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Which Type of Therapist Do You Need?

If you decide to seek out help for mental health, it should be easy to figure out which kind of professional to see. But choosing between psychiatrists, psychologists, therapists and counselors can be overwhelming. While the various types of mental health clinicians do differ in certain meaningful ways, there’s also some overlap between what they’re licensed to do, which issues they specialize in and how they approach treatment. Here’s a breakdown of the main types of mental health providers. 


Psychiatrists

Medical doctors who specialize in mental health

Psychiatrists hold either a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO). That means they’ve been through medical school and completed a residency in psychiatric health, and are licensed in the state where they practice. Their medical training qualifies them to treat both the mental and physiological components of mental health.

“[We] psychiatrists will sometimes identify ourselves as the most comprehensively trained people in the mental health clinical world,” said Jody M. Rawles, a psychiatrist, professor and medical director at the University of California, Irvine, Neuropsychiatric Center. “We tend also to take care of the most acute illnesses. A psychiatrist is a medical doctor first and, as that, we’re trained in biology, chemistry, physiology [and] pathology.”

Which services do psychiatrists provide?

Because psychiatrists are doctors, they’re able to diagnose and prescribe medication for mental health conditions, as well as recommend other medical tests and treatments. In addition to writing scripts, psychiatrists also receive training in psychotherapy (talk therapy). Still, psychiatrists are primarily experts of medicine. Though some psychiatrists might administer therapy themselves, they’re far more likely to refer patients to other mental health professionals. 

How are psychiatrists different from other mental health professionals?

With their medical training and background in biology and chemistry, psychiatrists are uniquely qualified to prescribe medication for mental health disorders, as well as evaluate the physiological impact of mental illness and order lab tests. “All psychiatrists work in hospitals during some part of their training, so they have worked with the most acute and most difficult patients,” Rawles said.

Psychiatrists can also monitor other ailments that manifest with psychiatric symptoms. When doctors prescribe medication for conditions such as depression, anxiety, bipolar disorder and ADHD, they are able to work with patients to ensure that dosages are correct and there are no interactions with other drugs they might be taking.


Psychologists

Highly trained, licensed professionals who can make diagnoses and offer counseling

Psychologists aren’t medical doctors, but they have years of specialized education behind them. “The term ‘clinical psychologist’ [means] that the person holds a PhD or PsyD, which is doctoral-level training,” explained Sheela Raja, a licensed clinical psychologist and author of Overcoming Trauma and PTSD

In addition to earning doctorates, psychologists need to pass a national licensing exam and get licensed by the state, a process that involves thousands of hours of supervised clinical practice. The exact number of hours varies by state. In Michigan, for example, it’s 6,000 hours, whereas in California, it’s 3,000.  

Which services do psychologists provide?

Clinical psychologists can perform psychological testing, diagnose mental disorders and administer therapy. In general, they cannot prescribe medication. Although there some exceptions; in three states, “appropriately trained” psychologists can be granted prescribing rights.

Many psychologists work in conjunction with other health professionals, including psychiatrists and primary care providers, to furnish treatment. But it’s not uncommon to see only a psychologist. You can see one alone for individual therapy, with your partner for couples therapy or as part of a group. Group therapy often focuses on short-term issues, such as grief counseling.

How are psychologists different from other mental health professionals?

While psychiatrists are the authorities on treating mental illness with medication, psychologists have the most extensive, intensive training in psychotherapy of all mental health professionals.


Psychotherapists, therapists and counselors

A diverse group of experts trained to provide non-drug therapy 

Here’s where things can get confusing. “Therapist” and “counselor” are often used interchangeably, and neither one is a legally protected title. Technically anyone can call themselves a therapist or a counselor. So, without further specification, these two standalone titles don’t say much about someone’s training or credentials.

Psychotherapist, however, is a protected title. To use it, someone must be licensed, have a master’s degree or doctoral degree, and have supervised training in psychotherapy. But there are many paths to psychotherapy licensure. And different types of mental health professionals, including psychologists and mental health counselors, might call themselves psychotherapists. 

