If you’re just tuning in now, this is the third article of a four-part series on how to find a good therapist. In posts one and two I addressed the stigmas that keep people from seeking out therapy, and the different kinds of psychotherapy that exist. Several people have requested that I write about the difference between psychologists, psychiatrists, social workers, and the like, so in this installment I’m going to do just that. Before I do, however, there are two things that I want you to keep in mind:
1) A good amount of what I’m about to describe boils down to things like how much time a clinician spends in school. However, whether someone is a good therapist has a lot to do with who they are as a person, and whether that person is the right therapist for you has to do with how well you two work together. So as I describe the differences between degrees, please understand that this is not all as hierarchical as it might sound.
2) This information is not meant to influence what kind of therapist you should seek out, but to help you to understand the referral(s) you’ve gotten. In the next post, I’ll be covering how to get a good referral in more detail. This post is simply meant to give you a little extra insight into what the letters mean that come after someone’s name.
Dig? OK, let’s go.
When it comes to clinical psychologists, there are two different kinds of degrees that one can have: a doctorate in psychology (Psy.D.) or a doctorate of philosophy in the field of psychology (Ph.D.). The difference between the two is that the dissertation requirements for a Ph.D. are more quantitative in nature, but both degrees require a considerable amount of training in how to “do” therapy, and they’re otherwise very similar. You shouldn’t experience any difference as a client.
The main difference between psychologists and psychiatrists is that psychiatrists are medical doctors (M.D.s). As a result they focus mostly on biological treatments and are able to prescribe medication. How much training a psychiatrist receives in conducting therapy varies depending on which program they attend, and there are some psychiatrists who practice as therapists. In my professional experience, however, I’ve known few psychiatrists who focus on therapy; most of the psychiatrists that I have worked with have focused on prescribing medication. In some states, psychologists can prescribe medication if they get additional training, but those instances are rare.
Clinical social workers are trained as therapists. On average, the formal part of their training (the time that they spend in school) is shorter than it is for psychologists by a little more than half. As a result, they learn less about specific things like theory, psychological testing or assessments, the brain and biology, and psychopharmacology. However, by the time clinical social workers get licensed they have a lot of experience in the art of therapy. With regard to initials, licensed clinical social workers have the letters L.C.S.W. after their names.
Finally, in some states there’s also something called a marriage and family therapy degree (M.F.T.). Marriage and family therapists spend about the same amount of time in school as social workers and take a comparable amount of time to get licensed (usually several years, depending on state requirements). The coursework and training for this degree focuses on couples and families, but they are not restricted from working with individual adults, and many of them do.
So, what does all of this mean for you? I would say that the primary distinction between these degrees has to do with whether someone has a medical degree or not. If you’re specifically looking for medication, then you need to seek out someone who is a licensed prescriber, and in the vast majority of instances that person is going to be a medical doctor (M.D.).
If you’re not sure whether you need medication, you may want to seek out a therapist and discuss your concerns with him or her. From there, that therapist can refer you to a psychiatrist, depending on what you decide. It’s often best when medication is involved to pursue those two things (medication and therapy) at the same time, because many studies have shown that being in therapy increases the effectiveness of medication by quite a bit. So even if you feel like medication is right for you, I would always recommend therapy as well.
In my next and final post on this subject, I’ll be talking about how to get good referrals and how to use first sessions as an interview of sorts. By the last article, you’ll have the information you need to find the therapist that’s right for you.
Photo credit: mjmyap