Reviewing the Mental Health Professions- Who do I need to see?

I have written a previous blog about the differences in mental health professionals and what their titles mean, but recently I have noticed that quite a few clients are still unsure about these differences. The differences between psychiatrist, psychologist, and counselor/therapist are not a matter of status or schooling, but more akin to knowing the difference between a gastroenterologist (stomach doctor) and a cardiologist (heart doctor). There is a need for better education of the public about the differences in these professions, so patients/clients are not searching in the wrong places for help and wasting their own time and money. The good news is there is no chance for any kind of danger, meaning a psychiatrist will not provide a service to a patient who actually needs a counselor that will cause harm. The professions are closely related enough that they are more likely to work in tandem to provide mental health help to an individual as opposed to providing any service that works contrary to the other professions. Still, knowing the difference is valuable and also helps keep communication clear to others about what kind of mental health services a person is receiving.

Psychiatrists: Medical Doctors for the Brain

Psychiatrists seem to be an almost mythical creature to people who have never sought treatment in the mental health realm. I have heard individuals ask if psychiatrists are involved in the treatment of everything from depression to heart conditions. The truth is a psychiatrist is simply a medical doctor who has specialized in the treatment of mental health conditions. This is not the same as a neurologist, who is a medical doctor who specializes in the physical brain and nervous system. There is some overlap between these specialties, but a psychiatrist deals with mental health issues that you may associate with a therapist like anxiety, depression, bipolar disorder, etc. A psychiatrist is an essential part of treating many mental health issues, but not for everyone. Essentially a psychiatrist in modern times can best be classified as a mental health medication specialist. They are the ones who know the most, and have the most access, to mental health medication ranging from antidepressants to antipsychotics and everyone in-between. Many people are confused by a psychiatrists role because they have heard from others, or even experienced themselves, their primary care physicians prescribing mental health medications. This is quite common, as primary care physicians are able to provide mental health medications and are often the first source for people to turn to when struggling with their mental health. Psychiatrists are there for when a person needs either a more specially trained professional to manage their medications, as is the case in things like severe bipolar or schizophrenia, or when they are looking to create an ongoing relationship with a medical doctor who is going to directly oversee their mental health while their primary care focuses on the other areas of the body. Psychiatrists are often hard to get an initial appointment with, but still are fairly regularly needed to best ensure treatment of people with mental health disorders that are not direct results of temporary situations.

 Psychologists: Working with the Brain to work on the Brain

Psychologists are the least commonly sought mental health professional, not due to a lack of ability but more so due to many of them specializing in dealing with issues of the brain that are not frequently experienced. It is first important for people to understand that a psychologist is not someone who has an undergraduate degree in psychology, nor is a mental health counselor who received a master’s degree in counseling. A psychologist refers to a person who has received a PhD in psychology ranging from clinical psychology to neuropsychology and quite a few other degrees. While for the average person’s daily life this may not be essential knowledge, when seeking treatment for issues of the mind/brain it is important to make sure that if one is seeking a psychologist that they find someone with these educational qualifications and not seek out someone who simply studied psychology in undergrad.

So, when would someone see a psychologist? Well, in a lot of cases a psychologist is a part of a treatment team at a hospital. If someone is in the hospital for neurological problems, head injury, or severe mental health disorders they will be evaluated once or multiple times by a psychologist. Psychologists have a real expertise in assessment and testing that is very important when there is suspected damage to the brain that may manifest in behavioral or mood changes. Psychologists can actually become licensed to perform talk therapy like counselor/therapists, but many of them choose to go different paths. Essentially, it is possible for a psychologist to do talk therapy, focus on research on animals or humans at a university, or work at a hospital or treatment center for brain issues. You are unlikely to encounter a clinical psychologist who does talk therapy exclusively, but do not be deterred from a possible counseling focused relationship because a provider has a psychology masters or PhD. Asking your counselor about their credentials is never offensive as it is your right to know the educational background of those treating you.

 Counselors: Talk therapy focused, most involved with clients

As a counselor, it is definitely fair to believe I am biased towards counselors as being the most important part of mental health treatment. So, to combat this assumed bias let’s start the counselor section by identifying the things a counselor cannot do and will not be able to help you with. First and perhaps most important, counselors cannot prescribe medication of any kind. We are not medical doctors, we did not attend medical school, nursing school, or pharmacology school. There are some counselors, like myself, who get extra training in psychopharmacology (mental health medication), but this extra training makes me more aware of medicines and their effects and does not in any way qualify me to prescribe or even recommend medications for clients. The other thing a counselor cannot do is diagnose/test for certain disorders. Things like Autism, ADHD, Schizophrenia etc. require either psychiatrists or psychologists to make the proper diagnosis due to the testing required that counselors are not typically trained in.

What a counselor does provide is in depth, longer lasting sessions focusing on talk therapy and getting to know clients in a more personal way. Psychiatrists in particular often disappoint people who are expecting an hour long session to talk about their thoughts and feelings. Psychiatric appointments may last as short as 10 minutes, and likely no more than 20 minutes due to them seeing so many patients a day. Counselors spend 45-60 minutes with a client, often weekly, while a psychiatrist may see you for 20 minutes per 3 month span. This is not a criticism of psychiatry, but a warning for those who want a one stop shop for medication and talk therapy. Unfortunately in our current system there is no provider who does everything from testing, prescribing, talk therapy, and diagnosis all in one setting. Most clients who have recurrent or severe mental health issues need a psychiatrist and a counselor. A psychologist can be helpful at times but is usually not needed over longer periods of time. For those with more of a focus on self-improvement or less severe mental health struggles a counselor alone is often sufficient.

If you would like to start counseling while also discussing what kind of treatment may help you, please contact Life Enhancement Counseling Services today at 407-443-8862 to schedule an appointment with one of our experienced mental health counselors.


LECS Counselor