Video Transcript
Psychologist vs Psychiatrist
Stay-at-home mom Emily is feeling depressed and lonely after the birth of her daughter. After a few months of venting nightly to her husband, he recommends she see a counselor. Emily agrees and begins looking at options on their insurance panel. She is terribly confused as to who she should see and finds herself asking: ”What is the difference between a psychiatrist and a clinical psychologist?”
Both psychiatrists and clinical psychologists treat mental and behavioral health problems. A psychiatrist is a medical doctor who has graduated from medical school, passed the medical board exam, and completed a four-year residency in psychiatry. Psychiatrists are trained to do therapy like clinical psychologists, but many times they focus on medication management. If Emily wants psychotropic medications for depression, she would need to see a psychiatrist for a prescription and medication management. Clinical psychologists, by contrast, are not able to prescribe medications.
A clinical psychologist has a bachelor’s degree and a master’s in a psychology-related field and a doctorate or Ph.D. in clinical psychology. A doctorate degree is the highest degree in a field, so a clinical psychologist has acquired the highest possible degree in the specialty field of clinical psychology. Many clinical psychologists are required to get field experience for a year or two under the supervision of another clinical psychologist before getting licensed.
Emily was initially confused by the fact that both psychiatrists and clinical psychologists are called doctors. The difference is that a psychiatrist is a medical doctor, and a clinical psychologist is a doctor who has earned a doctorate in the field of clinical psychology.
Psychologist & Psychiatrist: Roles
Let’s now take a look at the different roles that clinical psychologists and psychiatrists take on and the differences between them.
1. Education
Medical school and a clinical psychology doctorate program are very different. Medical school and psychiatry residencies focus on the human body and brain and medicine to treat psychiatric disorders, while a doctorate program in clinical psychology is more concerned with the human mind, cognition, mental health conditions, and therapy techniques.
2. Psychotherapy
Both a clinical psychologist and a psychiatrist are trained to perform psychotherapy in the treatment of all mental health disorders in the Diagnostic Statistical Manual of Mental Disorders, in its fifth edition as of 2021 and called the DSM-V for short. In fact, because of their years of education and experience, clinical psychologists and psychiatrists are often sought out for treatment of the more serious psychiatric disorders such as schizophrenia, personality disorders, or psychotic bipolar disorder.
Because of the way the healthcare system operates, psychiatrists often focus more on diagnosis and medication management. Often psychiatrists have shorter visits with clients and patients than clinical psychologists. If a psychiatrist thinks that their client would benefit from additional therapy, they may refer their client to a clinical psychologist. The same is true for a clinical psychologist who notices that their patient or client needs medication; they will often refer the patient to a psychiatrist for dual treatment.
3. Work Environments
Psychiatrists and clinical psychologists can often be found working in private practice settings. A private practice of clinical psychologists usually has at least one psychiatrist on board for clients who need a prescription for medication. Some psychiatrists and clinical psychologists are also professors at universities. In fact, private practice may be the largest work environment for psychiatrists and clinical psychologists, but there are actually many other places of work where one would find a psychiatrist or clinical psychologist.
Psychiatrists and clinical psychologists may work in hospitals, mental health wards and hospitals, residential facilities, universities, prisons, government agencies, community assistance agencies, the military, substance abuse rehabs, employee assistance programs, retirement and assisted living facilities, etc. The list goes on; just about any environment that’s interested in treating the mental and behavioral health of clients, patients, students, employees, inmates, or residents might employ a psychiatrist or clinical psychologist.
4. Salary
On average, psychiatrists can command a higher salary because they have a medical degree, but this is not always the case. There are popular and highly sought out clinical psychologists who make more money than the average psychiatrist. According to the U.S. Bureau of Labor Statistics’ May 2019 information, psychiatrists make an average salary of $220,430 per year, while clinical psychologists make an average of $87,450. A clinical psychologist in private practice tends to have a higher salary than one in a social service or school setting.
