In place of my usual physiology Phriday post, I give you this…
“I think I need a psychiatric evaluation? Can you test me?” These are some of the questions I get from time to time. And they reveal an ongoing confusion about testings, assessment, evaluations, the world of psychiatry, psychology, and neurology. Interestingly, if you type in “psychiatric evaluation” into wikipedia, you actually get redirected to an entry on psychological evaluations and testing. So, let me try to differentiate a bit here:
What is a psychiatric evaluation? It is done by a psychiatrist who is a physician with special psychiatry training (courses and residencies). This evaluation is comprehensive but medical in nature. Expect the person to ask for your physical, behavioral, and cognitive histories, order blood tests or other medical exams, evaluate (by observation and interview) your mood, your reality testing, and mental status etc. Ultimately, after an extensive (and usually expensive) interview, the doctor will arrive at a psychiatric diagnosis (if appropriate) and may also recommend medicines to help with the problem–which they can prescribe. A few also provide ongoing talk therapy but most do not. Rather, they recommend you find a therapist for that part. They will follow up with med checks as needed to titrate or refine your medicines. When a person has a very difficult, complex, or lengthy history of mental health, or, when the person is needing a diagnosis for legal reasons, a psychiatrist is a good choice. They are usually gifted at extracting subtle physical and behavioral matters that may help correctly pinpoint the problem. While a person might well get anti-depressants from their regular doctor, a good psychiatrist is better able to deal with complex matters and follow you more closely to get the right compound and dosage.
Neurological Evaluation. Stating the obvious, a physician with neurological specialties and qualifications does a neurological evaluation. Neurologists specialize in…wait for it…the nervous system (brain, spinal cord, and 12 cranial nerves). A neurological evaluation includes many of the things evaluated by psychiatrists but with special attention to your motor and sensory systems, your reflexes, and similar kinds of things. You might more likely see a neurologist when you obviously have a neurological issue. Neurologists are more likely to specialize in ADHD, brain injuries, and psychiatric problems that result from dementias or other known physical problems. They are often better able to give and interpret MRIs and other imaging that might be appropriate. They will also prescribe and follow medications.
Psychological Evaluation, AKA testing, psych assessment. These are offered, mostly, by doctoral level psychologists. These evaluations will cover much of the same history, mental status, and provide diagnoses when appropriate. Interviews, just like the previous two options, are essential. However, what sets psychological evaluation apart is its use of standardized tests. These may be paper and pencil or electronic. They may be filled out by the client or by family members. The results provide a snapshot of behavior, or cognitive functioning, or mood by contrasting the individual results against a peer group. For example, a child may complete a computerized test to assess attention span. The results are compared to thousands of children taking this test who either are “non ADHD” and or ADHD. A good psychologist collects data from multiple data points (test data, interviews by client and maybe family, observations, etc.) and uses that data to make interpretations and recommendations for ongoing care. Usually, the best psychological evaluations begin with a very objective, specific question. Just throwing a bunch of tests at a person to “see what comes up” isn’t all that helpful. Just because something pops up doesn’t mean it is meaningful.
It is true that masters level therapists (licensed or not) give and interpret some tests. But most of the best tests can only be given and interpreted by doctoral level, licensed psychologists.
There are other types of evaluations. Neuropsychologists are doctoral psychologists with specialized training and help pinpoint brain injury, unravel more complex learning disabilities, etc. Neuropsychiatric evaluations are done by another similar but slightly different professional. You can check out their interesting history on this wikipedia page.
So, how do you choose what is best for you? Answer a few questions.
1. What do I really want to know when it is all said and done? What might help me decide how to proceed? The more specific you are, the more likely you can get the answer you want.
2. Do I think I need to focus more on physical options or behavioral options?
3. Do I think I’m likely to need medications? The physician types are better. Psychologists cannot prescribe meds (unless you live in Hawaii or are in the military).
4. If I am given a diagnosis, what do I need it for? Both doctoral level psychologists and psychiatrists are capable of giving you diagnoses. However, some people or systems value one opinion over another. Figure out if it matters for your purposes.
5. Am I looking for specific behavioral/relational suggestions? Then psychological evaluations are more appropriate.
6. Am I looking to form an ongoing therapeutic talk based relationship? See the psychologist.
Psychology and psychiatry are both concerned with how the mind works and, as such, they have many principles and practices in common. This often makes it difficult to differentiate between the two. In fact, it’s not unusual to find people who assume the two fields are one and the same, which results in the common habit of using the terms interchangeably.
