Therapists and psychiatrists both work in the mental health field, but their roles and responsibilities can vary. While some aspects of their work may overlap, there are key differences you should know about before deciding which career path is best for you.

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A therapist provides counseling services to patients in need of mental health care. They may work as a marriage counselor, child therapist, clinical psychologist, or another licensed position. During therapy, they can perform assessments, make diagnoses, and treat mental health disorders through a combination of approaches and methods.

Therapists are limited in terms of their ability to prescribe medications to their patients. However, there are a few exceptions. Some states allow licensed psychologists trained in clinical psychopharmacology to prescribe certain medications to treat mental health conditions.

A psychiatrist’s medical degree allows them to not just diagnose medical conditions, but also prescribe medications when needed. Psychiatrists work with patients to diagnose, treat, and prevent mental, emotional and behavioral issues. They can work in a variety of settings, including private practice, clinics, community centers, hospice programs, and many other places.

Psychiatric treatment may require different methods, such as psychotherapy (talk therapy) or medications like antidepressants, sedatives, anxiolytics, antipsychotic medications, hypnotics, mood stabilizers, and stimulants.

Becoming a psychiatrist comes with different educational requirements than becoming a therapist. That being said, some psychiatrists may offer different types of therapeutic treatment in conjunction with other techniques, however, they are not necessarily the same as those offered by a licensed therapist. Patients may choose to work with both a therapist and a psychiatrist, which can be beneficial when treating certain conditions.

A therapist can go by many titles, such as a licensed counselor, social worker, psychotherapist, psychoanalyst, or psychologist. Each of these career paths comes with its own educational track, training, and licensure. Their title may differ depending on laws in the state where they practice, and their services and the structure of those services can also vary.

There are many types of counseling careers, including:

Licensure requirements vary by state. For example, some states require that counselors hold a master’s degree and obtain certification through the National Board for Certified Counselors. Counselors may also be required to pass the National Counselor Examination, the National Clinical Mental Health Counseling Examination, or both in order to obtain a license.

Many states offer different types of counselor licenses. Search board directories by state to see the full list.

Clinical social workers perform under the umbrella of general social work. Social work in general is focused on the policies and practices that promote social welfare and equity. To become a clinical social worker, you need a master’s degree in social work (MSW), and most states also require you to complete a minimum number of hours of supervised experience.

As a clinical social worker, you can work with individuals, groups, and families to assess, diagnose, treat, and prevent behavioral disturbances. Professionals in this role might open up a private practice, treat hospital patients, or work alongside primary caregivers or with healthcare agencies. 

A psychologist must earn a doctoral degree in philosophy (Ph.D.) or psychology (PsyD). Depending on the program, applicants may also need a master’s in psychology as well. In order to practice, psychologists are typically required to obtain licensure, which can vary by state and job title. You can review each state’s requirements through the Association of State and Provincial Psychology Boards.

As with other therapy professions, psychologists can work in a variety of environments. According to the U.S. Bureau of Labor Statistics (BLS), elementary and secondary schools, healthcare centers, government organizations, and hospitals are the top employers of psychologists, following self-employment.

Individuals struggling with mental health challenges may be wondering whether they should begin treatment with a therapist or a psychiatrist. You may even be wondering about the differences between different types of therapists. Consulting with your primary care doctor can give you a better understanding of the options available.

Working with a therapist can be beneficial for patients confronting emotional, behavioral, or relational issues such as anxiety, depression, stress, trauma, or life transitions. Sessions may involve a combination of therapeutic approaches, such as cognitive-behavioral therapy (CBT), psychodynamic therapy, dialectical behavior therapy (DBT), and more. Through these approaches, therapists can help their clients develop self-awareness, learn coping skills, and make positive changes in their lives.

On the other hand, individuals with psychiatric conditions or those who may need medication to manage mental illness may find that a psychiatrist better fits their needs. A psychiatrist will work with patients to diagnose and treat, or prevent mental health challenges. These may include mood and anxiety disorders, attention-deficit/hyperactivity disorder (ADHD) and other severe mental illnesses. Prescribed medications can address biochemical imbalances, while psychoeducation can empower patients to confront their conditions and find relief.

In some cases, when symptoms are severe or complex, a combination of therapy and psychiatry may be recommended. Therapists and psychiatrists can work together to develop a holistic approach that addresses both the psychological and biological aspects of mental health. 

Your educational path to becoming a therapist will depend on the type of therapy you’re interested in. Before pursuing an advanced degree, it is a good idea to earn a bachelor’s degree in psychology. A master’s degree in counseling or social work, or a doctoral degree in psychology is a logical next step. Finally, you’ll need to gain hands-on experience through supervised clinical training before passing a licensing exam.

A psychiatrist is a doctor of medicine (MD) or osteopathic medicine (MO). In order to become one, you must attend medical school, complete a psychiatric residency, pass written and oral exams, complete a four-year residency, and possibly a fellowship. Many psychiatrists also become board certified by the American Board of Psychiatry and Neurology (ABPN).

Salaries for therapists can vary depending on the license, position, location, and years of experience. According to the U.S. Bureau of Labor Statistics (BLS), the median salaries for therapists in 2022 were:

As doctors, psychiatrists can command significantly higher salaries. The average annual wage for psychiatrists in 2022 was $247,350, according to the BLS.

Therapists and psychiatrists both work with individuals to improve their mental health conditions. They talk with patients to uncover what is wrong before developing treatment programs. Both professions seek to help patients improve their thoughts and behaviors to live happier, healthier, and more productive lives. The difference is in how each goes about achieving those results. While therapists focus on psychotherapy and behavioral changes, psychiatrists rely on medical interventions to treat mental health disorders.

Last updated November 2023