Lesson Summary
All right, now that you know the differences between the two professions, let’s take a moment or two to review them. A psychiatrist is a medical doctor who has completed four years of residency in psychiatry. A clinical psychologist has a Ph.D., or doctorate, in clinical psychology. Both are called doctors and both treat patients and clients with mental and behavioral health conditions.
Some of the key similarities and differences highlighted in this lesson are:
- Psychiatrists can prescribe and manage medications for their clients and patients; clinical psychologists, on the other hand, can’t.
- Clinical psychologists often spend more time doing psychotherapy than psychiatrists due to the way the U.S. healthcare system is set up.
- Psychiatrists and clinical psychologists can both work in private practice settings.
- They both may work in other settings as well, including prisons, schools, hospitals, and government agencies.
- On average, psychiatrists make a higher average salary than clinical psychologists; a clinical psychologist will typically earn more money in a private practice setting than in a social service or school setting.
The three main differences between psychiatrists and psychologists are:
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Psychiatrists are medical doctors, psychologists are not.
- Psychiatrists prescribe medication, psychologists can’t.
- Psychiatrists diagnose illness, manage treatment and provide a range of therapies for complex and serious mental illness. Psychologists focus on providing psychotherapy (talk therapy) to help patients.
Many people get psychiatrists and psychologists confused with each other.
Both psychiatrists and psychologists understand how the brain works, our emotions, feelings and thoughts. Both can treat mental illness with psychological treatments (talking therapies).
However, psychiatrists attend medical school and become medical doctors before doing specialist training in mental health. Because they are doctors, psychiatrists understand the links between mental and physical problems. They can also prescribe medications.
To go into it in some more detail, the main differences relate to:
- training
- treatments provided
- conditions treated
- getting an appointment.
Training
Psychiatrists are medical doctors with at least 11 years of training – usually more.
They first do a medical degree at university. Next they spend at least 1 or 2 years training as a general doctor.
They then complete at least 5 years training in the diagnosis and treatment of mental illness.
Psychologists have at least 6 years of university training and supervised experience.
They may also hold a Masters or Doctorate level qualification in psychology. If they have a Doctorate (PhD) a psychologist can call themselves ‘Dr’, but they are not medical doctors.
Clinical psychologists have special training in the diagnosis and treatment of mental illness.
Treatments provided
Psychiatrists can provide a wide range of treatments, according to the particular problem and what will work best. These include:
- medication
- general medical care, including checking your physical health and the effects of medication
- psychological treatments
- brain stimulation therapies such as electroconvulsive therapy (ECT).
Psychologists focus on providing psychological treatments.
Conditions treated
Psychiatrists tend to treat people who need their medical, psychological and social needs considered.
These are usually people with complex conditions, for example:
- severe depression
- schizophrenia
- bipolar disorder.
Someone who has attempted suicide or has suicidal thoughts will usually be seen by a psychiatrist.
Psychologists are more likely to see people with conditions that can be helped effectively with psychological treatments. This might include behavioural problems, learning difficulties, depression and anxiety.
Getting an appointment
As with all medical specialists, to see a psychiatrist you need a referral from your GP (family doctor).
To see a psychologist you don’t need a referral. However, in Australia a GP can refer you to a psychologist as part of a Mental Health Treatment Plan.
There are around 4000 psychiatrists working across Australia and New Zealand, while there are about 27,000 registered psychologists.
Working together
Psychiatrists and psychologists often work together. A psychiatrist might make an initial assessment and diagnosis, then refer you to a psychologist for ongoing psychological treatment (talking therapy).
Psychiatrists and psychologists also work together in hospitals as part of mental health teams.
Who should I see?
If you are unsure whether you should see a psychiatrist or a psychologist, talk to your GP. They can give you advice about whether a psychiatrist or a psychologist is right for you.
It will depend on your unique situation and the type of treatment you need. Some people might see both.
More about first steps to get help
More about psychiatrists
What Do Psychologists Do?
