I am often asked whether I am a psychologist or psychiatrist. Even after six years of graduate school and becoming a licensed psychologist, there are family members who ask me to clarify the distinction. This is a good example of how most people only have a vague understanding of the mental health field, and that we have a long way to go in our efforts to increase education and reduce stigma. So, what IS the difference between a psychologist and a psychiatrist?
Let’s start with me. As already mentioned, I am a psychologist. What this means is that I went through four years of intense classroom instruction on mental disorders (e.g., depression, anxiety, schizophrenia, ADHD, autism etc.), various models for treating mental health issues, biological composition of the brain, psychological testing, and standards for ethical practice. While taking classes, future psychologists are also working with patients while under supervision to learn and refine therapy and testing skills. After those four years, the students must go through a rigorous match process to be selected for their one-year internship. Internship often requires moving across the country, and involves a regular 40 hour week working directly with patients in therapy and testing, along with continued supervision. Not to mention somewhere along the way, they need to squeeze in completing a dissertation! After internship is complete, only then will the student be considered a doctor. However, they are still not able to use the term “psychologist” until they complete another supervised year of practice (post-doctoral residency), and pass both a national licensure examination and a state specific test of laws and regulations. Once licensed, psychologists are able to practice independently and provide therapy, testing, and consultation services.
Psychiatry is another specialty within the mental health field. It is very common for psychologists and psychiatrists to collaborate on patient care, to ensure the best outcomes for the patient. To become a psychiatrist, one must first complete everything that is involved with medical school. They begin with learning the general medical knowledge that every medical doctor must know to competently treat patients. They learn anatomy and physiology of the entire body, about the many illnesses that affect us (e.g., cancer, sprains, influenza, seizures etc.), and the proper treatments for those disorders. Somewhere along the way, medical students must decide whether they want to pursue a specialty practice, such as psychiatry or radiology, or if they want to remain a generalist who can serve as a primary care physician. Those who elect psychiatry as their specialty begin to focus on patients with mental health disorders and providing the best research supported medical treatment. In many cases, this involves prescribing medication (e.g., Lexapro for depression or anxiety, Seroquel for schizophrenia, Depakote for bipolar disorder etc.). While some psychiatrists also provide talk therapy, most will tell you that another mental health professional can provide more optimal treatment in that arena.
In very basic terms, psychologist = talking about making behavioral changes to improve mental health; psychiatrist = medication to improve mental health. While some feel there is a rivalry between the professions, I have nothing but the utmost respect for every psychiatrist I have encountered. For most mental health diagnoses, research indicates that a combination of behavioral strategies and medication produce the best outcomes. Nobody gains anything from unwarranted turf wars, least of all the people who need us most, our patients. I am more than happy to speak with your primary care provider or psychiatrist if you feel it would improve your care.
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