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Differences between psychologist and psychiatrist?
I am really interested in the field of mental health and psychology. I know psychiatrists can prescribe medication while psychologists can't, but is there any other major difference between the two careers? Is it worth the 4 years of medical school just to be able to prescribe drugs, or is there something else that I am unaware of? Thank you.
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Gregory’s Answer
Chennan,
Thank you for your questions, and they are very good questions! It is not unusual to hear what you have been told, that the difference is that one does talk therapy and the other prescribes medication. As a psychiatrist who has practiced for over 40 years, I can tell you for certain that I have done a lot more in my career than to prescribe medication, in fact much of my time with patients and colleagues has been spent helping them understand how medication is not likely to be helpful and often muddies the waters in terms of determining what actually has helped or will help someone recover. While we understand that certain life events and traumas alter brain chemistry and function, and we understand that some, but really very few, psychiatric conditions are "genetic", and we understand how certain medications "work" in the brain, we still are not able to state that most psychiatric conditions are caused by a mysterious chemical imbalance, presumably corrected by medications. That said, since I do have a background in the practice of medicine, there have been times that medication treatment is essential and life saving, and because those medications can have far-reaching effects and side effects in the human body, a full understanding of cardiology, endocrinology, neurology, and nephrology are essential to be able to safely treat patients with medications.
Psychiatrists are trained first in medicine, but then in their post-medical training residency, they learn how to conduct psychotherapy with patients as well as to treat some of the more troubled mentally ill patients than are typically seen by non-physician therapists. Psychiatrists also learn how to function as medical colleagues and consultants to other physicians as well as to non-physician therapists. In essence, an important part of being a psychiatrist is being comfortable in the role of consultant and advisor to colleagues who are treating individuals with less severe problems than those whom you would treat directly yourself. This is the role that psychiatrists will be taking in the future for sure and it is an important leadership role. However, it is not required. Some psychiatrists prefer to conduct psychotherapy in an office setting and not utilize medication, others prefer to do medication treatment exclusively, leaving, as you said, the talk therapy to others. Still other psychiatrists are comfortable functioning in a role that includes therapy and medication treatment.
That last statement is important to remember. I became a psychiatrist because I wanted to treatment patients in long term therapy. I was able to do that to some degree throughout my career, but it required that I challenge the mindset that patients and their therapists or doctors had given to them, that psychiatrists only focused on medication. However, I also realized that there were many others without medical training who were quite skilled and effectively treating many troubled individuals, and that what they needed were my skills as an expert and consultant even more than my skills as a one to one therapist. So I did both, and I think that is how many psychiatrists now and in the future will function.
So, Chennan, for you it really comes down to whether you are turned on by the idea of treating people using talk therapy, or if you are interested in taking more of a role as leader and consultant to others, able to speak the language of physicians as a psychiatric consultant to them and the language of psychiatry as a medical consultant to therapists, and treating those patients who really require your expertise yet reserving some time each week for a few therapy cases of your own. To do the latter, you have to be willing to take the time and energy to get into med school, pay for the costs involved in medical training, and then spend 4 years in residency learning how to become a modern psychiatrist. That's a lot of you want to work in an office seeing people for talk therapy, in which case you should consider alternative training.
I can tell from your question that you have already given a lot of thought to this, Chennan. We need psychiatrists more than ever and in the future it will be even more critical. I hope you consider taking that road but only if you want to take on the obligations it entails. It can be a very rewarding career! Good luck!
Thank you for your questions, and they are very good questions! It is not unusual to hear what you have been told, that the difference is that one does talk therapy and the other prescribes medication. As a psychiatrist who has practiced for over 40 years, I can tell you for certain that I have done a lot more in my career than to prescribe medication, in fact much of my time with patients and colleagues has been spent helping them understand how medication is not likely to be helpful and often muddies the waters in terms of determining what actually has helped or will help someone recover. While we understand that certain life events and traumas alter brain chemistry and function, and we understand that some, but really very few, psychiatric conditions are "genetic", and we understand how certain medications "work" in the brain, we still are not able to state that most psychiatric conditions are caused by a mysterious chemical imbalance, presumably corrected by medications. That said, since I do have a background in the practice of medicine, there have been times that medication treatment is essential and life saving, and because those medications can have far-reaching effects and side effects in the human body, a full understanding of cardiology, endocrinology, neurology, and nephrology are essential to be able to safely treat patients with medications.
Psychiatrists are trained first in medicine, but then in their post-medical training residency, they learn how to conduct psychotherapy with patients as well as to treat some of the more troubled mentally ill patients than are typically seen by non-physician therapists. Psychiatrists also learn how to function as medical colleagues and consultants to other physicians as well as to non-physician therapists. In essence, an important part of being a psychiatrist is being comfortable in the role of consultant and advisor to colleagues who are treating individuals with less severe problems than those whom you would treat directly yourself. This is the role that psychiatrists will be taking in the future for sure and it is an important leadership role. However, it is not required. Some psychiatrists prefer to conduct psychotherapy in an office setting and not utilize medication, others prefer to do medication treatment exclusively, leaving, as you said, the talk therapy to others. Still other psychiatrists are comfortable functioning in a role that includes therapy and medication treatment.