Psychologists receive education and professional training to research and apply assessment and treatment methods to help people cope with a variety of cognitive, emotional, behavioral and interpersonal problems. Within the field of psychology, there are several specialties, including clinical psychology, educational psychology, and neuropsychology.
These particular aspects of psychological study are also divided between research and the application of research. That is to say, some psychologists do active research studies, while perhaps also teaching or operating institutes that focus on advancing new ideas in psychological practice. Some psychologists work in applied fields, meaning they directly use what has been studied and published to help people improve their lives.
A few psychologists will work within both areas, either at the same time or at different points in their careers. For our purposes here, we will examine psychologists who work in applied clinical areas, known as clinical psychologists.
Clinical psychologists often earn doctoral degrees, which are typically either a PhD (Doctor of Philosophy in psychology) or a PsyD (Doctor of Psychology). Between postgraduate education and internships, etc., clinical psychologists spend an average of about seven years in training. Their applied clinical skills can include psychological testing and assessment and psychotherapy methods.
Clinical psychologists are licensed and regulated by state boards after they pass a national exam along with their state’s exam. Once they are licensed, psychologists must maintain their licensure through ongoing professional education. Clinical psychology interns who are working towards earning a license are permitted to practice under the supervision of a licensed psychologist. In some places, psychologists may be available to prescribe medications.
Psychologists with the proper education and credentialing can be given authority to prescribe psychiatric medications in Iowa, Idaho, Illinois, New Mexico, and Louisiana, as well as in the Public Health Service, the Indian Health Service, the U.S. military and the territory of Guam. Psychologists who are permitted to prescribe must have advanced training for this purpose or a master’s degree in psychopharmacology, which is the study of psychiatric and other related medications and their effects.
Clinical psychologists can be found in a variety of settings. They often work in outpatient facilities or offices, either as solo practitioners or as a part of a group practice or through telemental health (video conferencing). They also may practice in hospitals, health clinics, schools and universities, rehabilitation centers, community agencies or for businesses and industry. They may work with individuals, couples, families, or groups. They may also provide services for specific segments of the population, such as children and adolescents, veterans, LGBTQ persons, people with learning disabilities, or elderly persons.
Psychologists sometimes focus on specific problem areas, including substance abuse, depression and anxiety, posttraumatic stress disorder, chronic pain, brain injuries, and many others. In short, psychologists can help people from all kinds of backgrounds, with a variety of methods and tools to address the cognitive, emotional, behavioral, social and interpersonal problems that people can suffer in modern life.
Clinical psychologists are trained in psychometrics, which is the study and application of psychological testing. These tests include measurements of IQ and achievement, personality inventories, neuropsychological tests, employment and safety tests, attitude tests, personal interest inventories, screenings for certain psychological disorders, and many others.
Psychologists may meet with an individual and assess for which tests would be appropriate, or may use a battery of tests with which they feel most comfortable under certain circumstances. It may be important to note that not all psychologists use tests in every situation. But many agree that testing can be very helpful in making decisions about a person’s mental health diagnosis or outside of treatment, as in hiring individuals for high-risk occupations.
Psychologists generally agree that psychological tests do not completely offer an exact picture of an individual, their possible treatment needs, or whether or not they would be good candidates for a particular job. Instead, these instruments can provide additional and supportive information in connection with professionally performed interviews, especially for clinical purposes.
In the case of a psychologist assessing an individual’s treatment needs, psychological tests can help reveal such things as the deeper aspects of a person’s fears, personality issues, and the particular ways they may see themselves and the world around them. The information provided to the psychologist from those testing instruments can aid in providing a diagnosis, but perhaps more importantly, alert the provider of psychotherapy services to look for specific problem areas as the treatment progresses.
Understandably, some people might find psychological testing and the overall assessment process a bit intimidating. It may seem like you just answer a lot of questions and respond to items without knowing what it will ultimately say about you and how that information might be used.