If you’re trying to figure out whether a therapist or counselor is a good fit for you, Lisa Brateman, a psychotherapist and relationship specialist in New York City, recommends looking at their official title.

  1. Licensed professional counselors (LPCs) have a master’s in psychology. They can diagnose mental health issues and provide psychotherapy (including group therapy).
  2. Certified alcohol and drug abuse counselors help patients work through drug and alcohol abuse. They’ve gone through certification training, but don’t need to have an advanced degree.
  3. Licensed marital and family therapists (LMFTs) hold a master’s degree in a related field like psychology and are additionally trained to administer therapy for family and marital issues.
  4. Art or music therapists use artistic expression as a form of communication. Many hold an advanced degree in art (or music) therapy. Some instead have an advanced degree in a related field like psychology, plus post-degree certification as an art (or music) therapist.
  5. Licensed clinical social workers (LCSWs) have a master’s degree. They can diagnose mental health conditions and provide psychotherapy. They tend to approach therapy through a psychosocial lens, meaning they consider how psychological factors and social environment jointly influence mental health.

Even these professional titles, however, vary somewhat by state. For instance, an LPC is comparable to a licensed mental health counselor (LMHC), licensed clinical professional counselor (LCPC) or licensed professional clinical counselor (LPCC).

Michael J. Toohey, a clinical psychologist and professor at Antioch University Seattle, encourages patients to seek out licensed mental health providers. (A title that doesn’t include any of the terms explored in this article, such as “life coach,” suggests a lack of licensing.) But he doesn’t recommend focusing too much on which letters follow a licensed provider’s name.

“Credentials are important to ensure quality training,” Toohey said, “but the quality of the experience for each client is built upon the foundation of the unique relationship between that individual client and their mental health provider. Whether a psychologist, master’s-level counselor, psychiatrist or other mental health professional, it has been shown over and over again that clients improve the most when they have a good relationship with their mental health provider.”

Which services do psychotherapists, therapists and counselors provide?

All three furnish behavioral therapy. Depending on their licensing and focus, that might mean psychotherapy and/or psychological counseling, which aren’t the same thing.

Psychotherapy generally means longer-term therapy — lasting months or even years at a time — to address long-standing behavioral patterns or mental-health issues. You might receive psychotherapy to work through depression or PTSD, for example, or to address recurrent problems with self-confidence or relationships. Psychotherapy isn’t a monolithic treatment model; there are a number of different methods (or “theoretical orientations”). Two of the most popular include psychoanalysis, in which patients and therapists work through unresolved feelings and experiences, and cognitive behavioral therapy, in which patients identify disordered beliefs and then develop the skills to change them.

Counseling, on the other hand, focuses on shorter-term issues. You might attend counseling to work through a period of heightened stress, tackle a specific relationship problem or manage grief.

Most therapists and counselors help patients through both short- and- long-term mental health disorders and emotional issues, and they’ll work with you to find the right treatment plan. Brateman says that psychotherapists (who, again, need specialized training to claim the title) can treat any number of conditions, including anxiety and panic disorders, bipolar disorder, depression, eating disorders, PTSD, substance abuse and addiction, OCD, work issues and family therapy.

Where to start?

Even if you understand how mental health providers differ in terms of training, licensing and treatment focus, you still might not know the right person to see for your particular issue. That’s OK.

“My advice for someone who doesn’t know where to start is to see both a psychologist and a psychiatrist,” said Toohey. “Just like someone wouldn’t want to see a dentist for their opinion on a broken arm, clients would be better off seeing a psychiatrist for their recommendation on medicine and a psychologist for their recommendation on psychotherapy. Some psychologists offer a complementary consultation to determine which course of action might be the most appropriate — if a client is having financial difficulties, I would recommend they start there.”

Toohey says you can also start by seeing your primary care provider. Mental health isn’t their specialty, but they should be able to do a quick assessment and point you in the right direction. What’s most important is that you get help when you need it, from someone licensed to provide it.


This story has been updated.

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