Definitions are in order for these three designations: social worker, psychologist and psychiatrist. How else will you know the answer to ‘Who ya gonna call?’ Recently the local newspaper had a front page article in the “Your Health” section called “No Room On the Couch.” I was quite happy to see this coverage, especially in light of the opioid epidemic. And I am going to say right up front there are no easy answers to this problem. The mental health profession can be draining and not particularly financially rewarding compared with other medical endeavors, but the job is unique in its reward system. By that I mean it is always interesting and challenging, and the joy received from seeing an individual make connections that lead them to live better lives is hard to describe. I get to see the lights go on! So, on to definitions, and how to decide who to call for what.
Social Worker*, Psychologist and Psychiatrist: Defined
Social Worker, MSW, LCSW
Social workers attend graduate school, usually for a two year program, and must complete an additional 2-3 years of supervised practice, and pass a national exam to achieve licensure, designated by the letters “LCSW.” In North Carolina, they must also complete 40 classroom and/or online hours of additional training every two years. LCSW stands for Licensed Clinical Social Worker. Licensed Clinical Social Workers are specifically trained to perform psychotherapy, or ‘talk therapy.’ These mental health professionals do most of the heavy lifting in terms of 1:1 counseling in all sorts of arenas: addictions, couples counseling, anxiety of all types, depression, trauma, gender identity, etc. The primary reasons LCSW’s do most of the talk therapy, IMO, is that we are the least expensive and most available for appointments of the three categories discussed here, and we are licensed to accept insurance if we choose to do so. This will not be a popular opinion, I can assure you, but I believe it to be true. It certainly does not mean you would be shortchanged by electing this option, far from it. LCSW’s literally get the most practice at listening and sussing out what may best help a person sort out their emotions, stories, and misconceptions. We know how to hold a safe emotional space for you.
Psychologist
Psychologists attend graduate school in psychology. The American Psychological Association recognizes the doctoral degree as the minimum educational requirement for psychologists; these degrees include the Ph.D. (Doctor of Philosophy), Psy.D. (Doctor of Psychology), or Ed.D. (Doctor of Education). Some states allow people with Master’s degrees in psychology to use the term “psychologist.” Graduate training focuses on all aspects of human behavior, with an emphasis on research and scientific methods. In some states, they can prescribe medications, but this is usually left to MD’s, Psychiatrists (who are MD’s) or Psychiatric Nurse Practitioners. Psychologists are good at testing for categories in which they specialize such as ADHD, Learning Disabilities, or mental competency. They are often called on to provide documentation for individual school education plans known as “IEP’s.” They also do talk therapy, but generally tend to have less availability for this purpose due to the time demands of evaluation, psychological testing, and writing reports to summarize their tests. A good psychologist can be invaluable to getting the right school/work accommodations for your child.
Psychiatrist
Psychiatrists attend medical school and earn an M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathic Medicine) degree. They can go on for additional, specialized training in psychiatry during a residency (an additional 3-4 years). Training for psychiatrists focuses primarily on biological (vs emotional or mental) aspects of mental illness. Because of their medical training, psychiatrists can prescribe medications, and their work with clients may include talk therapy combined with medications. In the real world, they have very limited time for talk therapy because of their deep knowledge of psychiatric medications and the responsibility for prescribing the most appropriate medications. You will often sea psychiatrist for less than 15 minutes for medication management. An initial appointment can be difficult to obtain, and it is typical to have to wait for a couple of months or more to get in the door. As the referenced article above states, there is a shortage, and often practices are not taking new patients. Even more importantly, it is likely that the psychiatrist’s time is consumed by the most severe cases. In this area, the psychiatrist in the article mentioned that 50% of his cases involve opioid addiction.
*There are other types of licenses for various marriage and addiction counselors not discussed above for the sake of brevity, and because the ones mentioned are predominant in North Carolina, where I practice.
So to sum up:
- See a social worker (LCSW) for counseling.
- See a psychologist for in-depth testing for a specific issue.
- See a psychiatrist for severe disorders and medication management.
- But, you can also see a psychiatric nurse practitioner (NP’s) for med management, or your primary care physician.
P.S. I’m a big fan of psychiatric NP’s–they rock. And they know their meds.
If you need help sorting out what’s bothering you, call me or shoot me an email. I’m in your neighborhood and ready to help.
Psychologist Vs. Social Worker
Although social workers and psychologists are both in the helping profession and offer counseling services, there are some differences between the two careers.
A general social worker helps clients cope with human rights, socio-economic, legal and/or poverty issues. A clinical social worker, on the other hand, provides supports services to clients with emotional, mental and/or behavioral issues.
Clinical social workers usually works in a hospital, clinic, skilled nursing facility or private practice. They typically utilizes a multi-faceted therapy approach, with a focus on helping clients improve their emotional, physical and/or financial status.
