to be overkill for that. The requirements to get into a traditional PhD program in clinical psych are extreme and you don’t have to have it to see patients.
For hands on work, it is commonly licensed social workers that do what many people think of as clinical psychology in many states. That requires a masters degree and specialized clinical training. There are also psych nurses qualified to do see patients, counseling psychologists, addiction specialists and others.
I realize this is sounds confusing because it is. The TV and movie version of working through relationships and dealing with life problems tends to be done by people other than psychiatrists or doctorate level clinical psychologists. The requirements to do the more hands on talk therapy tends to be lower yet it is still often covered by medical insurance.
A therapist is someone who offers you treatment. That can be a psychiatrist, a psychologist, a licensed social worker, a physical therapist. Medicine is one kind of therapy. Talk is another kind of therapy. There are many combinations of therapies. Even psychologists sometimes work in an office with a psychiatrist and one may prescribe medication and see you two or three times a year while the other spends more time in talk therapy.
But there are still psychiatrists who use counselling combined with medicine with their patients. It wasn’t the old fifty minute hour that was so common before, but it was usually forty minutes. He was a most incredible physician. I think he was using Cognitive Behavior Therapy with me although he never called it that.
I don’t think there are many Freudian psychiatrists still associated with reputable hospitals, but that’s just my speculation. Psychiatry has moved on quite a bit since then. But I don’t mind being corrected if I am mistaken.
Many patients who have dealt with a mental illness tend to project their own experiences onto the reality of all of psychiatry. If something doesn’t work for them, it is worthless. But if tomorrow medicine found something to relieve the suffering and symptoms of one-third of Parkinson’s Disease patients, would we cast it aside and say in digust that it doesn’t work for most people?
I’m tired of seeing some patients discouraging others from trying medication therapy just because it didn’t work for them. My understanding is that SSRIs work for about one-third of the people who have depression. It took me 27 years to find the right medication, but not once did I discourage anyone else.
About $30 an hour.
I also want to point out that, in some states (like mine, Arkansas) allow psychologists to only have Master’s degrees.
Also, a psychologist can have a PhD OR a PsyD.
Psychologist seem to be more common than psychiatrists, and therapists (that aren’t the other two) are even more common. The way I’ve seen most clinics set up is that there are a bunch of case workers. quite a few therapists, a single psychologist, and a psychiatrist who is spread out amongst different clinics. This is what leads to each up the chain being able to give you less and less time.
Also, you are lucky if your insurance will pay for pyschologists and psychiatrists. My medicaid will only pay for a psychologist if there is a psychiatrist (or other M.D.) on staff. No, being in a treatment plan that includes both is not enough, even if the psychiatrist vouches for the psychologist.