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What is a psychotherapist vs a psychiatrist

Thinking about seeing a therapist but confused about all the different titles? Psychiatrist, psychologist, psychoanalyst, psychopharmacologist, psychotherapist — that’s a lot of psychos! Many people are perplexed by the preponderance of “p-words” in the mental health profession.

So, as Richard Nixon used to say, let me make things perfectly clear. (Admittedly, Richard Nixon was not the best person to turn to on issues of mental health — or clarity.) Here is a (remarkably incomplete) guide to the world of the mind:

Psychotherapist — This is an umbrella term for any professional who is trained to treat people for their emotional problems. Depending upon their academic degree, a psychotherapist can be a psychiatrist, psychologist, or social worker (among others), and work with individuals, couples, groups, or families.

Psychiatrist — This person has a medical degree and, unlike most psychotherapists, can prescribe psychotropic (psychiatric) medication. Many psychiatrists -— referred to as psychopharmacologists — provide only prescriptions and medication management; you would need to see a psychotherapist additionally for talk therapy. Traditional psychiatrists continue to practice psychotherapy.

Psychologist — This person has a Ph.D. in psychology. In addition to performing talk therapy, they have training in psychological testing (i.e., the Rorschach test, among others). They can also perform research protocols. (Psychologists who concentrate on research generally work in academic or research settings.) Some psychologists who are trained specifically to do clinical work (rather than research) have “PsyD” (Psychology Doctorate) as their academic degree, rather than Ph.D.

Social Worker — When people hear “social worker,” they think of professionals who provide social services in hospitals and agencies. However, some social workers also practice psychotherapy. Their education is somewhat similar to that of a psychologist (although they may have only a master’s degree), but they are usually more attuned to the individual in their environment, and they do not provide psychological testing. Depending upon the state in which they are licensed, social workers may be LCSWs (Licensed Clinical Social Worker), LICSWs (Licensed Independent Clinical Social Worker), LSWs (Licensed Social Worker), among an alphabet soup of titles.

Psychoanalyst — After receiving a professional degree, some psychotherapists go on to extensive special training in this in-depth therapy modality that helps people get to the root of their problems. Psychoanalysis, as first invented by Sigmund Freud, is the only method that works with the unconscious — motivations and defense mechanisms that are out of our awareness, and therefore cause us to repeat harmful patterns. The couch, free association, dream analysis, and transference (originally defined as the patient transferring his or her feelings toward their parents onto the analyst), are all exclusive tenets of psychoanalysis. The unfortunate stereotype of the silent therapist who only wants to talk about people’s childhoods (rather unfairly) comes out of this model.

Today, many psychoanalysts are drawn to more contemporary models that build on, but also greatly diverge from, Freud’s original thinking. These therapists — sometimes known as “relational analysts” — are more active and interested in people’s current-day problems and how they are influenced by past experience. We look at how people interact with others in ways that only reinforce existing fears and patterns, and we look to create new experiences and ways of seeing oneself, including within the therapeutic relationship. Contrary to the stereotype, psychoanalysts do give advice and opinions, but we also do much more than that.

Traditionally, psychoanalytic patients came to sessions at least three times a week and lay on the couch. Today, many people in psychoanalytic (or psychodynamic) psychotherapy attend only once or twice a week. The couch is optional; some relational analysts never use it at all. Psychoanalysis differs from other forms of psychotherapy (like cognitive-behavioral therapy) in that it is more comprehensive and emphasizes getting to the bottom of problems, rather than simply alleviating symptoms.

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Differences between psychology, psychiatry and psychotherapy

This page explains the significant differences between roles in psychology, psychiatry and psychotherapy.

Staff working in these roles tend to deal with different types of problems, although there is also considerable overlap in their work.

Male psychologist with patient

Below is a brief description of each of the different areas.

Psychology is the study of people: how they think, how they act, react and interact. It’s concerned with all aspects of behaviour and the thoughts, feelings and motivation underlying such behaviour.

Psychology is a discipline that is firstly concerned with the normal functioning of the mind and has explored areas such as learning, remembering and the normal psychological development of children. It has been one of the fastest growing university subjects and is increasingly available in schools and colleges.

Psychologists are not usually medically qualified and only a small proportion of people studying psychology degrees will go on to work with patients.

