Can Therapists Prescribe Medication?

By: Beth Krietsch

In most cases therapists cannot prescribe medication. Their training focuses on talk therapy rather than managing and prescribing medication, but they can refer patients to psychiatrists and other providers for their medication needs. 

What kind of therapist can prescribe medication?

Most therapists cannot prescribe medication. Therapists such as psychologists, licensed professional counselors, marriage and family therapists, and licensed clinical social workers are licensed mental health professionals. They usually have advanced degrees and undergo extensive training, but they do not have prescribing privileges.

Therapists specialize in helping people understand their thoughts, emotions, and behaviors. They use approaches like cognitive behavioral therapy (CBT) to address depression, anxiety, trauma, and other mental health conditions. When needed, therapists can help connect patients with a provider who is licensed to prescribe psychiatric medication, such as a psychiatrist. 

Which providers prescribe psychiatric medication?

The following healthcare providers can prescribe psychiatric medication. 

Psychiatrists 

Psychiatrists are medical doctors who hold either a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree. They have completed medical school and a residency in psychiatry and are licensed to prescribe and manage medication.

Their medical training provides them with deep knowledge of psychiatric medications, including how these medicines work in the body and brain, how different medications interact, and how to make treatment decisions.

Psychiatric mental health nurse practitioners (PMHNPs)

Psychiatric mental health nurse practitioners (PMHNPs) are advanced-practice registered nurses with specialized training in medications used to treat mental health conditions. PMHNPs assess, diagnose, and treat adults and children with mental health conditions and substance use disorders. As part of this, they prescribe and manage medications. 

Primary care providers (PCPs)

Primary care providers (PCPs) such as family doctors and internal medicine physicians hold either a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree. They may prescribe common psychiatric medications, like selective serotonin reuptake inhibitors (SSRIs) for anxiety or depression, as part of your medical care. For more complex care and medication decisions, they typically refer patients to a psychiatrist or PMHNP. 

Psychologists with specialized prescribing privileges 

Generally, psychologists in the U.S. do not prescribe medication and instead focus on talk therapy and psychological assessments. 

However, in some states, psychologists can obtain limited prescribing authority after completing additional specialized training in clinical psychopharmacology. Because the list of states and their requirements change as new legislation is enacted, check your state’s current psychology licensing board for up-to-date information.

Physician assistants (PAs)

Physician assistants (PAs) are healthcare professionals who are licensed to practice medicine under the supervision and direction of a doctor of medicine (MD) or doctor of osteopathic medicine (DO). They complete coursework in pharmacology and have prescribing privileges in all 50 states. PAs working in psychiatric settings or as a primary care provider may prescribe and manage medication under a physician’s supervision.

What is the difference between a therapist and a psychiatrist? 

There are clear differences between a therapist and a psychiatrist. While both practice in the mental health field, they undergo different types of training and also approach treatment in different ways.

Therapists such as licensed psychologists, licensed professional counselors, licensed clinical social workers, and marriage and family therapists mainly use talk therapy to address emotional and behavioral concerns.

Licensed psychologists hold a doctorate-level degree (PhD or PsyD) and undergo extensive training to diagnose and manage mental health conditions. Other types of therapists generally hold a master’s degree.

Their training focuses on psychotherapy and they help people address challenges, understand their thoughts, and develop coping skills using approaches like cognitive behavioral therapy (CBT).

A psychiatrist is a medical doctor (MD or DO) who diagnoses mental health conditions and prescribes medication like antidepressants, anti-anxiety medications, and mood stabilizers. Some psychiatrists offer talk therapy but most focus on medication management. Often, they see patients less frequently or for shorter visits than a therapist might.

How to talk to your therapist about medication

If you’re curious about medication, you can start by having a conversation with your therapist. During your next session, chat with your therapist about your symptoms and ask whether a referral to a provider who can prescribe medication makes sense.  In some cases, your provider may even raise the idea of a referral before you do, based on your symptoms. 

Keep in mind that a referral doesn’t mean therapy has failed or that you should stop going to therapy. A therapist cannot write you a prescription, but they still play a big role in your care. They can talk with you about your symptoms, assess your condition, discuss treatment options, refer you to a healthcare provider who can prescribe medication, and coordinate with that provider. 

If you’re not currently working with a therapist, an online therapy platform like BetterHelp is a good place to get started. A BetterHelp therapist can talk through your symptoms with you and help you decide on next steps, such as whether medication is worth exploring. 

Betterhelp also offers an online psychiatry platform that allows you to connect with a psychiatrist. Betterhelp accepts insurance with many providers in-network with most major insurers.  

*Based on finalized paid psychiatry visits with a copay. Insurance availability, coverage, and costs vary by state, plan, provider network, and provider availability.

How therapy and medication can work together

In some cases, the most effective treatment is a combination of therapy and medication. This is because medication and therapy can be complementary and address different aspects of mental health. 

Medication can influence brain chemistry to address symptoms like intense anxiety, racing thoughts, difficulty concentrating and low mood. And therapy helps people process difficult experiences, understand and address thoughts, and develop coping skills to manage symptoms over time. When appropriate, these two approaches can be combined for comprehensive care.