Psychiatry vs therapy

[camillalev]

I'm looking into seeing a psychiatrist or a therapist but am unsure if is there a difference between the two. Has anyone who has goes to both noticed a difference in how they approach helping their patients?

[Downtown]

Camil, in the USA alone, there are three- to four-hundred-thousand therapists, most of whom have a masters degree in psychology or therapy. About 100,000 of them are licensed psychologists, i.e., hold a PhD in psychology and are licensed to practice in a State. Generally, the person having the most formal training and experience in therapy is a psychologist.

 

Yet, after therapists have been out of school and practicing for 10 or 15 years, some of those holding only a masters degree will be better at performing therapy than some of the psychologists. Hence, if you have reason to believe that a certain therapist is exceptionally good, it would be prudent to consider using him even though his formal training is only at the masters level. As is true for the members of any profession, therapists exhibit large differences in their skill sets. It therefore is important to do some research when selecting one.

 

If you need medication prescribed, the psychologist will refer you to a psychiatrist, who holds an M.D. degree in addition to the PhD in psych. Due to that extra degree and the years of medical school required, a psychiatrist typically charges double what a psychologist is able to charge. For this reason, and because psychologists spend far more time devoted to therapy, it usually makes sense to see a psychologist every week or two for therapy and see a psychiatrist every six months or so to review your medication needs. For more information about the differences among therapists, I suggest you read Dr. Jim Hunt's article, "MD, PhD, MA, MFCC, or MFT -- Who are These People?"

[burnt]

You see a psychiatrist (doctor) for the mental illness related medications--he decides what chemicals (anti-depressants, anti-anxiety pills etc.) you need. Psychiatrists have MD (medical doctorate degree).

 

You see a therapist or psychologist for the mental illness related "talking". These people specialize in psychology and social work (their degrees could be PhD, but doesn't have to be) and their work involves in talking to you to guide your thoughts and behaviors.

 

Best option--see both. For most people, it's a combination of medications and talk therapy that helps.

 

(I personally, am a heavy believer in therapy; and will only choose to take chemical pills as a last resort.)

[d0nnivain]

One's a medical doctor. The other is a counselor. The psychiatrist will not usually do talk therapy with you. He or see may read reports from the therapist & may meet with you every so often, at least every 90 days, to make sure you are not having an adverse reaction to the meds they prescribe but that's it.

 

 

I prefer talk therapy to pills.

[carhill]

One practical difference I noted was, in general, all the non-MD therapists we interacted with were directly accessible. With the MD's it was more likely to see their PA or NP and not the MD him or herself. Since NP's have a DEA license in my state, they'd sometimes be the primary point of contact except for certain controlled substances.

 

If I had to draw a distinction it would be the MD's focused most on the physiology and chemistry of the brain and the PhD's and other therapists focused on psychology and behavior, how the brain manifested its functions into behavior.

[camillalev]

Got it! Thanks for the responses, this was super helpful! For me medication is a last resort, so I will probably see a therapist first. I'm looking through a list of therapists through my health insurance and it seems try all have different approaches.. Has anyone found that one specific approach them helped them?

[Satu]

I went to see a Child Psychologist, but he was only six, so I didn't have much confidence in his skills.

[dichotomy]

I have seen both. I saw a psychiatrist for about 2 years after my divorce. He was both a talking guy and a medicine guy. He tried lots of meds on me - nothing really worked because I was dealing with trauma and not brain wiring issues. It was interesting because he dealt with lot of very mentally ill people and had seen it all. Nothing (and I mean NOTHING) I could say would have shocked him nor would he have blamed me for anything thought or action I did. I could have told him "I drove to a farm last weekend and raped a sheep and I am knitting a sweater from its wool" and he would have said "Well ok lets discuss that" ...In a way this kind of helped me - because I kind of felt sane compared to the many different people he saw. I also felt safe to say any weird thoughts or feelings in my head or have a breakdown in his office. But he was also not very sympathetic to my pain.

 

After this - I saw two female therapist as both a couple (MC with my wife) and saw these two alone IC afterwards. Each brought empathy and support and were good talkers. I would say they were a more UN-accepting of bad behavior or thoughts. Not exactly blame - but more "hey that's not healthy dont do that or think that - we need to work on this behavior or thoughts.... I want you to do this and that". When my wife was in there -this kind of approach was very helpful.

 

All of this was very expensive by the way - but I had insurance for 80% of it.

 

My oldest child also saw both - but the psychiatrist was only a check in for meds and summary once every 2-3 months - and worked with the therapist for weekly work.

Edited March 19, 2016 by dichotomy

[SunnyWeather]

Got it! Thanks for the responses, this was super helpful! For me medication is a last resort, so I will probably see a therapist first. I'm looking through a list of therapists through my health insurance and it seems try all have different approaches.. Has anyone found that one specific approach them helped them?

 

 

depends on what you would be seeing one for.

 

also, would like to point out PsyD's are another type of psychologist. they are skilled in testing. lots and lots of testing after which treatment plans are implemented according to which box on the DSM they allocated you to.

 

also, it's important to know that with any insurance coverage, PsyD's, PhD's, MD's and even therapists *have* to give you some kind of diagnosis--pathologize you-- even if all you wanted some support during a difficult time.