It’s often confusing to others what the differences are between the various mental health disciplines. From psychologists to psychiatrists to counselors and therapists, we’re all different from each other. Here’s your guide to the types of mental health professionals and how they can help you. (And yes, it’s perfectly fine to have more than one of us on your team at a time.)
Psychiatrists Prescribe Medications
Degree Needed for Independent Practice: Doctorate
Licensure/Letters Behind their Name: MD
Psychiatrists are the only members of the mental health professions who can prescribe medication. They have completed medical school and a residency in psychiatry. While most psychiatrists receive training in various types of therapy while completing their training rotations, as the field evolves and more medications come on the market, psychiatrists are the gurus on medications in mental health.
While some pediatricians, family doctors, and OB/GYNs will prescribe some small doses of medications to treat mental health conditions, many have begun to refer their patients to psychiatrists so they can receive the best care in terms of those medications. Most psychiatrists treat either children or adults. Currently, due to the number of people on medications, there can be a long wait to get in to see a psychiatrist for your first appointment (particularly in eastern North Carolina where I live). If your primary doctor gives you a temporary prescription, ask them if they are willing to continue to writing your prescription, or if they would like for you to see a psychiatrist. That way, you can move quickly to get an appointment scheduled, as it can sometimes take three months to get in for an appointment.
Some psychiatrists engage in more therapeutic interventions than medications and spend time asking questions. Those appointments will go longer than the typical 15 minute sessions where they review how your medications are working for you.
One Important Word of Caution: if you have been prescribed medications, always consult with your doctor before just going off of them. Some of the mental health medications can have a negative impact on you if you suddenly stop them for any reason (including just forgetting to get your prescription filled). Always use your medications as directed and be sure to ask your pharmacist or doctor if you have any questions about them. This will help to keep you safe and healthy.
Psychologists Connect the Mind to the Individual
Degree Needed for Independent Practice: Doctorate (Ph.D. or Psy.D.)
Licensure/Letters Behind their Name: LP (Licensed Psychologist); LPA (Associate practicing under the supervision of a doctoral level psychologist- all master’s level psychologists remain under this level of supervision)
Psychologists consider themselves part of the “hard sciences” as opposed to the “soft sciences.” Psychologists love to zero in on the brain. They work hard to understand the individual’s inner world, and are fabulous at treating conditions such as schizophrenia, dissociative identity disorder, personality disorders, and other psychological conditions that are complex in nature.
Psychologists are the mental health professionals who do all of the testing. So when clients are looking for official tests for work or school, psychologists are the people to call. While the rest of us can do some assessments, they are simple questionnaires that help us, as opposed to in-depth measures that look at personality.
Many psychologists work in the schools, helping students with their Individual Education Plans (IEPs) and overseeing specific testing that helps the schools to better serve their students.
Psychologists often rely heavily on the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association. This goes hand in hand with their focus on pathology.
Counselors Advise Individuals on Actions to Meet Goals
Degree Needed for Independent Practice: Masters Degree (M.A. or M.S.)
Licensure/Letters Behind Their Name: LPC (Licensed Professional Counselor); LPCA (Associate practicing under the supervision of a more experienced clinician)
Counselors typically train in colleges of education. There, they are able to choose between two tracks of learning that prepare them to either work in schools or in private practice. Because of this, professional counselors have extensive training in career, vocational, and lifestyle development.
You have probably worked with these counselors in grade school or while in college. Counselors in private practice will help their clients to take a closer look at how their current life situation fits in with their goals and reality, and to assess what areas need to change to make them feel better about things.
Degree Needed for Independent Practice: Masters Degree (M.S.W.); Doctoral Degrees optional (mostly for teaching and research at the university level)
Licensure/Letters Behind Their Name: LCSW (Licensed Clinical Social Worker); LCSWA (Associate practicing under the supervision of a more experienced clinician)
Social workers at every level have a great deal of training that focuses on connecting their clients to resources. With course work that prepares social workers for school settings, along with substance abuse and gerontology work, social workers are passionate about helping their clients to overcome the obstacles to resources that hold them behind.
Some master’s level social workers go on to achieve training that allows them to combine their knowledge of resources with mental health treatment. They focus on treatment theories that help them to better understand how society impacts and influences individuals. Some examples of their focus areas include social justice, feminist theory, and community partnerships.
Marriage & Family Therapists Look at the Whole Picture
Degree Required for Independent Practice: Masters Degree (M.A. or M.S.); Doctoral Degrees are optional
Licensure/Letters Behind Their Name: LMFT (Licensed Marriage & Family Therapist); LMFTA (Associate practicing under the supervision of a more experienced clinician)
Clearly, this is my favorite group, since I am a Marriage and Family Therapist (MFT). 🙂 Unlike every other mental health discipline, we look at the bigger picture while working with whoever is in the room with us. This is “family systems theory.” Even if one person is in the room, we are assessing and looking at how all of the relationships in your life impact you. Those relationships can be with the people who raised you, the people you live with, the people you work with, your faith, your physical health, your goals and dreams, everything.
From day one of our graduate training, marriage and family therapists are the only mental health professionals who are trained how to treat relationships, romantic or familial or friendships or co-workers or whomever.
Some of the other mental health professionals may have been trained at a time before there was distinct licensure for marriage and family therapists available in all 50 states. Others, may have sought out additional training specifically on how to work with relationships. So if you work with one of those professionals on a relationship issue, be sure to ask about their training and the focus of their practice.
Which One Should I Choose?
With so many disciplines, it can seem overwhelming trying to choose which one is the best for you. Depending on what issues you want to focus on, there can be room for a team of various backgrounds to help you.
For example, if you are going through a challenging time in your relationship, you may be working with a marriage and family therapist. As a result of the extra time you are devoting to saving your marriage, your child may experience some troubles at school. So you are brought in to meet with the school counselor, who recommends some additional testing done through a psychologist.
Some of the things you should look for when choosing a therapist include:
- interaction style
- therapy style
- cost and insurance
- complete privacy and confidentiality