Understanding the Difference Between a Psychiatrist and a Therapist

Medically Reviewed by Mark Hrymoc, M.D., Chief Medical Officer, double-board certified in General & Addiction Psychiatry

When seeking help for mental health concerns, many people wonder whether they should see a psychiatrist or a therapist. While both play important roles in mental health care, they differ in training, approach, and the types of services they provide. Understanding these differences can help individuals make informed decisions about the kind of support that best meets their needs.

What Is a Psychiatrist?

A psychiatrist is a medical doctor (M.D. or D.O.) who specializes in diagnosing, treating, and preventing mental health disorders. Psychiatrists complete medical school, followed by a residency in psychiatry, where they gain specialized training in the biological, psychological, and social components of mental illness. This medical background allows them to prescribe medication, order and interpret diagnostic tests, and evaluate the effects of medical conditions on mental health.

In addition to medication management, psychiatrists may provide psychotherapy, though many focus primarily on diagnosis and pharmacological treatment. They often work with individuals who have complex mental health needs, such as bipolar disorder, schizophrenia, severe depression, or treatment-resistant anxiety disorders. According to the American Psychiatric Association, psychiatrists are uniquely positioned to integrate physical and mental health considerations in treatment planning.

What Is a Therapist?

The term “therapist” generally refers to a licensed mental health professional who provides talk therapy, also called psychotherapy. This can include psychologists (Ph.D. or Psy.D.), licensed clinical social workers (LCSW), licensed marriage and family therapists (LMFT), and licensed professional counselors (LPC). Therapists typically hold advanced degrees in psychology, counseling, or social work and are trained in evidence-based therapeutic approaches such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and psychodynamic therapy.

Unlike psychiatrists, therapists do not attend medical school and cannot prescribe medication in most states (the exception being a small number of psychologists with additional training and prescribing privileges in specific jurisdictions). Therapists focus on helping clients develop coping skills, process emotions, and make changes in thought and behavior patterns. They may work with individuals, couples, families, or groups and treat a wide range of concerns, from everyday stress to significant mood or trauma-related disorders.

Training and Education: Key Distinctions

The most significant difference between psychiatrists and therapists is in their educational paths. Psychiatrists spend years studying medicine, including anatomy, physiology, pharmacology, and neurology, before specializing in psychiatry. This allows them to understand how mental health symptoms can be influenced by physical health, brain chemistry, and medication. Therapists, on the other hand, receive specialized training in counseling theories, therapeutic techniques, and psychological assessment, with a primary emphasis on interpersonal and emotional processes rather than medical interventions.

Scope of Practice and Services Provided

Psychiatrists are authorized to:

• Prescribe and monitor psychiatric medications

• Diagnose mental health disorders using medical and psychological evaluations

• Order laboratory tests or imaging to rule out underlying medical causes

• Provide psychotherapy, though less commonly as their primary focus

Therapists are authorized to:

• Provide psychotherapy using various evidence-based modalities

• Offer guidance and strategies for coping with stress, trauma, or relationship issues

• Conduct psychological assessments (in the case of psychologists)

• Refer clients to psychiatrists or other medical professionals if medication may be beneficial

Both professionals can play integral roles in mental health care, often collaborating to provide comprehensive treatment. For example, a person with severe depression might see a psychiatrist for medication management and a therapist for ongoing talk therapy.

Which Professional Should You See First?

Choosing whether to see a psychiatrist or therapist first depends on your symptoms, preferences, and treatment goals. If you are experiencing symptoms that may require medication—such as severe mood changes, psychosis, or suicidal thoughts—starting with a psychiatrist can ensure that medical and psychiatric needs are addressed promptly. If your concerns are primarily related to stress management, relationship challenges, or developing coping skills, beginning with a therapist might be more appropriate.

In many cases, a combined approach offers the most benefit. Research published in The American Journal of Psychiatry shows that treatment plans incorporating both medication and psychotherapy are often more effective for conditions like major depressive disorder than either intervention alone.

Collaboration in Mental Health Care

While psychiatrists and therapists have distinct roles, they frequently collaborate to provide integrated care. A psychiatrist may diagnose and prescribe medication, while a therapist offers ongoing support to help the patient process emotions, navigate life challenges, and practice new coping strategies. This partnership ensures that treatment addresses both the biological and psychological aspects of mental health.

Making the Right Choice for Your Needs

The decision to work with a psychiatrist, therapist, or both depends on the nature and severity of your symptoms, your treatment preferences, and access to care. Some individuals may only require talk therapy, while others benefit from a combination of therapy and medication management. Understanding the unique roles of each professional helps ensure you receive the right type of care for your circumstances.

Seek Support

Finding the right mental health professional is an important step toward healing and emotional well-being. Psychiatrists can address mental health concerns with a medical perspective, while therapists provide ongoing support through evidence-based talk therapy. Working with one or both can help you navigate challenges more effectively and move toward your mental health goals. For assistance connecting with licensed psychiatrists and therapists in Los Angeles, call (310) 601-9999 or visit www.mentalhealthctr.com to explore available treatment options.

References

1. American Psychiatric Association. (2023). What is psychiatry?

2. National Alliance on Mental Illness. (2022). Mental health professionals: Who’s who and what they do.

3. American Psychological Association. (2022). Understanding psychotherapy and how it works.

4. Gabbard, G. O. (2014). Gabbard’s Treatments of Psychiatric Disorders (5th ed.).

5. World Health Organization. (2019). Mental health: Strengthening our response.

6. Cuijpers, P., et al. (2014). Adding psychotherapy to pharmacotherapy in depression and anxiety disorders: A meta-analysis. World Psychiatry, 13(1), 56–67.

7. Norcross, J. C., & Lambert, M. J. (2018). Psychotherapy relationships that work III. Psychotherapy, 55(4), 303–315.

8. Wampold, B. E., & Imel, Z. E. (2015). The Great Psychotherapy Debate. Routledge.

9. Insel, T. R. (2009). Disruptive insights in psychiatry: Transforming a clinical discipline. Journal of Clinical Investigation, 119(4), 700–705.

10. Thase, M. E., & Friedman, E. S. (2019). Is combined treatment the best approach for chronic depression? American Journal of Psychiatry, 176(6), 454–456.