By Charletta Dennis, M.D., CCHP | Medical director of behavioral health at Priority Health with Board Certification in Psychiatry and Forensic Psychiatry
Choosing who to see for your mental health concerns can feel overwhelming, but it doesn’t have to be complicated.
When your mental health or a loved one’s is at stake , you want to make the best decision possible about the care you receive. However, that determination can be complicated by the seemingly endless options available — not only when it comes to choosing who to see, but choosing what kind of mental health professional is right for your situation.
Psychiatrist, psychologist and therapist are likely familiar terms, but what does each type of mental health provider actually do and what does that mean for you? We break it down below so you can choose the best path for you with ease and confidence.
Psychiatrist vs. Psychologist vs. Therapist: The quick answer
Psychiatrists, psychologists and therapists are all licensed mental health providers, though there are a few differences to keep in mind.
Psychiatrist
A psychiatrist is a physician — either a medical doctor (MD) or a doctor of osteopathic medicine (DO) — who specializes in psychiatry. According to the American Psychiatric Association, their approach includes assessments of both the mental and physical aspects of psychological problems.
“Psychiatrists are physicians who train like other physicians. They attend medical school and the training is based in medical practice,” says Dr. Charletta Dennis, medical director of behavioral health at Priority Health and a practicing psychiatrist and forensic psychiatrist.
Psychiatrists are qualified to diagnose patients, prescribe medications and provide psychotherapy (talk therapy), psychosocial interventions and other types of therapy treatments. Think of them like you would any other physician specialist. They are equipped to provide care for the most complex mental health conditions.
Psychologist
Unlike psychiatrists, psychologists are not medical doctors. They typically have a doctoral degree such as a PhD, PsyD or EdD. According to the American Psychological Association, psychologists are qualified to diagnose patients and use evidence-based psychotherapy to address short-term, long-term and chronic mental health conditions. While most psychologists are not qualified to prescribe medications themselves, they can work with primary care providers, pediatricians and psychiatrists to get patients the medications they need. They are equipped to provide care for severe and long-term mental health conditions.
“A key distinction between a psychiatrist and a psychologist is that a psychiatrist attends medical school while a psychologist attends a doctoral program,” Dennis says.
While a psychologist may be referred to as a therapist informally, you can check their credentials to gain a better understanding of their training and capabilities.
Therapist
Therapists undergo different education and training than a psychiatrist or psychologist, generally requiring a master’s degree in counseling, social work or psychology. They are qualified to provide talk therapy to manage mental health conditions such as anxiety or depression with healthy coping strategies. In addition, therapists can work with individuals, couples or families to help process trauma, navigate major life transitions or to better understand how past experiences influence current thoughts, emotions and behaviors. They are equipped to provide care for moderate short-term and long-term mental health conditions.
“A therapist can be a social worker, a psychologist or a limited licensed clinician,” Dennis says. “They can see people on a continuum as well.”
Understanding the nuance
When it comes to who can support and treat your mental health, it depends on severity and specific needs. It’s common for someone just entering a mental health care setting to start off by seeing a therapist.
“Someone who has mild symptoms of anxiety, depression or even bipolar disorder with some impairment in their ability to function at home, work or at school may seek out a therapist to understand what’s going on and to start psychotherapy,” Dennis says. “Not all illnesses require medication in the early stages or when symptoms are mild. If a person sees a therapist, that therapist may refer them to a psychologist or psychiatrist if they need specialized treatment.”
Seeing a combination of providers
Sometimes people may see a combination of these professionals as part of a collaborative care model. For example, someone who has both autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD) may see a psychiatrist for medications to manage their ADHD while also seeing a specialized psychologist or therapist for long-term behavioral and emotional support so they are better able to navigate social settings.
What does a psychiatrist do? (And when to see one)
While psychiatrists provide talk therapy as part of their practice, a primary role is to diagnose patients and prescribe medications as needed to treat a variety of mental health conditions. If someone is experiencing a serious or complex mental health concern, a psychiatrist can help them to identify the condition through medical and psychological tests in addition to discussions with the patient.
