Psychiatry vs. Therapy: 5 Main Differences

Do you need a psychiatrist or therapy? Might you benefit from both?

In the world of mental health care, it can sometimes be challenging to differentiate between the types of providers and what they do. Let’s take a closer look at the key similarities and differences between therapists and psychiatrists.

Before digging into the differences, we’ll first identify several similarities between therapy and psychiatry, so that you can better understand the roles they play in your care team.

It’s important to know that therapists and psychiatrists have the same ultimate goal: to provide treatment for people with mental health concerns and help them feel better. Psychiatrists and therapists both diagnose mental health conditions and directly care for people in a variety of settings, including online, in private practice, or in hospital settings. And both therapists and psychiatrists have specialized training to do what they do. It is common for psychiatrists and therapists to work closely together to cover the breadth of their members’ needs.

At  Brightside Health, we have a range of mental health professionals including therapists and psychiatric providers. To learn more, you can start with a free assessment. 

If you are experiencing a mental health crisis and need immediate help, please take advantage of the resources at the bottom of this page.

Even though their goals are similar, psychiatrists and therapists are mental health professionals that provide support in different ways, and the type of treatment they offer is generally quite different in scope. Let’s examine several ways in which therapy is different from psychiatry.

Training

Generally speaking, therapists and psychiatrists have different training backgrounds and educational qualifications. At Brightside, our providers are thoroughly vetted, trained, and licensed.

Psychiatrists

Psychiatrists are medical doctors who have completed medical school. As Psychology.org explains, the training to become a psychiatrist is very rigorous:

To become a psychiatrist, candidates complete a bachelor’s degree before attending medical school. Prospective psychiatrists study pharmacology, anatomy, biology, neurology, and disease, acquiring the knowledge necessary to prescribe medication. Graduates complete a residency, which typically lasts about 4 years, before seeking licensure. The process lasts about 12 years in total.

This means that all psychiatrists carry the title of MD (doctor of medicine) or DO (doctor of osteopathic medicine). This is not always the case for therapists, as we will discuss below, or for psychiatric nurse practitioners.

There is a growing trend of certified psychiatric nurse practitioners, also known as psychiatric mental health nurse practitioners (PMHNP) working in psychiatric practice. While PMHNPs are not medical doctors, they are advanced practice RNs and are trained and licensed to provide a wide array of treatments. The American Psychiatric Association explains the psychiatric nurse practitioner’s duties:

“They assess and diagnose, prescribe medications, provide psychotherapy, provide consultation and liaison services, and participate in policy and research development. All 50 states grant PMHNPs prescriptive authority to some level.”

Brightside’s psychiatric providers are psychiatric nurse practitioners or MDs and follow the American Psychiatric Association practice guidelines for prescribing medication. You can learn more about how we prescribe medication using our proprietary prescribing-engine for clinical decision support here.

Therapists

Unlike psychiatrists, therapists generally do not attend medical school. The educational background of therapists can vary depending largely on the interests of the therapist.

Therapists can be psychologists, with doctoral degrees (Ph.D., PsyD, or EdD) in psychology. As WebMD explains, after completing graduate school, psychologists will generally undergo an extended internship that “provides further training in treatment methods, psychological theory, and behavioral therapy.” A psychologist will then seek licensure to “do counseling and psychotherapy, perform psychological testing, and provide treatment for mental disorders.”

Some therapists are not doctorate-holding psychologists. Many certified therapists hold master’s degrees, and then additional qualifications designating them licensed mental health counselors or clinical social workers. Both designations require additional clinical training after graduate school, and both qualifications permit the holder to operate as a therapist. At Brightside, our licensed therapists hold a master’s degree or higher.

These differences in training are not the only difference between psychiatrists and therapists.

Scope of treatment

Probably the biggest difference between therapy and psychiatry has to do with the actual scope of the care they provide. Whereas therapists tend to focus on the mind and psychological factors that impact mental health, psychiatrists tend to center their care on the biological and physiological factors that shape mental health. 

As Healthline explains, “Generally speaking, the field of psychiatry rests on the idea that biological factors, like genetics, lead to the development of mental and emotional health symptoms. Psychiatrists recognize that social and environmental factors can also play a role, but they typically approach mental health symptoms from a biological angle.”

Therapists, on the other hand, focus primarily on how your feelings, thoughts, and behaviors interact. They’ll also help you learn key skills to help you cope with challenges. This distinction-along with the different training mentioned above-means that there are several functional differences between psychiatry and therapy.

Medication

Again because they are medical doctors and advanced RNs, and because they are trained to understand physiological matters that underlie mental health issues, psychiatrists can prescribe medication while therapists cannot. 

There are a number of mental health diagnoses that can be treated with medication. At Brightside, a psychiatrist may prescribe medication to treat:

• Anxiety
• Bipolar II
• Depression
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)
• And more

As Healthline points out, “you might prefer to try addressing your symptoms with therapy rather than medication. If you’re dealing with serious symptoms, though, your therapist may recommend just consulting a psychiatrist to explore medication options.” As previously noted, it’s not at all uncommon for therapists, psychiatrists, and psychiatric nurse practitioners to work together to treat individuals.

At Brightside, members can access therapy and medication, which has up to a 60% better chance of recovery than one treatment alone. 

Psychotherapy

Another area that therapists and psychiatrists work together is in the provision of therapy. As the name implies, these therapeutic methods involve talking about and working through mental health issues, as well as things in an individual’s past that may impact their current mental health status.

There are many approaches to therapy-at Brightside we adhere to evidence-based approaches based on the Unified Protocol, an enhancement of Cognitive Behavioral Therapy (CBT). Interestingly, both therapists and psychiatrists are trained to, and able to, provide psychotherapy. 

Generally though, as Psychology.org explains, “most psychiatrists treat patients primarily by prescribing medication, while psychologists [and other therapists] mainly rely on providing talk and/or behavioral therapy.” At Brightside, only therapists provide talk therapy.

Should I see a therapist or psychiatrist?

As you can see, there are many therapeutic options for individuals experiencing mental health concerns. The best answer to the question we have posed will depend on your symptoms, your diagnosis, and your particular needs. Though they can work separately, it can be beneficial for many individuals to talk to a therapist and a psychiatrist or psychiatric provider for support. In other words, it’s not psychiatry vs. therapy–sometimes it’s both!

If you are looking for mental health care, and are wondering if therapy, psychiatry, or both are right for you: