Psychologist, Psychiatrist, and Therapist: What’s the Difference?

A psychologist (probably a clinical psychologist) giving a child a projective test. (from the Bureau of Labor Statistics)

It’s very common for people to get confused about the terms “psychologist ” and “psychiatrist,” as well as related terms such as “therapist” and “counselor.” And it makes sense – each job falls under the broad umbrella of mental heath, each job has certain duties in common, and the duties for each job have changed over time.

It’s also common for the terms to be misused and misunderstood. For the sake of your education and impressing people at dinner parties, here’s the breakdown:

Psychiatrist: Psychiatrists have MD degrees. They are physicians who’ve specialized in psychiatry during their residencies. Their jobs usually entail working at a hospital or psychiatric clinic and treating patients for mental disorders that range from mild to severe. You also visit a psychiatrist when you need medication for any mental disorder. A family doc can prescribe basic meds (e.g. antidepressants for short term problems) but a psychiatrist is called upon when there is a longer term problem or a more severe disorder. Psychiatrists may also practice individual therapy.

Sometimes you’ll see psychiatrists in academic research, especially if the university has a medical school. My former boss at University of Colorado was a psychiatrist. He spent most of his time on research and getting grants, and one day per week treating patients. A limited number of universities have combined MD/PhD programs as well – Frasier and Niles (of the show Frasier) had MD/PhD degrees.

Psychologist: This is one of the more confusing ones because there are many kinds of psychologists and their job duties can differ greatly. Psychologists always have doctoral degrees – often a PhD, but sometimes a PsyD. What a psychologist does for a living depends on his or her doctoral and post-doctoral training.

Clinical and counseling psychologists focus on studying mental disorders and are trained both to do research and to treat patients. Which of these is emphasized more depends on the program: PhD programs are more research-oriented, while PsyD program focus more on practicing therapy. When they complete their training, they can work at clinics, universities, or open their own practices. When most people hear the word “psychologist,” they often assume you’re a clinical psychologist.

Academic or research psychologists focus strictly on research in both their training and their jobs. They typically work in universities, where they teach, do research, train PhD students, etc. Although some study mental disorders, their specialty areas vary from neuroscience (the study of the brain and its impact on behavior), to cognitive psychology (looking at thinking patterns, memory, etc), social psychology (looking at social influences, prejudice, etc), biological psychology (sensation and perception, behavioral genetics, hormones and behavior, etc), and others. They are scientists in every sense – they get research grants, conduct studies, and publish papers. I was a research psychologist before I left academia.

Therapist/counselor: These broader terms refer to those who provide services to individuals looking for therapy/counseling. Education varies. Most therapists have master’s degrees and, more importantly, state-issued licenses to practice. Those who practice therapy should have both of these requirements, unless they are still in training and supervised by someone qualified.

“Counselor” can range from a school counselor, who will have degrees and licenses, to an undegreed or unlicensed counselor in the mental health field. Sometimes, substance abuse treatment centers or residential facilities for troubled adolescents will employ Bachelor’s level counselors to serve their communities. Sometimes, these positions are a way to get supervised therapy training to obtain a degree or license.

People often ask about my background and education. I am a psychologist, technically speaking… a research psychologist. My PhD is in psychology, and my specialty area was behavioral genetics. Before I left the university to write, I only did research – I had a grant and published papers in scientific journals. Also, before I got my PhD, I got a master’s in clinical psychology. However, I did no internship and obtained no license, so I’m not a therapist.