The difference between a therapist vs. psychiatry is one of the most asked questions in the mental health arena.
The question of whether a therapist and a psychiatry are basically the same thing is one that many people pose.
The answer to that question however is no they are not.
Although they deal with the same kind of illnesses they are worlds apart in terms of credentials, education, legal authority and practice.
The difference between the two has significant consequences on the kind of care that you will receive.
In this in depth article by Mindvita we will explore the credentials medical authority, licensure, and practice differences between a therapist vs. psychiatry in a clear, research based and practical way.
Executive Overview: The Basic Differences in Therapist vs. psychiatry Credentials
At the most basic level the difference between a therapist vs. psychiatry begins with one single criterion.
A therapist is trained in the art of psychotherapy.
A psychiatry on the other hand is trained in the art of medicine first then in the art of psychiatry.
Although it may sound somewhat similar it has significant consequences on all other differences.
The difference between a therapist vs. psychiatry begins with the question of whether they can prescribe medication, order medical tests etc.
Educational Pathways: Therapist vs. psychiatry Training Requirements Compared
Therapist Education Requirements
The first difference between a therapist vs. psychiatry begins with education.
The educational requirements of a therapist are as follows:
- A Master of Social Work (MSW)
- A Master’s in Clinical Mental Health Counseling
- A Doctor of Psychology (PsyD)
- A PhD in Psychology
The training process takes between 6 and 8 years after high school.
Most states require between 2000 and 4000 supervised clinical hours before being licensed.
The deep specializations that a therapist undertakes include:
- Cognitive Behavioral Therapy
- Dialectical Behavior Therapy
- Trauma informed therapy
- Family systems therapy
- Behavioral interventions
It should also be noted that while answering the question “Is a psychotherapist a doctor?” we should also answer that for the most part the answer is no because they have master’s degrees not medical degrees although some do have a PhD or a PsyD which means that yes some are indeed doctors.
This should also be noted while discussing the debate between a therapist and a psychiatry.
Psychiatrist Education Requirements
The education requirements that a person must fulfill before becoming a psychiatry include:
- Bachelor’s degree with a pre med major
- Medical school which will earn a person an MD or a DO
- Four year residency program in psychiatry
- Optional: One year fellowship program in child and adult psychiatry forensic psychiatry addiction psychiatry
The total time that a person must spend before becoming a psychiatrist is between 12 and 14 years.
A psychiatrist is a licensed medical professional who is under the jurisdiction of state medical boards and he or she can also be certified by the American Board of Psychiatry and Neurology.
When comparing the debate between a therapist and a psychiatry have a deep education in the following areas:
- Pharmacology
- Physiology
- Pathology
- Neurology
- Internal medicine
This enables them to deal with mental illness while considering a person’s overall health.
Licensing and Legal Authority
Therapist Licensure
The licensing process for a therapist varies by state, with the most common being:
- Licensed Clinical Social Worker
- Licensed Professional Counselor
Licensed Marriage and Family Therapist - Licensed Psychologist
The credentials of these positions vary from state to state. Moreover the credentials are not transferable from one state to another.
In the context of the comparison between the therapist vs. psychiatry debate it is important to note that therapists can make diagnoses of mental health issues except in rare cases. However therapists cannot prescribe medication except in rare cases.
Psychiatrist Licensure
In order for a psychiatrist to practice the following requirements must be met:
- Valid medical license
- Psychiatric residency
- Continuing medical education
- Board certification
As medical doctors psychiatry are also qualified to:
- Prescribe medication
- Order blood tests
- Perform physical examinations
- Admit patients
- Address complex medical issues
One of the biggest differences between the two professions is also one of the most important differences between the therapist vs. psychiatry debate.
Prescriptive Authority: The Most Critical Credential Gap
If there is one critical difference between the two professions of therapist vs. psychiatry it is the fact that psychiatry are qualified to prescribe medication while therapists are not.
The psychiatry are qualified to prescribe:
- Anti depressants
- Mood stabilizers
- Anti psychotic medication
- Anti anxiety pills
- ADHD stimulants
In contrast therapists are not qualified to prescribe medication except in rare cases.
In fact the main reason why most persons who are looking for information on the difference between a therapist vs. psychiatry for the treatment of PTSD are looking for information on whether or not medication is required for the treatment of PTSD.
For example:
- Mild PTSD can be treated using trauma focused CBT.
- Severe PTSD that also includes panic attacks can be treated using SSRIs that are guided by a psychiatrist.
In the context of the debate between the two professions of therapist vs. psychiatry the difference between the two professions can be highlighted by the fact that therapists are trained using the therapy model while psychiatry are trained using the medical model.
Therapist Training Emphasis
- Modify behavior
- Manage emotions
- Process trauma
- Restructure cognition
- Manage relationships
Therapists usually see clients one time a week for 45 to 60 minutes.
For mild to moderate cases of PTSD therapy alone can help.
Psychiatric Training Emphasis
A psychiatry is trained to:
- Understand neurobiology
- Understand brain chemistry
- Make differential diagnoses
- Manage medication
A psychiatry can see a client once a week for 15 to 30 minutes.
When evaluating the debate on “Psychologist vs psychiatry” one should consider that:
Psychologists are trained to put a strong emphasis on testing and therapy.
