Monday, December 13, 2010

Demystification Monday: Psychiatrist vs. Psychologist

Do you know the difference? If so, move along. Nothing to see here.

But I am often surprised at how often folks confuse these two professions. It happens ALL the time. Just one example: the writers of the television show Bones alternately call Dr. Lance Sweets a psychiatrist and a psychologist. Unfortunately, if you look at his fictional educational credentials, it turns out he's a psychologist. Ugh. His massively boundary-crossing, you-should-lose-your-license-and-you-make-my-skin-crawl unethical behavior makes me wish he was batting for the other team (apologies to any psychiatrists out there. I shouldn't be wishing him on you, either).

Ahem. Sorry. Moving on.

The basic educational distinctions between a psychiatrist and a psychologist:

Psychiatrists are physicians.  They go to medical school. Then they do a residency that includes specialized experience in psychiatry. They get a license to practice and a federal narcotics license and blammo: practicing psychiatrist (I'm pretty sure I made that sound a lot easier than it actually is).

Psychologists ... are more complicated. But they are not medical doctors.

You can become a "psychologist" by a lot of different routes, but it's almost always by getting a doctoral-level degree (unless you're a "school psychologist", which is often a masters-level qualification). There are several kinds of doctoral degrees, though (Ph.D., Psy.D., Ed.D.). And even within the Ph.D.s, there are a lot of different kinds--clinical psychology, counseling psychology, school psychology, etc.. But no matter which degree you get, you have to qualify to take the national exam and the state exam, and only after you pass those do you get to call yourself a psychologist (legally).

Click to see the basic requirements to become a psychologist. Here's a quick rundown on me:

  • I have a bachelors degree in psychology (from Hope College ... it's in Holland, Michigan)
  • I have a Ph.D. in clinical psychology from the University of Delaware. It took me 6 years to get that sucker. Anyway, it was an APA-accredited program. I took certain classes, completed a lot of supervised clinical practice, and did quite a lot of research. I did my 1-year, full-time, APA-accredited clinical psychology/pediatric psychology internship at The Children's Hospital of Philadelphia.
  • I completed a 2-year postdoctoral fellowship at Brown University. I did more supervised, specialized practice and research during those years, and at the end of it, I took the state (RI) and national licensure exams.
So the most basic difference between psychiatrists and psychologist is MD vs. PhD (or other doctoral degree). But you know what? If you spend 8 years training to be a psychiatrist, you're going to think differently than if you spend that same 8 years training to be a psychologist. It's a different mindset, one I don't have the space to really explain here. Instead, I'll just offer:

The basic day-to-day distinction between psychiatrists and psychologists:

Psychiatrists evaluate, diagnose, and prescribe medication. They often work with another mental health professional who provides therapy.

Psychologists ... are more complicated. For the most part, we don't prescribe meds (there are 2 states that allow psychologists to prescribe if they get an extra masters degree in psychopharmacology). We do a lot of other things, though.

There's a general description here. Here's what I do:
  • I perform psychological evaluations (which include IQ testing along with other psychological tests) and diagnose.
  • I provide psychotherapy to children and families.
  • I consult to schools and daycares (and anyone else who's wondering things like, "Why is that 4yo throwing chairs and threatening to kill people, and how do I get him to stop?!?!)
  • I supervise and mentor other clinicians.
  • I do program evaluation and research.
  • I collaborate with other professionals regarding design of social service delivery systems and policies.
  • Oh, and I write novels.
That is all.

Now ... does that clear anything up? Are you writing a story that includes a psychologist, psychiatrist, or some other type of therapist? Do you wonder how to portray the therapy process? If anybody has questions about the psychiatrist/psychologist distinction or anything else related to portrayal of these professionals in YA fiction, please do comment. I'll either answer them directly or cover them in future posts!


  1. I knew the difference, but your explanation fleshes it out...a lot. Thanks.

  2. i knew one prescribed meds and the other didn't... but i wasn't sure which was which. thanks! :)

  3. I actually did know the difference, but I know there's a lot of confusion by lay people.

  4. Uh oh. I don't get along with shrinks. Especially shrinks for kids. Just kidding, that was all ... a long time ago.

    I know Justine well, and so have heard about you many times, but I can't believe it took me this long to realize you had a blog. Oh well, following now.

    Nice ta meet ya Sarah!

  5. I actually learned the difference in a psych class recently. It drives me insane because my mom still doesn't get it and she'll use the two terms interchangeably.

    I've never used a psychologist or psychiatrist in my fiction, but I have been considering it as a career path.