Psychology Vs Psychiatry: How The Difference Affects Diagnosis and Treatment
Updated May 09, 2019
Reviewer Laura Angers
Psychology and psychiatry are both concerned with how the mind works and, as such, they have many principles and practices in common. This interrelatedness, however, often makes it difficult to differentiate between the two. In fact, it is not unusual to find people who simply assume the two fields are one and the same, which results in the common habit of using the two terms interchangeably. It, therefore, becomes challenging for persons to choose between the two when considering psychology vs psychiatry to address their mental health issues.
It is important to remember that while psychology and psychiatry are quite similar and often work in tandem to provide the very best patient care, they do have several glaring differences. In this article we will provide a head-to-head comparison of psychology vs psychiatry with the aim of showing how these differences ultimately affect how patients are diagnosed for mental health conditions and the treatment, which is administered to them.
Definitions for Psychology Vs Psychiatry
What is Psychology?
The American Psychological Association defines psychology as "The scientific study of the behavior of individuals and their mental processes." Psychology is described as a social science as it focuses on the society as a whole as well as on the interactions (behaviors) of individuals within the society.
What is Psychiatry?
The American Psychiatric Association defines psychiatry as being "focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders. Psychiatry is a medical science (or branch of medicine) and it considers both the social and biological factors that affect the individual.
The Difference Between Psychology and Psychiatry
At a Glance
- Both psychologists and psychiatrists are doctors
- Both fields involve intensive study and training
- Both have access to some of the same diagnostic tools
- Psychologists specialize in an array of talk therapies
- In most states, only psychiatrists can prescribe medication
- Psychiatrists can use physical treatments such as shock therapy
- Psychiatrists handle the most severe mental health cases
Psychology Vs Psychiatry - Education and Training
Both psychiatrists and psychologists are doctors who have completed intensive courses combining both education and training. Psychiatrists, however, are medical doctors with the either the distinction M.D. or D.O. assigned to them. Psychologists, on the other hand, have completed a doctoral degree that entitles them to be addressed as "Doctor" and have either the Ph.D. or Psy.D. distinction assigned to them.
Psychiatrists begin their careers with the same medical school education as all other medical doctors. They learn all about the different systems in the body, illnesses that can affect them and how these illnesses can be identified and treated. Their many courses include anatomy, behavioral science, biochemistry, neuroscience and psychiatry. In addition, they are exposed to working in a minimum of 6 specialist areas. They leave medical school with a degree in medicine and at this point are known as either a Doctor of Medicine (M.D.) or a Doctor of Osteopathic Medicine (D.O.).
To specialize in psychiatry, doctors then spend at least 4 years in residency training focusing on psychiatry. They train in a variety of medical settings with patients of all age ranges and gain exposure to the diversity of mental health issues that patients face. Upon completion of residency, most doctors opt to apply to the American Board of Psychiatry and Neurology for board certification. Some choose to pursue further study in a subspecialty, such as child and adolescent psychiatry, forensic psychiatry, or addiction psychiatry.
Psychologists must first complete doctoral studies, typically earning either a Doctor of Philosophy (Ph.D.) or a Doctor of Psychology (Psy.D.). Following this, graduates are required to fulfill a 1-to-2-year residency which provides a practical setting for them to gain experience in methods of treatment and problem-solving techniques, as well as psychological and behavioral therapy, among other things.
Licensing in some states then requires that psychologists complete a further 1-to-2 years working under the guidance and supervision of an authorized mental health professional before being fully recognized as psychologists. Areas of specialization within psychology include clinical psychology; behavioral and cognitive psychology; as well as family psychology. Psychologist can attain certification in their specialty from the American Board of Professional Psychology.
Psychology Vs Psychiatry - Diagnosing Patient Issues
There is a vast difference in how psychiatry vs psychology goes about diagnosing patient's mental health issues. This is a direct result of the differences just looked at in their education and training.
Psychiatrists are medical doctors and, as such, are also able to draw upon a plethora of diagnostics tests including medical laboratory tests and computerized tomography (CT) scans. In order to specifically label a mental health condition, psychiatrists rely on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Within this are descriptions of the various mental disorders and their criteria, such as symptoms, which are used to diagnose each illness.
Both psychiatrists and psychologists use a variety of psychological tests and assessments to discern personality type, aptitude in a particular area, cognitive ability and emotional functioning. Psychologists, however, receive extensive training in administering and interpreting multiple of these tests, examples of which include Minnesota Multiphasic Personality Inventory (MMPI) and the Rorschach Inkblot Test. Psychologists also make use of the DSM-5.
Psychology Vs Psychiatry - Treatment Options
As trained medical doctors, psychiatrists are legally authorized to prescribe medication. Much of the work they do with patients centers on treating chemical imbalances in the brain and medication management. Of course, their medical training means that psychiatrists will take other factors into consideration. Through physical examination and possible tests, they will try to eliminate other possible causes for the patient's condition before starting them on a course of medication
In most states, psychologists who wish to have a patient placed on medication, or to check whether the medication they are already on is the correct one in right dosage, must refer them to a psychiatrist or other medical doctor. Thanks to the pioneering work of psychologists such as Jack Wiggins Jr., there is currently a handful of states which give psychologists prescribing powers for certain psychiatric medications. There is also a push for more states to follow suit as it is felt that prescribing powers greatly widen the scope of treatments psychologists can offer to their patients.
Psychotherapy (also known as talk therapy) involves talking with patients about the problems they are facing and helping them to:
- Identify circumstances in their lives (such as divorce or death of a loved one) which contribute to their mental health issue
- Become aware of whatever behavior or emotions are contributing to their condition
- Make use of behavior modification techniques
- Develop healthful coping strategies and appropriate problem-solving techniques
The ultimate aim of psychotherapy is helping patients to once again take pleasure in life by restoring their sense of control.
