A client talking to a therapist or psychiatrist in an office.

Do I Need a Therapist or Psychiatrist: How to Decide

Mental health services are more widely available than ever, but with that comes the question of figuring out what service is right for you. Who prescribes medication? Who can teach you coping skills? So here’s a simple explanation to help you find the right therapist or psychiatrist for you.

What’s the difference between seeing a therapist or psychiatrist?

Psychotherapy or counseling usually means “talk therapy.” You sit in a room with the therapist, talk about your problems, and come up with solutions together. There are variations like art therapy, play therapy, group therapy and even adventure therapy. Therapists help you build a stronger relationship with yourself and other people in your life.

You can think of “therapist” as an umbrella term with several types:

  • Professional counselors are pretty much what most people think of as “talk therapy.” This is what I am, hello!
  • Marriage and family therapists specialize in working with couples and families.
  • Clinical psychologists have doctoral-level knowledge and sometimes work as therapists, sometimes work in institutions or community agencies.
  • Social workers may also do counseling work, may be case managers or involved in other social services.
  • Depending on where you live, there may be a lot of overlap in what these professions do. In Texas, where I work, all of these professions can diagnose and treat mental illnesses. It’s also common for one person to hold multiple licenses.

Psychiatry is a special case! Psychiatrists are physicians (MD) who can prescribe medication for mental health. Most professionals in the previous group are not trained to prescribe medication. Appointments with psychiatrists are often shorter, more focused on symptoms and medication management, and may feel more like doctor appointments. Because, well, they are doctors. Psychiatrists can also prescribe behavioral treatments like exercise, journaling and coping skills if they choose.

These are generalizations. Some psychiatrists are also psychologists or therapists. Psychologists with PsyD degrees can prescribe medication in certain states. When in doubt, ask the provider what working with them would look like.

Many people get best results from working with a therapist and psychiatrist, to ensure all sides of their recovery are addressed.

Try reaching out to a therapist if:

  • You want to get support weekly or biweekly.
  • You want plenty of time per session to explore your problems.
  • You are more interested in talk therapy, changing your behaviors, or developing coping skills than in medication.
  • You want to try couples therapy, group therapy, or another treatment psychiatrists usually don’t cover.

Key words to look for: clinical psychologist (PhD, PsyD), LPC, LCSW, LMFT, LMHC, LCDC.

Try a psychiatrist if:

  • You want to try psychiatric medication.
  • You want to better understand what’s going on with your brain chemistry.
  • You’re already on medication, and want an expert to help you manage it.
  • Your symptoms don’t get better from talk therapy or behavioral treatments alone.
  • You have an illness that usually needs medication for best results.
  • The therapist you want to see also happens to be a psychiatrist. They are out there!

Key words to look for: Psychiatrist.

If you can’t decide between a therapist or psychiatrist, try interviewing them.

When in doubt, ask. I love it when my clients ask me what kind of work I do. It helps make sure that we’re a good fit before we start working together! And if we aren’t, I’m happy to refer them to a psychiatrist, or marriage and family therapist, or whoever is best qualified to treat them.

Some useful questions to ask a therapist or psychiatrist are:

  • What license do you hold?
  • What do you specialize in?
  • How long are your sessions and how often would we meet?
  • Do you do talk therapy, medication, or other treatments?
  • If there’s a particular treatment I want (CBT, EMDR, art therapy…) can you provide it?
  • If not, can you refer me to someone who does?
  • How would we know if I’m getting better?

I hope this helped you get a better idea of what to look for when seeking help. Don’t hesitate to contact me if you have questions, or if you’re interested in starting therapy for yourself.