What’s in a name? The differences between the “psychs”: psychotherapists, psychologists, and psychiatrists

If I had a dollar for every time I’ve been asked if I can prescribe medications I’d be bathing in champagne, Mariah Carey style. But I totally get it. There are a lot of mental health terms that sound alike; add in different things like certifications, licenses, etc., and it can get really confusing. So here’s a handy little list of who’s who in the mental health world:

  • Psychotherapist=Also called therapists or counselors, psychotherapists are mental health professionals with a Master’s degree or higher who provide psychotherapy to individuals, groups, and/or families. In addition to the advanced degree, all licensed psychotherapists must have passed a certification exam, registered with their state’s supervisory board, and completed at least 2,000 hours of supervised therapy. All licensed therapists are able to diagnose and treat mental illnesses but none of them are allowed to prescribe medications. There are three main “flavors” of psychotherapist but they all have similar foundational training:
    • LPCs (Licensed Professional Counselors) have a pretty all-encompassing counseling education which includes treatment of individuals, families, and groups.
    • LMFTs (Licensed Marriage and Family Therapists) have more training in couples and family therapy.
    • LCSW (Licensed Clinical Social Worker) training tends to be more focused towards treating folks in clinical, health, or agency settings.
    • Additionally, be aware that in some places, like Colorado, someone with zero education in counseling/therapy/psychology can call themselves a psychotherapist as long as they pay a fee and register themselves with the state Department of Regulatory Agencies. As you may imagine, this is not the route I’d generally recommend going if you are looking for a therapist.
  • Psychiatrist= Psychiatrists are physicians who have completed medical school and then received an additional 4-7 years training in psychiatry (a residency and a fellowship). They are medical doctors and will either be an M.D. or a D.O. (Doctor of Osteopathy). These guys are the ones who typically prescribe psychotropic (mental health) medications and unfortunately these days this is often their main job. Gone are the days where people would receive counseling sessions along with their prescriptions; more often what will happen is that you’ll get your prescription from a psychiatrist and then they’ll refer you to a counselor for therapy.
  • Psychologist= A psychologist has a doctorate in counseling or psychology, will have passed their licensing exam, and be registered with their state supervisory board. Some specialty areas of psychology, like neuropsychology, require that the individual has also completed a fellowship in their specialty. Additionally, there are a few states where psychologists can prescribe mental health medications once they’ve completed training in this.

*There is currently a nationwide shortage of psychiatrists, so it’s becoming more and more common for people to have mental health medications prescribed by their family/general practice doctor instead (or their pediatrician, if it’s for a kid). Psychiatric Nurse Practitioners are also becoming more common; these are nurses who have at least a Master’s degree as well as special training in mental health. *

So there you have it, the general differences between psychotherapists, psychiatrists, and psychologists. Of course, there are a few extra folks in the mental health field such as CACs (Certified Addictions Counselors), school psychologists, and psychiatric technicians who play super important roles, but these are the main players. Feel free to get in touch if you have more specific questions!

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