Both psychiatrists and psychologists will practice various forms of psychotherapy, which may include a single patient, a couple, a family or a group of persons who share similar problems. The difference arises from the fact that psychiatrists are primarily concerned with medical treatments and medication, whereas psychologists are exclusively focused on psychotherapy. It is not uncommon for a psychiatrist to refer patients to a psychologist so that they may benefit from the psychologist's specific area of expertise in psychotherapy.
There is a myriad of therapies that psychologists engage in depending on which approach or combination of approaches they feel will produce the desire results for a particular patient. A few of these are:
- Psychoanalysis - This focuses on helping patients to discover, examine and learn to cope with repressed thoughts and emotions which may be deeply buried in their unconscious mind. It is an in-depth method of psychotherapy that has been proven effective for patients dealing with depression; personality disorders; persistent relationship issues; emotional struggles and trauma, as well as neurotic and self-destructive behavior patterns.
- Cognitive behavior therapy (CBT) - This mode of psychotherapy seeks to change the way patients behave in difficult situations by changing their thought patterns. CBT is a short-term approach used to treat current issues patients are facing, such as anxiety, stress, anger and eating disorders.
- Cognitive analytic therapy (CAT) - In using CAT, a psychotherapist helps patients to identify early experiences which may contribute to their current mental health issues - for example, overly controlling parenting leading to an overly rebellious nature in adolescence or adulthood. Patients in CAT are very actively involved in the processes used by the psychotherapist and in developing strategies to curb their maladaptive behaviors.
- Gestalt therapy - This client-centered form of psychotherapy is often used for patients who are experiencing relationship difficulties, depression, anxiety and low self-esteem. It has also been shown to have positive effects in cases where patients' emotional stress is manifested physically through migraine headaches and back spasms. Gestalt therapy encourages bringing possibly painful issues to the fore using methods such as drama or art so that they can be positively dealt with in an environment where patients feel safe and secure.
- Hypno-psychotherapy - This is defined as the clinical use of hypnosis to augment psychotherapeutic interventions. It is meant for the treatment of deep psychological issues and psychiatric illness, through selective attention and suggested experiences. Hypno-psychotherapy is often combined with cognitive behavior therapy in a treatment known as cognitive/behavior hypnotherapy (CBH).
- Dance/Movement therapy (DMT) - This is an expressive therapy and in some instances it is referred to as movement psychotherapy. It draws on the well-researched relationship between movement and emotion. Dance/movement therapy is sometimes applied in the treatment of eating disorders, as well as poor self and body image.
- Art therapy - This is another expressive form of therapy in which the art is used as a release medium for patients' emotions, or the art that patients produce is evaluated by the therapist for underlying signs of a mental health issue. It is often used in the treatment of children and adolescents but has also been proven effective when used with adults.
- Integrative or holistic therapy - This is practiced by some psychologists who feel a fusion of certain aspects of different therapies is the best approach to take with a particular individual.
As medical doctors, psychiatrists have a range of physical treatments, which can be used with patients. These are most often reserved for severe cases of mental illness, however, and some treatments have traditionally been surrounded by controversy over their use.
Some treatments listed by the American Psychiatric Association include:
- Electroconvulsive therapy (ECT) - Also known as shock therapy, this involves the use of electrical currents to the brain to induce seizures as a way of treating severe depression, as well as catatonia and mania.
- Transcranial magnetic stimulation (TMS) - This is the non-invasive use of a magnetic field generator to stimulate certain areas of the brain. It has been used effectively in patients whose severe depression does not respond to medication.
- Deep brain stimulation (DBS) - A neurostimulator (a.k.a. a brain pacemaker) is implanted in the patient's brain. Electrical impulses are then used to treat conditions such as obsessive-compulsive disorder (OCD).
- Vagus nerve stimulation (VNS) - This is another form of electrical stimulation applied to the brain as a way to treat medication-resistant depression.
- Light therapy - This relatively new technique is used to treat both seasonal and non-seasonal depression.
Psychology Vs Psychiatry - Which Is Right for You?
There are two important factors to keep in mind when considering psychiatry vs psychology for treatment of a mental health issue.
Severity and type of the mental health condition
Psychiatrists are most often concerned with dealing with the most complex of mental illnesses. These include schizophrenia, severe depression, having highly irrational thoughts and bipolar disorder, as well as conditions that are physically disabling for the patient. Individuals who are suicidal - whether they are having suicidal thoughts or have attempted suicide - will also usually be treated by a psychiatrist instead of a psychologist.
However, in the case of behavioral problems, mild forms of depression, anxiety, phobias or learning difficulties, the skills of a psychologist may be the most appropriate.
Approach you are most comfortable with
The difference between psychology and psychiatry in their approaches to treatment means that some persons will naturally feel more comfortable with one than the other. For instance, persons who are cautious about the side effects of medication or about taking medication in general will tend to gravitate toward the services of a psychologist.
Also, treatment by a psychotherapist is usually more time intensive in that sessions are often scheduled on a weekly basis and are normally longer than those with a psychiatrist. Psychiatrists will generally see patients on a weekly or monthly schedule with typically shorter sessions focused on medication management.
The bottom line is whether you or your loved ones are suffering from a mental health issue, reaching out for help is the most important step you can take. Your course of treatment may involve a psychologist, psychiatrist or both. No matter which it is, you can be rest assured that they will be working in tandem with you to help you regain mental and emotional stability, as well as your joy for living.