Psychologist vs psychiatrist: what is the difference?

Deciding to seek support is an important step in itself. The next question is often confusing: should I see a psychologist or a psychiatrist? These professions may look similar, but their training, ways of working and responsibilities differ. Below we describe the most common roles and which one might suit you. Professional titles and responsibilities vary somewhat from country to country, so treat this as a general overview.

What does a psychologist do?

A psychologist has a university degree in psychology. Clinical psychologists usually go on to postgraduate training specialising in assessing mental health difficulties and providing psychotherapy. Psychologists work through conversation, psychological assessments when needed and evidence-based therapy methods.

For many concerns, such as anxiety, stress, relationship problems, grief, self-esteem, adjustment difficulties or mild to moderate low mood, working with a psychologist can be a good place to start. Psychologists do not prescribe medication; if they think medication might help, they will refer you to a psychiatrist.

What does a psychiatrist do, and who can prescribe medication?

A psychiatrist is a medical doctor who has completed specialist training in psychiatry. They consider possible physical causes of mental symptoms, make diagnoses and, when needed, start and monitor medication. In mental health care, the psychiatrist is the professional who can prescribe.

Seeing a psychiatrist is important if symptoms are very intense, daily functioning is seriously affected, sleep or appetite have changed markedly, or you have taken psychiatric medication before. For many people the best results come from a psychiatrist and a psychologist or psychotherapist working together. Always make decisions about starting, changing or stopping medication together with your doctor.

A common belief is that seeing a psychiatrist means things must be very serious. That is not the case. Psychiatrists help with a wide range of concerns, from sleep problems to anxiety, and not every appointment ends with a prescription. Sometimes the visit is simply an assessment, followed by a recommendation to continue with therapy.

What is a psychotherapist, and what is a counsellor?

A psychotherapist is a professional with in-depth training and supervision in a specific therapy approach, such as cognitive behavioural therapy, schema therapy, EMDR or family therapy. They may be a psychologist, a psychiatrist or another mental health professional. What matters is that their therapy training and experience are clearly stated.

Counsellors are usually trained in counselling or guidance. They often work in schools, organisations and counselling centres, supporting people with adjustment, personal development, career and relationship issues. Family counsellors focus on communication within families and between couples.

What do speech therapists and special education experts do?

Some professionals work in fields close to mental health but with a different focus:

• Speech and language therapist: works with communication difficulties such as speech delay, stuttering, voice and swallowing problems.
• Special education expert: supports the learning needs of children with learning difficulties, autism or other developmental differences.
• Occupational therapist: works on everyday living skills, sensory regulation and fine motor skills.
• Life coach: helps with goal setting and personal growth; treating mental health conditions is outside the scope of coaching.

Which professional should I see, and how do I choose?

If you are unsure, you do not have to work it all out alone. After a first meeting, a professional will usually think through with you what kind of support fits best and refer you to a colleague if needed. These questions can help you choose:

• Are the professional's degree and, where relevant, licence or therapy training documented?
• Do they have experience with the issue you want help with?
• Do they work in a language you feel comfortable speaking?
• Would you prefer online or in-person sessions, and do they offer that?
• After the first session, did you feel listened to and understood?

On InnerWell, experts' diplomas and documents are checked before their profile goes live. You can filter by topic, profession and the language you speak to find someone who suits you.

If you are having thoughts of harming yourself or you are not safe right now, do not wait to choose a professional: call 112 immediately. If you would like a quick check on your mood, the depression test below this article can give you a sense of where you stand; the result is not a diagnosis.