A psychiatrist is the best fit for you if you have mental health concerns that likely require medication, such as anxiety, depression, obsessive-compulsive disorder, certain eating disorders, borderline personality disorder, bipolar disorder, schizophrenia or several other mental health conditions. Essentially, if your symptoms and the behavior caused by those symptoms are having a major impact on the way you function in life or the way you perceive reality, then seeing a psychiatrist is appropriate. They are also the best equipped to provide care for co-occurring conditions such as anxiety and ADHD.
It’s important to know that psychiatrists can have specialized training in areas such as substance use disorders or child and adolescent psychiatry, so keep that in mind when looking for a provider.
What does a psychologist do?
A psychologist can do some of the same things as a psychiatrist, except they aren’t a medical doctor and cannot prescribe medication unless they have the credentials to do so. However, they also undergo years of additional education and training to provide psychotherapy.
There are two types of psychologists to know about: clinical psychologists and counseling psychologists. Both take a talk therapy–based approach rather than a medication-based or combined approach. The major difference between them is that a clinical psychologist typically handles more serious mental health concerns than a counseling psychologist does.
While many psychologists have several different therapy techniques within their toolbox, some specialize in specific talk therapy approaches such as:
- Cognitive behavioral therapy (CBT): Treats mental health concerns such as anxiety disorders, depression, OCD, eating disorders, substance use disorders and post-traumatic stress disorder (PTSD)
- Acceptance and commitment therapy (ACT): Treats mental health concerns such as anxiety disorders, depression, substance use disorders, OCD, eating disorders, stress and chronic pain
- Eye movement desensitization and reprocessing (EMDR): Treats mental health concerns such as anxiety disorders, depression, trauma, PTSD, grief and phobias
- Dialectical behavior therapy (DBT): Treats borderline personality disorder, self-harming behaviors, eating disorders, substance use disorders, bipolar disorder and suicidal ideation
While not an exhaustive list, these types of therapy approaches are common. It’s important to remember it can take trial and error to find the therapy approach that works best for you.
Therapist, counselor, social worker: What’s the difference?
Therapists, counselors and social workers are all licensed to provide mental health care for mild to moderate mental health concerns. However, their goals and settings are different.
Therapist
Therapists are the most common type of mental health professional. They provide long-term talk therapy treatment and may use a specific therapy approach in their practice, such as EMDR. Therapists may work with individuals, couples and/or families.
A therapist’s goal is to work with clients to more deeply understand their behaviors and emotions and to provide coping mechanisms to navigate difficult situations and strategies to overcome unwanted behaviors, thoughts and feelings. They can also help clients work through anxiety triggers, trauma, daily stress and relationship issues.
Counselor
Counselors are similar to therapists but rather than long-term care, they usually offer structured, short-term support with a specific goal in mind. Counselors use talk therapy and other resources to provide specialized help for substance use disorders, career guidance and a variety of mental health conditions.
Counselors usually need a master’s degree and supervised clinical hours, but each state has its own licensing requirements. According to the American Counseling Association, you can find counselors in schools, employee assistance programs, government agencies, rehabilitation centers and prisons in addition to their own private practices.
Social worker
What differentiates social workers from therapists and counselors is that they are more focused on the impact families, communities and systems have on a person’s well-being. Social work requires a Bachelor of Social Work for entry-level positions and a Master of Social Work for clinical roles. If a social worker wants to provide therapy services, then they must complete additional education and licensing.
Social workers’ main goal is to connect individuals and families with community resources; access to housing, food and healthcare; and social services. They take a holistic approach by helping people improve their mental health while also connecting them with the resources they need to improve the external circumstances that may be contributing to mental health concerns.
Who can prescribe medication? Credentials compared
Psychiatrist – Yes
A psychiatrist is a medical doctor and therefore qualified to prescribe medications. However, Dennis explains that if symptoms are severe to the point that your life is being impacted or if your depression or anxiety is so severe that the symptoms are unmanageable by a primary care physician, then your doctor will likely refer you to a psychiatrist for medication management.