On the flip side, a psychologist focuses on human behavior and examines how the human mind functions. In other words, a psychologist explores why people think and behave the way they do.
The main function of a psychologist is to diagnose and treat a variety of mental health and emotional problems. Psychologists typically specializes in one particular area such as: elderly, children, couples or families.
Education
Both a social worker and a psychologist are required to have a bachelor’s degree or higher to practice, but there are some differences in the type of degree needed to practice in each profession.
Social Work
A social worker must have a master’s degree in social work to practice as a social worker. Although it is not required to have a bachelor’s degree in social work, it is important to take courses in sociology, psychology and economics before graduating from an undergraduate program.
Social workers also have to be licensed before offering clinical services to clients. A social worker must successfully complete at least 3,000 hours of clinical supervision and pass the licensure exam to be classified as a licensed social worker.
Psychology
A psychologist, on the other hand, must have a doctoral degree (Ph.D., Psy.D. or Ed.D.) to practice. It is not required to major in psychology in order to enter a graduate psychology program.
Once the psychologist has successfully received his/her master’s degree in a psychology-related area, he/she must obtain a doctoral degree in psychology, complete a supervised internship (in psychology) and pass a licensure and/or certification exam.
Social Worker Responsibilities
General social workers provide support services to clients experiencing financial, physical, emotional, mental and/or legal hardships (U.S. Bureau of Labor Statistics). They help clients obtain childcare services, living assistance, health care and/or welfare benefits.
Clinical social workers, also known as licensed clinical social workers, tend to help clients receive more clinical services such as counseling and/or therapy.
A clinical social worker treats a variety of emotional, mental and behavioral disorders like depression and anxiety. When appropriate, a social worker refers clients to mental health specialists like psychologists and/or psychiatrists.
According to the U.S. Bureau of Labor Statistics, the main goals of clinical social workers are: to create treatment plans and provide counseling to individuals, families, couples, children and/or groups. They typically collaborate with other health professionals (such as: physicians, psychiatrists, psychologists and nurses) to support the client’s emotional, physical and mental health.
Psychologist Responsibilities
Psychologists study, examine and document how people respond and relate to each other and the world around them. A clinical psychologist may interview clients, order diagnostic tests, administer personality, performance and/or intelligence assessments and/or provide counseling services (such as: behavior modification programs, cognitive-behavior therapy, etc.).
It is important to note that only two states: Louisiana and New Mexico allow clinical psychologists to prescribe medications to clients.
According to the American Psychological Association, most psychologists split their time between conducting research studies, teaching and providing counseling services/psychotherapy.
When practicing, a psychologist’s main responsibility is to utilize a variety of psychological techniques and methods (interviews, observations and/or psychological tests) to assess and treat the client’s emotional and psychological issues.
Once the psychologist has diagnosed the client, he/she develops a treatment plan specifically tailored to the client’s needs. The psychologist may collaborate with other health professionals (like a clinical social worker) or he/she may work alone.
If the psychologist does not feel that he/she can provide the services that the client needs, he/she refers the client to another healthcare professional like a social worker, specialized psychologist, psychiatrist, etc.
Similarities & Differences
There are many similarities between social workers and psychologists. For instance, both provide counseling/supportive functions to the clients.
Social service agencies like child protective services tend to hire people with sociology, social work or psychology degrees to perform the same or similar tasks.
In addition, most graduate and doctoral programs train social work and psychology students in the same or similar manner.
In other words, clinical social workers offer many of the same counseling/support services as clinical psychologists. The majority of clinical social workers and clinical psychologists use a variety of psychological techniques to assess, diagnosis and counsel individuals, children, couples, families and groups.
The main difference between psychologists and social workers is that psychologists are also are trained to administer psychological tests (like intelligence and personality assessments), while social workers are not.
In addition, psychologists tend to have a slightly different perspective of the therapeutic process. They tend to focus more on cognitive processes and behaviors then social workers.
Social workers provide social service resources to clients (food stamps, welfare benefits, etc.), while psychologists provide mental health services (counseling and therapy) to clients.
As mentioned previously the lines between social work and psychology are often blurred so it is possible for both social workers and psychologists to perform the same or similar duties.
Moreover, both social workers and psychologists tend to work in the same settings (private practices, educational institutions, mental health facilities, hospitals, clinics, skilled nursing facilities and community centers), but psychologists can specialize in other areas besides clinical and general psychology (like marriage and family therapy, corporate psychology, school psychology, sports psychology or health psychology).
On the other hand, social workers tend to be classified as general social workers or clinical social workers with an emphasis on children, individuals, families, couples and/or groups.
Lastly, psychologists, unlike general social workers, have more opportunities to teach graduate studies and conduct research studies.
