What is the difference between a Psychologist, a Psychotherapist, a Counselor, and a Psychiatrist?
Which one do I need?
I get asked this question at least once a week. It can be very confusing for consumers to figure out the difference between a psychologist, a psychiatrist, a psychotherapist, a mental health counselor, a clinical social worker and a life coach, particularly since these titles can also vary by state. So, let me try to shed a little light.
In the state of Florida, any professional that is licensed under either the Board of Psychology or the Board of Clinical Social Work, Mental Health Counseling, and Marriage and Family Therapy can call themselves a “psychotherapist”. A Psychiatrist can also refer to himself/herself as a psychotherapist. That’s because psychotherapy is the art and practice of “talk therapy”. Talk Therapy was originated by pioneers like Sigmund Freud and Carl Jung, and later expanded upon by famous therapists such as Carl Rogers, Aaron Beck, Abert Ellis, Fritz Perls, Irving Yalom, Donald Michenbaum and others.
Psychiatrists are medical doctors. That is a key distinction between psychiatrists and other psychotherapists. As physicians, they can prescribe medication. Whereas (at least in the State of Florida), other psychotherapists do not prescribe medication. Nowadays, most psychiatrists focus their practice on medication management and non-physician psychotherapists focus on doing talk therapy. Typically, individuals seeking treatment that requires medication will see a psychiatrist occasionally to manage their medication, and a psychotherapist every week or every other week for the other part of treatment, the “talk therapy”. This is because research shows that medication combined with psychotherapy is more effective than medication alone.
So then, who are the majority of psychotherapists? Well, there are several different educational paths that lead to becoming a psychotherapist. But to keep things simple, we can say there are 3 general categories:
Masters level therapists have a Masters degree (4 years of undergraduate work, plus 2 years of graduate training) in field such as Mental Health Counseling, Clinical Social Work, or Marriage and Family Therapy.
Psychologists have Doctoral-level training (4 years of undergraduate work, plus 5 years of graduate training) in either clinical psychology or counseling psychology. Psychologists with a Ph.D. are trained in both research and clinical work, whereas psychologists with a Psy.D. only have clinical training.
Hypbrids (like myself !)
Obviously, “hybrid” is not an official title, but I use the term to describe psychotherapists that do not fit clearly into one of the above categories. For example, me! After completing 4 years of undergraduate work, I completed a Masters degree in Mental Health Counseling (at which point I became a masters-level psychotherapist and began practicing psychotherapy). A few years later, I went back to school for a second Masters in Child and Human Development, and a Ph.D. (Doctorate) in Social and Personality Psychology. I received graduate training in both clinical and research programs. So, although I am licensed as a Masters-Level therapist, I actually have more training than most psychologists.
Ok. now the BIG question:
Which one is better?
There’s no simple answer to that! In my career I’ve seen amazingly effective masters-level therapists, and terrible psychologists and psychiatrists. I’ve also worked with fantastic psychologists and psychiatrists. So, here’s what I think: pick a psychotherapist that works with the type of issue you are going to therapy for and see them for a few sessions. Then, you be the judge! If you feel they understand you and your problem and your sessions are helping you learn, grow, create change, and feel better, then that’s probably a therapist that will be helpful to you. Give it your best effort and participate actively in your therapy by working on things on your own in between sessions. You’ll get better results that way! But if you don’t feel a strong connection with your therapist, then find someone else. In the end, the most important factor in psychotherapy success is the quality of your alliance with your therapist.