Psychologists can specialise in a number of areas, such as mental health and educational and occupational psychology. In healthcare, psychologists specialise in clinical, counselling, forensic or health psychology.

Psychological therapy roles

There are also roles using psychology for other staff, including assistant psychologists, psychological wellbeing practitioners and high intensity therapists

Psychiatry is the study of mental health problems and their diagnosis, management and prevention. Psychiatrists are medical doctors who have qualified in psychiatry. They often combine a broad general caseload alongside an area of special expertise and research.

Psychotherapy is conducted with individuals, groups, couples and families. Psychotherapists help people to overcome stress, emotional and relationship problems or troublesome habits.

There are many different approaches in psychotherapy, or talking therapies, which include:

  • cognitive behavioural therapies
  • psychoanalytic therapies
  • psychodynamic therapies
  • systemic and family psychotherapy
  • arts and play therapies
  • humanistic and integrative psychotherapies
  • hypno-psychotherapy
  • experiential constructivist therapies

A psychotherapist may be a psychiatrist, psychologist or other mental health professional, who has had further specialist training in psychotherapy. Increasingly, there are a number of psychotherapists who do not have backgrounds in the above fields, but who have undertaken in-depth training in this area.

Medical psychotherapists are fully-qualified doctors who have qualified in psychiatry and then undertaken a three or four-year specialist training in psychotherapy. Their role is in the psychotherapeutic treatment of patients with psychiatric illnesses.

Therapists vs. Psychiatrists

Therapists and psychiatrists both focus on treating mental health disorders and the associated symptoms, but they go about it in different ways. The most distinct difference is that psychiatrists have a medical degree and can prescribe medications and medical treatments. Because of the difference in education and training, psychiatrists also command a higher salary than therapists.

Table of Contents

The Difference Between Therapists and Psychiatrists


A therapist can be a counselor, psychologist or other professional licensed to provide mental health care. “Therapist” is an umbrella term for professionals who are educated, trained and licensed to provide talk therapy or psychotherapy. During therapy, they can assess, diagnose and treat mental health disorders.

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Most professionals who can call themselves therapists cannot prescribe medications that might be useful in treating mental health conditions. However in some states, psychologists with training in clinical psychopharmacology can prescribe certain medications to treat mental health conditions, according to the American Psychological Association.


A psychiatrist has a medical degree  that allows them to not only diagnose medical conditions but also prescribe medication. A psychiatrist focuses on diagnosing, treating and preventing mental health disorders, including depression, anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), schizophrenia, bipolar disorder, sleep disorders, eating disorders and substance abuse.

Psychiatrists use several treatment methods, including psychotherapy (talk therapy) and medications, such as antidepressants, sedatives, anxiolytics, antipsychotic medications, hypnotics, mood stabilizers and stimulants.

Is a psychiatrist a therapist?

Most psychiatrists only manage patients’ prescriptions and other medical treatments and do not offer talk therapy. Patients often work with both a therapist and a psychiatrist to best treat their mental health disorders. However, some psychiatrists offer talk therapy and other clinical treatments to patients.

Types of Therapists

A therapist can be a licensed counselor, social worker, psychotherapist, psychoanalyst or psychologist. All these individuals have different education tracks, training and licenses.

What a therapist can call themselves may differ depending on state law. The services they offer and the structure of their services also often differ.

Licensed counselors

There are many types of counseling careers, including:

  • Marriage and family counselors.
  • Mental health counselors.
  • Substance abuse and behavioral disorders counselors.
  • Rehabilitation counselors.
  • School guidance counselors.

Many states require licensed counselors to have master’s degrees and obtain certification through the National Board for Certified Counselors . Counselors might be required to pass the National Counselor Examination , the National Clinical Mental Health Counseling Examination or both to obtain a license.

States offer different types of counselor licenses.

Most marriage and family counselors complete a master’s degree in family therapy. States might require marital and family therapists to pass the licensing exam by the Association of Marital and Family Therapy Regulatory Boards.

Clinical social workers

Clinical social workers must earn a Master of Social Work degree, complete two years of post-degree direct clinical experience and pass the Association of Social Work Boards’ Social Work Licensing Exam.