While psychology and psychiatry are quite similar and often work in tandem to provide the very best patient care, they do have several key differences. In this article, we’ll compare psychology and psychiatry to show how these differences can affect an individual’s diagnosis and treatment.
Confused About The Differences Between Psychiatry And Psychology?
Get Answers. Schedule An Appoinment With A Licensed Psychologist Online.
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What’s the Difference?
As we’ll discuss in this article, there are a number of differences between psychologists and psychiatrists, as well as psych evaluations. Generally speaking, the most important difference is that psychologists treat patients with talk therapy and psychiatrists treat patients with medical procedures and prescription drugs. The right approach for any given individual can depend on their condition, the severity of the condition, their personal preferences, their geographical area, and their ability to pay.
What are the Similarities?
Over the course of this article, we’ll also see that there are a number of similarities between psychologists and psychiatrists. Most importantly, both work to help patients overcome mental and emotional obstacles to living happy and healthy lives. In fact, they often work together to achieve this goal.
What is Psychology?
The American Psychological Association defines psychology as “the scientific study of the behavior of individuals and their mental processes.” In other words, psychology focuses on society as a whole as well as on interactions between individuals.
What is Psychiatry?
The American Psychiatric Association defines psychiatry as being “focused on the diagnosis, treatment and prevention of mental, emotional, and behavioral disorders.” In other words, psychiatry is a medical science that considers the social and biological context of individuals.
The Difference Between Psychology and Psychiatry At a Glance
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Both psychologists and psychiatrists are doctors.
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Both fields involve intensive study and training.
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Both professionals have access to some of the same diagnostic tools.
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Psychologists specialize in an array of talk therapies.
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In most states, only psychiatrists can prescribe medication.
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Psychiatrists can use physical treatments, such as shock therapy.
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Psychiatrists handle the most severe mental health cases.
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Psychology Vs Psychiatry – Education and Training
Both psychiatrists and psychologists are doctors who have completed intensive courses combining both education and training. In brief, psychiatrists are medical doctors who have received the distinction of M.D. or D.O. Psychologists, on the other hand, have completed a doctoral degree that entitles them to be addressed as “Doctor” and have received either the Ph.D. or the Psy.D. distinction.
To provide more detail, Psychiatrists begin their careers with the same medical school education as all other medical doctors. They learn all about the different systems in the body, including various illnesses that can affect these systems and how these illnesses can be identified and treated. They take courses in anatomy, behavioral science, biochemistry, neuroscience, and psychiatry, among many others. In addition, they’re exposed to working in a minimum of six specialist areas. They leave medical school with a degree in medicine and, at this point, are known as either a Doctor of Medicine (M.D.) or a Doctor of Osteopathic Medicine (D.O.).
To specialize in psychiatry, doctors also spend at least four years focusing on psychiatry in residency training. As part of this residency, they train in a variety of medical settings with patients of all age ranges, gaining exposure to the diversity of mental health issues that patients face. Upon completion of their residency, most opt to apply for board certification with the American Board of Psychiatry and Neurology. Some also choose to pursue further study in a subspecialty, such as child and adolescent psychiatry, forensic psychiatry, or addiction psychiatry.
Psychologists follow a different route. They must first complete doctoral studies, typically earning either a Doctor of Philosophy (Ph.D.) or a Doctor of Psychology (Psy.D.). Following this, graduates are required to fulfill a one- to two-year residency. This provides them with a practical setting where they can gain experience in methods of treatment and problem-solving techniques.
Different states have different requirements for psychologists. In some states, they must work an extra one to two years under the guidance and supervision of an authorized mental health professional before being fully recognized as a psychologist. Areas of specialization within psychology include clinical psychology, behavioral and cognitive psychology, and family psychology. Psychologists can attain certification in their specialty from the American Board of Professional Psychology.
In summary, when it comes to education and training, the main difference between psychologists and psychiatrists is the focus of their studies. However, both are concerned with why people think and behave the way that they do.
Confused About The Differences Between Psychiatry And Psychology?
Get Answers. Schedule An Appoinment With A Licensed Psychologist Online.
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Psychology Vs Psychiatry – Diagnosing Patient Issues
There is a vast difference in the way that both fields diagnose a patient’s mental health issues, mainly because of the differences in their education and training. Based on their studies, a psychiatrist will look for physical or chemical explanations, while a psychologist will look for social or personal explanations.
