Psychiatrist Vs. Therapist: What’s the Difference?

Updated September 27, 2018

Reviewer Whitney White , MS. CMHC, NCC., LPC


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So, you have decided to see someone to talk about the issues you have been having lately, but do you know who to see? There are so many choices: psychiatrist, therapist, psychologist, counselor, which one would be best for you? Well, it helps if you know the difference between them. Two options that many people find themselves choosing between include a psychiatrist and a therapist.

Psychiatrist

A psychiatrist is a medical doctor who has attended four years of medical school, one or two years of internship training, and more than three years of special training as a psychiatrist resident. Psychiatrists typically don't provide therapy, but they can prescribe medication and diagnose medical illnesses like diabetes or high blood pressure. Psychiatrists are also able to determine the effects a mental condition can have on other medical issues such as heart disease, obesity, and alcoholism.


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Therapist

A therapist is an umbrella term that can include counselors, psychologists, and psychotherapists. It basically covers all those who practice 'talking' therapy. A therapist is a mental health professional who has at least a master's degree in that field but does not need a Ph.D. or M.D. to practice therapy. Each state in the U.S. uses different terms to issue licenses to professionals who are therapists. Depending on state law and licensure rules, therapists can diagnose, assess, and treat mental health disorders. They are not able to write prescriptions for medication, but they frequently collaborate with medical doctors and psychiatrists to ensure your treatment is cohesive.


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Psychiatrist vs. Therapist: How to Choose

If you are still not sure which one you should see, there are some things to ask yourself that can help.

  • What is the issue you want to talk about or problem you need help with? Do you prefer the idea of medication only treatment? Treatment that incorporates both medication and therapy? Do you prefer the idea of only seeking therapy? If you know you want to try medication treatment as part of your approach to helping yourself, you will need to consult with a psychiatrist or your regular doctor. If you plan to incorporate a therapy, like cognitive behavior therapy, talking with a counselor is a good step.
  • Is it a family issue that involves more than just you? If you're having family or relationship issues, talking with a family therapist or professional counselor will provide you with specific insight into relationship dynamics and helpful ideas for solving problems.


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Time Factor

When you visit your psychiatrists, you'll likely only be in their office for 15-minute med checks after your initial visit. This typically happens once every three months, as long as you aren't having problems with your medication or experiencing a mental health crisis. In those cases, you would see them as often as they deem necessary for your safety.


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Most therapists provide one-hour sessions. You may work out shorter sessions with them if you have an extremely busy schedule or are in a financial crunch. The most common interval is once a week. However, if you are doing well and only want to check in occasionally, you might see your therapist once every two weeks or once a month. During a mental health crisis, you might be able to see your therapist more than once a week for extra support.

Their Role

A therapist is first and foremost a helper. Although the therapist may offer guidance, suggestions, and education about your problem, they don't make demands. Therapists may use homework to help you continue your work between sessions and thus help you make improvements more quickly.

A psychiatrist will likely make recommendations on medication interventions, check with you about the helpfulness of the medication, and talk with you about any problems that the medication may present for you.


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Cost of Treatment

Treatment by a psychiatrist is typically higher than treatment by a therapist. However, a therapist's treatment can be just as costly as a psychiatrist's. The cost of treatment may be determined by whether or not you have insurance, what area you live in, and the types of mental health professionals available in your area.


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Referrals

Both psychiatrists and therapists will refer to one another when either believes you may be helped by the other. For example, if you visit a therapist who notes that you show an interest in medication treatments, and that your symptoms may be helped by medication, they will refer you to a doctor for an evaluation.

If you see a psychiatrist first, they may determine that therapy is an essential part of your treatment plan. In this case, they may refer you to a therapist you can see in conjunction with your psychiatric treatment.

If you're unsure whether you need a psychiatrist or a therapist, just choosing a starting point is the most important thing. You can speak with your medical doctor or make an appointment with a psychiatrist or therapist to get started. If you know what type of treatment you will be most interested in, choose accordingly.

You can speak to a licensed therapist online at BetterHelp with no obligation to stay in therapy with them, unless you find it helpful. The insight of a therapist can be very helpful in determining what your symptoms mean, and what can be done to support you in managing them.

Moving Beyond Indecisiveness

You may still be having a hard time knowing where to turn for help. It's normal to have these feelings, especially if you are new to the mental health community. In addition, some mental disorders contribute to your indecisiveness. People who are depressed often have trouble making choices.


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The first thing you need to remember is that you'll probably have the opportunity to change your mind if you realize you've made the wrong choice for you. Second, therapy can help you learn decision-making techniques and give you an opportunity to practice these, which can have a helpful impact in many areas of life. The most important thing on the journey to wellness is to get started, regardless of where or how.


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