Psychiatry puts a strong emphasis on medication and medical evaluation.
This is what is commonly confused in evaluating the debate on “therapist vs psychiatry.”
Diagnostic Authority and the DSM-5-TR
Both use the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision or “DSM-5-TR” in diagnosing.
The difference is that psychiatry can also rule out medical problems.
For example:
The reason for depression with depression symptoms can be thyroid disease.
Hallucinations can be a symptom of a neurological disorder.
A psychiatry can run tests to find out what is going on with a person something that a therapist cannot do.
This is one of the biggest differences between a therapist and a psychiatry.
Specializations and Subspecialties
Therapist Specializations
A therapist specializes in:
- Trauma therapy
- Couple counseling
- Addiction counseling
- Child therapy
- Grief counseling
Sometimes they specialize in EMDR, DBT etc.
Psychiatric Subspecialties
A psychiatry specializes in:
- Child and adolescent psychiatry
- Geriatric psychiatry
- Addiction psychiatry
- Forensic psychiatry
- Consultation liaison psychiatry
A workforce study done by the Association of American Medical Colleges found that there is a shortage of psychiatry that will continue to exist until 2030.
Therefore it is even more important to understand the difference between a therapist and a psychiatry.
Salary and Workforce Differences
The median salary of a therapist and a psychiatry:
Therapist: $55,000 to $85,000
psychiatry: $220,000 to $320,000+
This is another factor that differentiates psychiatry from a therapist.
The cost of each session also varies:
Therapy session: $100 – $200+
Psychiatric evaluation: $250 – $500+
This is another point of differentiation between the two.
When to See a Therapist vs psychiatry
When to See a Therapist:
- When you need talk therapy.
- When you need help with stress, grief or relationship issues.
- When you prefer non medication treatment.
- When you have mild to moderate issues.
When to See a psychiatry:
- When you need medication.
- When you have hallucinations, mania or treatment resistant depression.
- When you have medical complications.
When You May Need Both
The Therapist vs Psychiatrist debate in most circumstances is answered with: both!
- Major Depressive Disorder
- Bipolar Disorder
- Schizophrenia
- Severe PTSD
This is especially relevant with regard to the Therapist vs psychiatry debate with regard to PTSD as both will almost assuredly provide better results.
Common Misconceptions
Is a psychotherapist a doctor?
Most are not medical doctors; some may have a degree in psychology.
So with regard to “is a psychotherapist a doctor?” we should make sure we know what we’re asking.
With regard to the Therapist vs psychiatry debate the answer is clearly no.
Psychologist vs psychiatry means the same thing
No.
With regard to the question of “Psychologist vs psychiatry ” one will be dealing with therapy while the other will be dealing with medication.
The misconception that one is “better” or “worse” at their job than the other is what leads to confusion with regard to the debate between therapist vs psychiatry .
Therapists are less qualified
This statement is not true.
The statement should read “Therapists are differently qualified.”
Both require a rigorous education and training process.
The Significance of This Credential Difference for Patients
The debate between therapist vs psychiatry is significant because:
- Treatment
- Insurance
- Medication
- Emergency Situations
- Cost
- Long term Results
For example a person with bipolar disorder treated only by a therapist with no medication will have their manic episodes worsen.
A person with mild anxiety treated only by a psychiatry with few medication checks will not address their behavioral issues.
The credentials of a therapist vs a psychiatry play a large role in the quality of care that is provided to a patient.
Final Takeaway: Credentials Determine Scope Not Value
The debate between therapist vs psychiatry is not about who is better at their job.
The debate is about credentials.
The credentials of psychiatry are that they have medical training.
The credentials of therapists are that they have depth in psychotherapy.
At Mindvita we strongly recommend an integrated approach whenever possible.
The best systems are those that foster collaboration.
To summarize:
The difference between a therapist vs psychiatry is that a psychiatrist has medical training.
- Only a psychiatry can prescribe medication.
- Both can perform a diagnosis.
- Both are needed.
- Both can be beneficial to many.
Understanding credentials can help you make informed decisions.
Frequently Asked Questions
How Do I Choose Between a Therapist vs Psychiatrist for Anxiety?
To answer the question of how to choose between a therapist vs psychiatry for anxiety the answer is that if you have severe anxiety a psychiatrist can help while if you have mild to moderate anxiety a therapist can help.
Is a Psychotherapist a Doctor If They Have a PhD?
To answer the question of is a psychotherapist a doctor if they have a PhD the answer is that a psychotherapist is not a doctor even if they have a PhD because a psychotherapist cannot prescribe medication at least not in most states.
What Is the Difference in a Psychologist vs Psychiatrist for Diagnosis?
To answer the question of what is the difference in a psychologist vs psychiatry for diagnosis the answer is that both can perform a diagnosis using the DSM-5-TR manual.
Do I Go to a Therapist vs Psychiatrist for PTSD Symptoms?
To answer the question of do I go to a therapist vs psychiatry for PTSD the answer is that a therapist can help with PTSD while a psychiatrist can help with PTSD if the symptoms are severe.
Can I switch from a therapist to a psychiatrist if therapy alone isn’t working?
To answer the question of can I switch from a therapist to a psychiatrist the answer is that yes many people can benefit from a psychiatrist.