That last statement is important to remember. I became a psychiatrist because I wanted to treatment patients in long term therapy. I was able to do that to some degree throughout my career, but it required that I challenge the mindset that patients and their therapists or doctors had given to them, that psychiatrists only focused on medication. However, I also realized that there were many others without medical training who were quite skilled and effectively treating many troubled individuals, and that what they needed were my skills as an expert and consultant even more than my skills as a one to one therapist. So I did both, and I think that is how many psychiatrists now and in the future will function.
So, Chennan, for you it really comes down to whether you are turned on by the idea of treating people using talk therapy, or if you are interested in taking more of a role as leader and consultant to others, able to speak the language of physicians as a psychiatric consultant to them and the language of psychiatry as a medical consultant to therapists, and treating those patients who really require your expertise yet reserving some time each week for a few therapy cases of your own. To do the latter, you have to be willing to take the time and energy to get into med school, pay for the costs involved in medical training, and then spend 4 years in residency learning how to become a modern psychiatrist. That's a lot of you want to work in an office seeing people for talk therapy, in which case you should consider alternative training.
I can tell from your question that you have already given a lot of thought to this, Chennan. We need psychiatrists more than ever and in the future it will be even more critical. I hope you consider taking that road but only if you want to take on the obligations it entails. It can be a very rewarding career! Good luck!
Updated
Perry’s Answer
Hello Chennan.
I'm going to focus my answer here on *clinical* psychologists, those who treat people directly. In fact there are many different kinds of psychologists who do many different things related to psychology.
The short answer is that a clinical psychologist is a PhD or a PsyD [I won't differentiate those two here. It's not necessary for the purposes of your question]. A psychiatrist is an MD [which is what I am].
So, Psychologist: PhD or PsyD. Psychiatrist: MD.
In terms of training, both complete college of course. But here they diverge. Future psychologists go on to graduate school to learn to treat people, ultimately becoming a clinical psychologist, while future psychiatrists go to medical school and then specialized residency training in psychiatry.
After that, individual people go off to do subtly different specific things, but the basics are that psychologists become experts at doing different types of talking therapy [important], while psychiatrists can prescribe medications [important]. You already know this, but yes, there is more to it than that. I touch on this very briefly below.
Which is worth it? You will have to figure that out for yourself over time. Ask people in both fields when you have the opportunity. Go to career fairs. Keep an open mind.
For me, medical school and psychiatry residency was definitely worth it. More than just prescribing medications, I am first an MD immersed in the medical world, which is where I want to be. But psychologists are happy to be immersed in their PhD [or PsyD] psychotherapies world.
This is a crude basic answer which may anger some others, but it gives you the overall starting idea. I hope.
I'm going to focus my answer here on *clinical* psychologists, those who treat people directly. In fact there are many different kinds of psychologists who do many different things related to psychology.
The short answer is that a clinical psychologist is a PhD or a PsyD [I won't differentiate those two here. It's not necessary for the purposes of your question]. A psychiatrist is an MD [which is what I am].
So, Psychologist: PhD or PsyD. Psychiatrist: MD.
In terms of training, both complete college of course. But here they diverge. Future psychologists go on to graduate school to learn to treat people, ultimately becoming a clinical psychologist, while future psychiatrists go to medical school and then specialized residency training in psychiatry.
After that, individual people go off to do subtly different specific things, but the basics are that psychologists become experts at doing different types of talking therapy [important], while psychiatrists can prescribe medications [important]. You already know this, but yes, there is more to it than that. I touch on this very briefly below.
Which is worth it? You will have to figure that out for yourself over time. Ask people in both fields when you have the opportunity. Go to career fairs. Keep an open mind.
For me, medical school and psychiatry residency was definitely worth it. More than just prescribing medications, I am first an MD immersed in the medical world, which is where I want to be. But psychologists are happy to be immersed in their PhD [or PsyD] psychotherapies world.
This is a crude basic answer which may anger some others, but it gives you the overall starting idea. I hope.
Updated
David’s Answer
The main differences between psychologists and psychiatrists are:
1. Psychologists can be certified and licensed.
2. Psychiatrists are licensed to prescribe medication for mental disorders (psychologists cannot).
3. Psychologists can be certified and licensed with a Master's
4. Psychiatrists need a doctorate.
-David Padilla
1. Psychologists can be certified and licensed.
2. Psychiatrists are licensed to prescribe medication for mental disorders (psychologists cannot).
3. Psychologists can be certified and licensed with a Master's
4. Psychiatrists need a doctorate.
-David Padilla