Psychiatrists are medical doctors who can draw upon diagnostics tests, including medical laboratory tests and computerized tomography (CT) scans. In order to specifically label a mental health condition, psychiatrists rely on the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Within this manual are descriptions of the various mental disorders and the criteria used to diagnose each illness.
Both psychiatrists and psychologists use a variety of psychological tests and assessments. Psychologists, however, receive extensive training in administering and interpreting these tests. They also make use of the DSM-5.
Psychology Vs Psychiatry – Treatment Options
In this section, we’ll discuss the three most common treatment options.
Medication
As trained medical doctors, psychiatrists are legally authorized to prescribe medication. Much of the work they do with patients centers on treating chemical imbalances in the brain and managing medication. Of course, their medical training means that psychiatrists will take other factors into consideration. Through physical examination and possible tests, they’ll try to eliminate other possible causes for the patient’s condition before prescribing a course of medication.
In most states, psychologists who want a patient to begin medication or reassess their current dosage must refer the patient to a psychiatrist or another medical doctor. However, thanks to the pioneering work of psychologists like Jack Wiggins Jr., there are currently a handful of states where psychologists have prescribing powers for certain psychiatric medications. There is also a push for more states to follow suit and widen the scope of treatments psychologists can offer to their patients. This is important because many common emotional and mental disorders are most effectively and efficiently treated with a combination of talk therapy and medication.
Psychotherapy
Psychotherapy, which is also known as talk therapy), involves talking with patients about the problems they’re facing and helping them to:
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Identify circumstances in their lives (such as divorce or death of a loved one) that are contributing to their mental health issue.
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Become aware of any behaviors or emotions that are contributing to their condition.
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Make use of behavior modification techniques.
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Develop healthy coping strategies and appropriate problem-solving techniques.
The ultimate aim of psychotherapy is helping patients to rediscover pleasure in life by restoring their sense of control.
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Both psychiatrists and psychologists practice various forms of psychotherapy, which may include working with individuals, couples, families, or groups of people who share similar problems. The difference in their work arises from the fact that psychiatrists are primarily concerned with medical treatments and medication, whereas psychologists are (usually) exclusively focused on psychotherapy. It’s not uncommon for a psychiatrist to refer patients to a psychologist, so they may benefit from the psychologist’s specific area of psychotherapy expertise.
Psychologists engage in many types of talk therapy, depending on which approach or combination of approaches they think will most help a particular patient.
- Psychoanalysis
– This method focuses on helping patients to discover, examine, and learn to cope with repressed thoughts and emotions that may be buried deep in their unconscious mind. It’s an in-depth method of psychotherapy that has been proven effective for patients dealing with depression, personality disorders, persistent relationship issues, emotional struggles, and trauma, as well as neurotic and self-destructive behavior patterns.
- Cognitive behavior therapy (CBT)
– This mode of psychotherapy seeks to change the way patients behave in difficult situations by changing their thought patterns.
CBT
is a short-term approach used to treat current issues patients are facing, such as anxiety, stress, anger, and eating disorders.
- Cognitive analytic therapy (CAT)
– Using CAT, a psychotherapist helps patients to identify early experiences that may be contributing to their current mental health issues. For example, overly controlling parenting typically leads to an overly rebellious nature in adolescence or adulthood. Patients in CAT are actively involved in the process, helping to develop strategies that will curb their maladaptive behaviors.
- Gestalt therapy
– This client-centered form of psychotherapy is often used for patients who are experiencing relationship difficulties, depression, anxiety, and low self-esteem. It has also been shown to have positive effects in cases where patients’ emotional stress is manifested physically through migraine headaches and back spasms. Gestalt therapy encourages bringing possibly painful issues to the surface using methods like drama or art, so they can be addressed positively in an environment where patients feel safe and secure.
- Hypno-psychotherapy
– This is defined as the clinical use of hypnosis to augment psychotherapeutic interventions. It’s meant for the treatment of deep psychological issues and psychiatric illness through selective attention and suggested experiences. Hypno-psychotherapy is often combined with CBT in a treatment known as cognitive/behavior hypnotherapy (CBH).
- Dance/Movement therapy (DMT)
– This is an expressive therapy, and in some instances it’s referred to as movement psychotherapy. It draws on the well-researched relationship between movement and emotion. Dance/movement therapy is sometimes applied in the treatment of eating disorders and poor self-image.
