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Therapy vs. Psychiatry: How Are They Different and How Are They the Same?

January 26th, 2022


When I began considering working in the mental health field, I realized quickly that I was pretty confused about the various types of providers that I was seeing online. There seemed to be a bunch of smiling faces with a series of random letters following their names. Sometimes there was only one set of letters, but other providers had multiple. I knew that each provider had a different title, but I did not know how that made them different from each other.

There were counselors, social workers, therapists, psychiatrists, psychologists, and on and on. As I received more education, I was able to understand the nuances of each degree and title, but recognize that for the average consumer of mental health care, this can be quite confusing. Below, I will describe the different types of mental health providers and describe ways in which they are different, and ways in which they are similar.

Who Can Prescribe Medicine?

One of the most common questions that I get as a therapist is whether or not I can prescribe my clients' medication. Because therapists are most often not medical providers, they cannot prescribe medication. Mental health prescribers are trained medical professionals with an emphasis on mental health medication.

The traditional mental health prescriber is a psychiatrist who is a medical doctor that specializes in mental health. Historically, psychiatrists would often meet with their patients for therapy and also manage their medication. Currently, psychiatrists most often focus on medication management and partner with therapists for their patients’ therapeutic needs.

While psychiatrists are traditionally known for prescribing mental health medication, other medical providers can do so as well. People who are licensed Medical Doctors (MD), Doctors of Osteopathy (DO), Licensed Physician Assistants (PA), and Nurse Practitioners (NP) can prescribe medication because they have the appropriate training.

If you are seeking mental health medication, it is recommended that you seek medication management from someone with these credentials who has expertise in mental health. These providers have to attend medical school and have completed a psychiatric residency. Once they have these credentials, they can diagnose and treat their patients. Though most primary care providers are legally able to prescribe mental health medication, they may not have the same depth of training as a person whose training emphasized mental health services.

What About Talk Therapy?

Though many people can engage in medication management as part of their mental health care routine, some people choose not to engage in medication management and solely focus on talk therapy. Deciding who to work with for talk therapy can at times feel difficult.

Numerous types of licensures and skill-sets are utilized to provide talk therapy. Though each licensure has its own emphasis, they all have the skills and training needed to provide therapeutic care. Below I will discuss some of the common licensed professionals who can practice therapy:

  • Counselors: People who are counselors have a graduate degree in counseling and have either a partial license as an LPC or a full license of LCPC. Full licensure is awarded to counselors who have completed about two years of work after graduating from a graduate-level counseling program. Counseling programs often focus directly on training students to work in a clinical mental health role.
  • Psychologists: People whose professional title is psychologist have a doctoral degree in psychology. Most client-facing psychologists have a PsyD which is a doctor of psychology. Psychologists can also hold a Ph.D. in psychology, but those with a Ph.D. often focus more on research than client-facing work. Psychologists can provide therapy, but due to having a doctoral degree, they are also able to conduct psychological testing.
  • Psychological testing is utilized to diagnose and understand underlying mental health concerns that are not always clearly identified in a typical mental health assessment.
  • Social Workers: People who are social workers typically have a master's of social work and have either a partial license as an LSW or a full license as an LCSW. Full licensure is awarded to social workers who have completed roughly two years of clinical work after graduating from a social work program. Social work differs from other mental health professions due to an emphasis on understanding a person as they exist in their environment. Social workers are trained to specifically identify and focus on how environmental and community factors influence mental health.
  • Marriage and Family Therapists: People who are marriage and family therapists (MFTs) have completed a graduate program in marriage and family therapy. A partially licensed MFT has an AMFT and a fully licensed provider has an LMFT. Though MFTs are specifically trained in the provision of family and couples therapy, they are also able to provide individual sessions. An MFT may be an appropriate fit for your therapy if relational challenges are an area of focus for your therapy.

Something to keep in mind when choosing a therapist or other mental health provider is that each provider has its orientation. When being trained, clinicians learn about different techniques like Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Psychodynamic Therapy, trauma-informed therapy, etc. A clinician’s theoretical orientation will shape how they engage in sessions with you.

For example, if you do not think that you want to do therapeutic assignments between sessions, a CBT or DBT therapist would likely be a poor fit because those orientations rely upon therapeutic assignments. When searching for a therapist, it is important to research and identify what may be an appropriate fit for your personal needs. Additionally, when working with any provider whether they are a therapist or psychiatrist, it is valid to name what you think may be helpful in the treatment and what may be less so.

Making an appointment to support your mental health is a huge and sometimes scary step. Having a clear understanding of who you are seeing is a helpful way to build confidence going into your first session.

Written By: Sarah Kelly, LSW, CADC

Clarity Clinic

At Clarity Clinic, we have highly trained staff who specialize in therapy and psychiatry services. To learn more about how we can support your mental health, call Clarity Clinic on (312) 815-9660 or schedule an appointment today.

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