Clinical psychologists can explain the testing and assessment process thoroughly before the assessment begins, along with providing informed consent documents that can be read and clarified, so that individuals know exactly where the information is going, who will see it, and how it will be used. These consent forms allow individuals to provide authorization before testing can proceed. When people are apprised of the reasons and the specific purpose of psychological testing, they tend to cooperate freely, and sometimes even find the process interesting and informative.
As mentioned earlier, not all individuals who seek mental health treatment are subject to psychological tests, but clinical psychologists may decide to use these instruments if needed. In any case, psychologists who provide assessments will conduct a clinical interview for the individual, or for a couple or family who need relationship therapy.
The structure of a clinical interview can vary depending on the psychologist, the particular individual(s), and the situation at hand. But essentially, clinical interviews offer opportunities for clinical psychologists to understand the persons involved, their personal, health and family histories, specific symptoms or problems they’re struggling with, and any other questions or issues that are relevant to their needs. It’s also often an opportunity for patients, or their families or caregivers, to ask their own questions about what the psychologist is perceiving about them and their circumstances, and what they may expect about treatment going forward.
As the assessment process finishes, clinical psychologists provide conclusions based on their evaluations, and use their training and experience to form a clinical diagnosis (if appropriate) and other ideas to shape a mental health treatment plan. An important part of training in clinical psychology involves psychopathology, or the study of mental disorders.
Psychologists know how certain behaviors or other information and data they receive can be used to classify particular disorders that may apply to individuals. Formulating a diagnosis helps the treatment professionals involved to know specifically what they are dealing with, and can better plan and anticipate the needs of people in their treatment programs.
One important document used in formulating a diagnosis is called the DSM-5, which stands for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. This large book holds just about every known psychological disorder, the symptoms of each one, and how to tell one disorder apart from another. Psychologists can inquire about specific symptoms and match those with disorders listed in the DSM-5 to create the most accurate diagnosis.
However, even with all of the tools available to a clinical psychologist, an initial diagnosis may not be entirely clear, or for that matter, all information from the individual may not be immediately available. For example, people with certain disabilities or language and cultural differences may require more time or assistance to complete the assessment process. If so, psychologists can provide initial findings and impressions with caveats to allow for more information as it becomes available.
The total package of information from the initial evaluation can be used for the emerging treatment plan. If the clinical psychologist is a part of the treatment team, then he or she will retain that information for their purposes. But whether or not the psychologist is providing treatment, they will share their findings with any other member of the treatment team, including a treating psychiatrist.
Clinical psychologists themselves can use any number of therapies in which they have specific training and expertise. The most common of these therapies is psychotherapy, which is talk-based, and can involve individuals, couples, families, or groups. In this case, the psychologist may also be referred to as the “therapist” or “psychotherapist.”
Among clinical psychologists who provide therapy, there are often many different approaches and techniques that are used to meet different clinical demands. These include psychodynamic therapy, cognitive behavioral therapy, psychoanalysis, dialectical behavioral therapy, emotionally focused therapy, existential therapy, and several others. Certain psychologists may also provide other psychological treatments such as hypnosis or EMDR (Eye Movement Desensitization and Reprocessing).
Psychotherapy patients often wonder which type of therapy approach is best. And certainly, there can be a lot of controversy among therapists themselves as to what works best. But studies have shown that the type of therapy used is less important to an individual’s overall improvement in well-being than the particular therapist providing the therapy. Thus, no matter what kind of technique is used, it’s the fundamental quality of the therapist and the sense of rapport between therapist and patient that usually determines the best results.
There is no doubt that qualifications, training, and experience are important factors when choosing a therapist for yourself or your loved-one. Understanding their specialties and how they typically provide their services is also helpful in making an informed choice on who you will be entrusting with your mental health care. But it is also important to establish a good sense of connection and affinity for that professional. You may not necessarily experience that immediately with a therapist, but soon enough, having a solid measure of confidence in that therapist will promote successful therapy along the process.
Good therapists, including clinical psychologists, understand this principle, and should invite patients and those who are considering therapy to express openly their concerns about therapy, and promote honest feedback about how the therapist is doing as treatment goes forward.
