Is There Even a Difference?
It’s early September and school is back in session. Maybe the start of the school year has been very difficult for your child (or for you as a parent). Maybe you have more time to take care of yourself now that your kids are at school during the day. Perhaps you’re anxious about starting or resuming college or graduate school classes. Of course, it could be that you’re not even affected by this time of transition, but you’re struggling all the same.
Whether the issues include depression, anxiety, or ADHD symptoms like trouble with focus and attention or hyperactivity, you might be looking for a psychiatrist. Or is it a psychiatric nurse practitioner? Or a PA? Should you call a psychologist? What about a therapist or a counselor? What is the difference? Which one is best for you? How can you tell the difference between each?
It is quite common for these terms to be confused or used interchangeably. Psychiatrists, psychiatric nurse practitioners, PAs, therapists, and psychologists all play important roles in mental health care. However, there are differences between these types of professionals, both in terms of training and the type of care they offer. In this article, I will focus on clarifying the general services you can expect from these professionals and how you can identify one type of professional from the others.
Psychiatric Providers
Psychiatrists, nurse practitioners, and physician assistants are psychiatric providers. Psychiatrists are physicians – they have completed medical school and a residency (sometimes a fellowship, as well). Nurse practitioners and physician assistants have completed graduate school – they have received a master’s degree (sometimes a doctoral degree). Each are trained to assess, diagnose, and provide treatments which include prescription medications. In many states, including Texas, nurse practitioners and physician assistants must have some level of supervision from and collaboration with a physician.
“...Psychiatrists, nurse practitioners, and physician assistants...are trained to assess, diagnose, and provide treatments which include prescription medications...They treat issues such as depression, anxiety, ADHD, bipolar, and schizophrenia."
While psychiatric providers can and do provide psychotherapy (further discussed below), their training and thus, their treatment, often focuses more on prescribing medications. They treat issues such as depression, anxiety, ADHD, bipolar, and schizophrenia. The initial visit with a psychiatric provider may last anywhere from 45 to 90 minutes. Follow up visits range from 15 to 30 minutes each and generally occur every 1-3 months.
To identify a physician, look for “MD” (medical doctor) or “DO” (doctor of osteopathy) after the provider’s name. To identify a psychiatric nurse practitioner, look for designations such as “PMHNP” (psychiatric and mental health nurse practitioner) and “APRN” (advanced practice registered nurse). To identify a physician assistant, look for “PA” listed after the provider’s name.
Psychologists & Therapists
Psychologists and therapists are often referred to as “counselors.” Psychologists and therapists do not prescribe medication. Rather, they provide psychotherapy or “talk-therapy” to treat many of the same mental health issues that psychiatric providers treat. In other words, they provide a different type of treatment for depression, anxiety, PTSD, bipolar, and other mental health issues.
Some people seem to believe that these providers just listen and give advice. However, psychologists and therapists are trained to implement specific techniques that have shown through research to be effective. They are also trained to identify when a certain technique is more appropriate than others, depending on a variety of factors such as the issue being treated.
“Psychologists and therapists...provide psychotherapy or “talk-therapy”...a different type of treatment for depression, anxiety, PTSD, bipolar, and other mental health issues....[they] are trained to implement specific techniques that have shown through research to be effective.
While the duration of a therapy visit may depend on the therapist or the type of therapy he or she is providing, you can generally expect a therapy session to last approximately one hour. You can also expect therapy sessions to occur more frequently, usually once a week. However, some situations may call for sessions to occur more often or less often. Sometimes a client and therapist will discuss this matter and come to a decision together.
Technically, anyone can call themself a “counselor,” regardless of their training. However, one must have specific training to be a psychologist or a therapist. A psychologist is trained at the doctoral level and will list “PhD” or “PsyD” at the end of his or her name. A therapist is trained at the master’s level (or higher) and will list designations such as “LPC” (licensed professional counselor), “LSCW”(licensed clinical social worker), or “LMFT” (licensed marriage and family therapist).
“...each type of provider is trained to identify when a patient needs to be referred...Psychiatric providers routinely refer patients to therapists; therapists routinely refer patients to psychiatric providers.”
Who Should You Call?
I could answer this question with a lot of research data and expert opinions about the types of treatment that are most effective for various disorders. Instead, I will say that in many cases, a combination of therapy and medication is more effective than either medication or therapy alone. Additionally, each type of provider discussed above is trained to identify when a patient needs to be referred to another type of provider. Psychiatric providers routinely refer patients to therapists; therapists routinely refer patients to psychiatric providers. As such, unless a healthcare professional has made a specific recommendation, don’t be afraid to start with the type of provider that you prefer. The most important thing is to take that first step toward healing, whether it is with a psychiatric provider or a therapist/psychologist.