- Art therapy
– This is another expressive form of therapy in which art is used to release patients’ emotions. In addition, the art that patients produce is evaluated by the therapist for underlying signs of a mental health issue. It’s often used in the treatment of children and adolescents, but it has also been proven effective for adults.
- Integrative or holistic therapy
– This is practiced by some psychologists who feel a fusion of different therapies is the best approach to take with a particular individual.
Confused About The Differences Between Psychiatry And Psychology?
Get Answers. Schedule An Appoinment With A Licensed Psychologist Online.
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Physical Treatments
As medical doctors, psychiatrists are trained in a range of physical treatments that can be used with patients. However, these are most often reserved for severe cases of mental illness, and some treatments are known for being controversial.
Some treatments listed by the American Psychiatric Association include:
- Electroconvulsive therapy (ECT)
– Also known as shock therapy, this involves the use of electrical currents to the brain to induce seizures in order to
treat severe depression
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catatonia, and mania.
- Transcranial magnetic stimulation (TMS)
– This is the non-invasive use of a magnetic field generator to stimulate certain areas of the brain. It has been used effectively in patients whose severe depression does not respond to medication.
- Deep brain stimulation (DBS)
– In this treatment, a neurostimulator (a.k.a. a brain pacemaker) is implanted in the patient’s brain. Electrical impulses are then used to treat conditions like obsessive-compulsive disorder (OCD).
- Vagus nerve stimulation (VNS)
– This is another treatment where electrical stimulation is applied to the brain to treat medication-resistant depression.
- Light therapy –
This relatively new technique is used to treat both seasonal and non-seasonal depression.
Psychology Vs Psychiatry – Which Is Right for You?
When you’re trying to decide between using psychiatry and psychology to treat a mental health issue, there are two important factors to keep in mind.
- Severity and Type of Mental Health Condition
Psychiatrists often deal with the most complex mental illnesses. These include schizophrenia, severe depression, having highly irrational thoughts, and bipolar disorder, as well as conditions that are physically disabling for the patient. Individuals who are suicidal, whether they’re having suicidal thoughts or have attempted suicide, will also usually be treated by a psychiatrist instead of a psychologist. However, in the case of behavioral problems, mild forms of depression, anxiety, phobias, or learning difficulties, the skills of a psychologist may be the most appropriate.
- Approach You’re Most Comfortable With
The difference in the way that psychology and psychiatry approach treatment means that some people will naturally feel more comfortable with one than the other. For instance, people who are cautious about the side effects of medication or about taking medication in general will tend to gravitate toward the services of a psychologist.
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Also, treatment by a psychotherapist is usually more time intensive because it often requires weekly sessions, and sessions are normally longer than those with a psychiatrist. Psychiatrists will generally see patients for shorter sessions on a weekly or monthly schedule to focus on medication management.
Unfortunately, many people also make their decision based on their geographic location and ability to pay. Even in very rural areas, most people will have access – or at least, better access – to medication than to talk therapies. Medication is also more likely to be covered by insurance. However, there are several talk therapy options (such as online therapy) that cost about the same as insurance copays.
When you or your loved ones are going through a mental health issue, it’s important to reach out for help. Your course of treatment may involve working with a psychologist, a psychiatrist, or both. If you’re interested in talk therapy, you may want to consider a service like BetterHelp. This platform offers affordable online therapy that may be more convenient than meeting someone in person. If the idea of online therapy seems strange to you, consider reading the following reviews of BetterHelp counselors from people experiencing a range of life’s challenges.
Counselor Reviews
“My conversations with Jennifer have really been helping me grow and learn more about myself. I can tell that she is very knowledgeable as well as being very committed to her clients who truly cares about their success and well being. Jennifer has created an open, welcoming, and non-judgemental environment where I am not afraid to be myself. I would certainly recommend Jennifer to anyone interested in counseling.”
“Tara has been the most impactful counselor I’ve had. After over a year of talking with her, I have reached the point where I am able to troubleshoot my anxiety and stress on my own because of our weekly sessions. She has helped me learn how to process difficult life transitions and I couldn’t be more grateful. This platform and program has been a life saver.”
Moving Forward
Hopefully, this comparison of psychologists and psychiatrists will help you determine which is right for you. When in doubt, connect with a professional who can help you figure out which option is best. It’s always important to get the help and support you deserve.