A psychologist must earn a Doctor of Philosophy (Ph.D.) or Doctor of Psychology (PsyD). Some programs require Ph.D. or PsyD applicants to have a master’s in psychology, as well. Psychologists have a significant amount of clinical and research training.

Each state has licensing requirements, including passing an exam, which can be reviewed through the Association of State and Provincial Psychology Boards.

Should I See a Therapist or a Psychiatrist?

Who you should see for mental health care depends on your problems and goals. Talk therapy with a counselor or psychologist can be helpful if you are having trouble dealing with stress, family or marriage difficulties, school, work or social situations. However, if you are experiencing more severe or disturbing symptoms, such as hearing or seeing things that are not there, having violent thoughts toward others, or having thoughts of self-harm or suicide, you may consider seeing a psychiatrist. If you are not sure which type of health care professional to talk to, you may want to consult with your primary care doctor.

If you are interested in talk therapy, know that there are differences between psychologists and other therapists. Counseling psychologists can assess, diagnose and treat severe psychological issues. They will address your emotional, social and other health concerns, which can help you struggle less in school, at work, as part of a family or in social settings. A psychologist also will focus on helping you make decisions to treat and improve your mental health.

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A therapist, depending on their training and license, will use talk therapy, which is a common tactic to encourage you to reach your own answers and conclusions about your problems. Therapists can give you coping strategies, help you alter negative thinking patterns and manage stress. Depending on the therapist’s background, they might not have the same ability to diagnose and treat mental health conditions as a psychologist.

You might prefer to look for a therapist who specializes in certain issues. For example, if you are struggling with alcohol or drug abuse, you might benefit from finding a therapist who is a licensed substance abuse counselor. The first step is to review the types of counselors your state licenses and look for an experienced, licensed professional.

Differences in Education

Depending on the type of therapist, the professional will likely have a master’s or doctoral degree. Therapists’ education and training differ depending on state requirements and the services they offer. Many hold a master’s degree in counseling or social work or a doctoral degree in psychology. It is important to note that supervised clinical training is required before passing a licensing exam.

Psychiatrists are doctors who attend medical school, complete a psychiatric residency, pass written and oral exams, and usually become board certified by the American Board of Psychiatry and Neurology. Unlike the various types of therapists, a psychiatrist is either a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO).

Differences in Training

Most states require licensed counselors, social workers and psychologists to complete a certain amount of supervised clinical experience before they can practice independently.

Psychiatrists have the most direct medical training through medical school and a four-year psychiatric residency. They have education and training regarding the body and the brain and nervous system (neurology).

Therapist vs. Psychiatrist Salaries

Salaries for therapists vary depending on the professional’s license, position, location and years of experience. According to the U.S. Bureau of Labor Statistics (BLS), median salaries in 2021 were:

Because psychiatrists are doctors, they have higher salaries. The average annual wage for psychiatrists in 2021 was $249,760, according to the BLS.

Therapist vs. Psychiatrist Checklist

Two Different Professions With the Same Goal

Therapists and psychiatrists both work with individuals to improve mental health symptoms. They talk with patients, uncover what is wrong and help patients improve their thoughts and behaviors to live happier, healthier and more productive lives. The difference is how these two professions go about it. While therapists focus on psychotherapy and behavioral changes, psychiatrists use medical treatments, including prescription drugs, to treat mental health disorders.


What is the difference between a therapist and a psychiatrist?

A therapist is a licensed counselor or psychologist who can use talk therapy to help you treat mental health symptoms and improve how you manage stress and relationships. A psychiatrist is a medical doctor who can diagnose and prescribe medication to treat mental health disorders.

What is the difference between a psychologist and a psychiatrist?

A psychologist has a master’s or doctoral degree and uses various psychotherapy methods to improve patients’ symptoms. A psychiatrist has a medical degree and can utilize many treatment options, including medications, to treat mental health conditions.

Which profession takes the most time?

Becoming a psychiatrist requires the greatest time commitment. Psychiatrists must complete an undergrad degree, medical school and a four-year residency. Many therapists complete bachelor’s and master’s degrees, and some go through a year or two of supervised clinical training.

Does a psychiatrist or therapist get paid more?

A psychiatrist’s salary is much higher than a psychologist or licensed counselor’s salary. Therapists’ salaries vary significantly depending on their training and area of expertise.

Last Updated: May 2022