Psychologist – Maybe
Most psychologists have a doctoral degree such as a PhD, PsyD or EdD, or a master’s degree and are therefore unable to prescribe medications.
Licensed psychologists in nine states are allowed to prescribe certain medications (mostly for anxiety and depression) after undergoing additional, specialized training, an exam and certification. Those states are Colorado, Hawaii, Idaho, Illinois, Iowa, Louisiana, New Mexico, Utah and Vermont. Michigan currently does not allow psychologists to gain a certification to prescribe. If you’re interested in seeing a psychologist in these states who can prescribe medication, make sure to check they have the appropriate certification for the state in which you’re located.
Non-certified psychologists in those states and all psychologists in other states will work with a primary care physician or psychiatrist who can handle the prescription side of treatment if needed.
Therapist – No
Therapists do not have the credentials required to prescribe medications. Therapists, counselors and social workers are not doctors and there are no state-specific laws enabling them to prescribe. Instead, they typically have a master’s degree in marriage and family therapy, clinical mental health counseling or social work.
Who should you see first? A simple decision guide
Choosing which type of provider to see isn’t an exact science. Even providers within each type of role have different approaches to therapy. That said, there are a few questions you can ask yourself when deciding which type of provider to see that should point you in the right direction.
- How severe is your mental health concern?
If you’re experiencing visual hallucinations, voices in your head, major depressive episodes, hopelessness, frequent panic attacks, trouble concentrating, manic episodes, other worsening symptoms or a combination of any of these, then it’s time to see a psychiatrist.
If you’re experiencing persistent emotional distress that impacts your ability to function, then a psychologist or psychiatrist is likely the best choice.
If you have mild to moderate anxiety, depression, PTSD or trauma or unhealthy coping habits, behavioral concerns, difficulty navigating social situations, emotional distress that interrupts your routines or are struggling with a major life change or relationship, then a therapist or psychologist is likely the best option for you. - Do you need medication?
Psychiatrists are the only mental health profession licensed to prescribe all types of mental health drugs in all 50 states. Only certified psychologists in certain states can prescribe medication, while therapists are unable to prescribe.
However, psychologists and therapists can work with primary care providers to connect clients with a doctor who can prescribe certain medications. For more severe mental health conditions, a psychologist will need to refer a client to a psychiatrist. - What are your goals?
If your goal is to get your mental health condition under control with a combination of medication and talk therapy, then seeing a psychiatrist is likely the best option. They can provide psychotherapy treatment while helping you find the medication that works best for your needs.
If your goal is to receive treatment for a moderate or long-term mental health condition without medication, then consider a psychologist or therapist. Either can provide you with the resources and tools needed to better manage a variety of mental health conditions and behavioral problems.
If your goal is to more deeply understand your behavior, emotions, motivations and thoughts to create healthier coping habits and better navigate certain situations, then a therapist is likely the right choice for you.
Dennis recommends you start by setting up an appointment with your primary care physician. They can likely refer you to an appropriate mental health provider within your healthcare plan network.
If you don’t have a primary care doctor, any behavioral health clinic will more than likely have resources available to connect you with a therapist, psychologist or psychiatrist. You can even reach out to your behavioral health care coverage provider for help finding the right care.
Seek immediate emergency help if you’re experiencing suicidal thoughts or thoughts of harming yourself or others. If you live in the U.S., call or text 988 to contact the 988 Suicide & Crisis Lifeline. You can find their chat function here. You can also go to your hospital’s emergency department. Oftentimes they can consult with psychiatrists, psychologists and therapists.
How to find an in-network mental health provider with Priority Health
If you have a Priority Health plan, first check to see what kind of mental health coverage your plan provides. You can call 800.673.8043 (TTY 711) to chat with Priority Health staff and gain a better understanding of your benefits and treatment options. The behavioral health team also is available 24/7 to provide crisis support. More information about Priority Health’s mental health services can be found here.