What’s the Difference Between a Psychiatrist and a Therapist?

When you’re struggling with mental health challenges, knowing who to turn to can feel overwhelming. You may have heard the terms psychiatrist and therapist used interchangeably, but the truth is, they serve very different yet complementary roles within the mental health field. Understanding the difference between a psychiatrist and a therapist is essential in choosing the right type of mental health support for your specific needs.

While psychiatrists are certified doctors who can diagnose mental health conditions and prescribe psychiatric medication, therapists can solely provide therapy sessions. Therapists are usually a good starting point for your first time receiving mental health care. If they believe you need a diagnosis or medication, they will refer you to a psychiatrist in your area.

Whether you’re dealing with anxiety, depression, bipolar disorder, or complex mental health conditions, knowing your options is the first step to getting the help you deserve.

In this article, you will learn:

• The differences between therapists and psychiatrists
• What kind of care do these mental health professionals provide
• How to know whether a psychiatrist or therapist is right for you

Psychiatrist vs. Therapist: The Key Differences

Psychiatrists are medical doctors. This means they complete medical school, undergo clinical training in psychiatry, and are licensed to diagnose and treat mental health conditions, often through a combination of medication and brief therapy. In the U.S., a psychiatrist must complete a four-year undergraduate degree, four years of medical school (or osteopathic medicine), and at least four years of psychiatric residency.

Because a psychiatrist is a medical doctor, they can:

• Prescribe medication
• Provide medication management
• Diagnose psychiatric symptoms
• Order and interpret lab tests and brain imaging when necessary
• Offer medical interventions for severe mental illnesses

On the other hand, therapists are trained to offer talk therapy, also called psychotherapy. A “therapist” might be a:

• Licensed Mental Health Counselor (LMHC)
• Licensed Clinical Social Worker (LCSW)
• Licensed Therapist
• Clinical Psychologist (who holds a doctoral degree in psychology)
• Marriage and Family Therapist (MFT)

Therapists are not medical doctors and cannot prescribe medication (with rare exceptions in some U.S. states for certain psychologists with additional training). Instead, their role is to:

• Help clients develop coping skills
• Treat mental health issues through therapeutic techniques like Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT)
• Support individuals and families through life transitions, trauma, relationship challenges, and stress management
• Develop a personalized treatment plan to guide recovery

Education and Credentials

Psychiatrists are medical doctors who have completed a psychiatry residency. Their focus is biological and medical treatment of mental illness. Because of their education and credentials, they are able to diagnose conditions and prescribe medications.

Clinical psychologists have a PhD or PsyD in psychology or a related field. They focus on providing psychological assessments, therapy, and behavioral interventions. Some might be able to diagnose mental health conditions; however, they cannot prescribe medication.

Lastly, therapists have a Master’s degree in a mental health-related field. They might be a Licensed Clinical Social Worker (LCSW), a Licensed Mental Health Counselor (LMHC), or a Marriage and Family Therapist (MFT). Therapists can offer talk therapy, mental health support, and teach you how to develop healthy coping skills.

What Do They Treat?

Psychiatrists are best suited for:

• Severe mental illnesses such as bipolar disorder, schizophrenia, obsessive-compulsive disorder, and major depressive disorder
• Cases where medication management is essential
• Clients with complex mental health conditions requiring integrated medical and psychiatric care
• Care in settings like a psychiatric hospital, geriatric psychiatry, or adolescent psychiatry

Therapists are ideal for:

• Mild to moderate mental health symptoms
• Individuals seeking to improve emotional resilience, develop coping strategies, or process trauma
• Ongoing support for mental health challenges in daily life
• Specialized therapy, like family therapy, group therapy, or online therapy

Many people with mental health conditions see both psychiatrists and therapists. Having access to medication and therapy at the same time makes it possible to fully manage more complex mental illnesses like bipolar disorder or severe depression.

Which One Should You See First?

If you’re unsure whether you need medication or therapy, starting with a primary care doctor can be a good first step. They can refer you to the appropriate mental health professional and rule out medical conditions that may mimic psychiatric symptoms.

If your concerns are predominantly emotional or relational—such as anxiety, burnout, grief, or interpersonal conflict—a licensed therapist or mental health counselor is a solid starting point. They can also refer you to a psychiatrist if medication might be helpful.

However, if you’re experiencing symptoms like persistent suicidal thoughts, hallucinations or delusions, severe mood swings, or symptoms that interfere with basic functioning, you should see a board-certified psychiatrist or visit a psychiatric hospital.

Can They Work Together?

Yes—and ideally, they should.

Integrated mental health care is increasingly common, where therapists and psychiatrists collaborate on a shared treatment plan. For example, someone with bipolar disorder might see a psychiatrist for medication management and a therapist for cognitive behavioral therapy.

This combination can offer the most comprehensive support, targeting both the biological and psychological aspects of mental illness.

Cost and Insurance

Most health insurance companies provide coverage for both therapy services and psychiatric care. However, psychiatrists often charge higher rates due to their medical training, and it may be harder to find one who accepts your insurance.

Therapists in private practice may offer sliding-scale fees based on income. Some online therapy platforms also offer lower-cost sessions, though they typically do not include psychiatric services.

Current Statistics on Mental Health Services in the U.S.

If you are feeling like no one else in the world understands the problems you are facing, knowing the statistics on mental health in the U.S. can combat feelings of isolation.

• According to the National Alliance on Mental Illness (NAMI), 1 in 5 U.S. adults experiences mental illness each year.[1]
• About two-thirds of Americans with a diagnosed mental health condition were unable to access treatment in 2021, even though they had health insurance.[2]
• The American Psychological Association (APA) found that combined treatment (therapy + medication) is significantly more effective for many mental health disorders than either method alone.[3]

Get Connected to a Top-Rated Mental Health Treatment Center

Choosing between a psychiatrist and a therapist isn’t about picking the “better” provider—it’s about finding the right fit for your mental health needs.

If you’re dealing with mild to moderate symptoms, therapy alone may be transformative. If your condition is more complex, medical treatment under a psychiatrist might be necessary. And often, the best care comes from a team-based approach.

At New Jersey Behavioral Health Center, we can offer you a comprehensive mental health program that includes both psychiatry and therapy. Contact us today for more information on how to get started.

FAQ: Understanding Mental Health Professionals

1. Can a therapist diagnose mental health disorders?

Yes, many therapists—especially clinical psychologists and licensed clinical social workers—are trained to diagnose mental health conditions. However, their diagnostic authority may vary by state and licensure. Unlike psychiatrists, they do not typically use lab tests or prescribe medication but rely on clinical interviews and standardized assessments.

2. What’s the difference between a psychologist and a therapist?

All psychologists can provide therapy, but not all therapists are psychologists. Psychologists hold a doctoral degree (PhD or PsyD) and often specialize in psychological testing, assessment, and research-based therapy. Therapists may hold a master’s degree and focus primarily on talk therapy and behavioral interventions. Psychologists can diagnose complex psychological conditions and sometimes work in academic or hospital settings.

3. Can I see both a psychiatrist and a therapist at the same time?

Absolutely. This is often recommended. Your psychiatrist can manage medication, while your therapist helps with emotional processing, behavior change, and long-term coping. Many people find this dual approach more effective, especially for chronic or severe mental health conditions.

4. What should I expect during my first session with a mental health provider?

Your first session, whether with a therapist or psychiatrist, usually involves a comprehensive intake assessment. You’ll discuss your mental health symptoms, personal history, current challenges, and treatment goals. The provider may also ask about your physical health, medications, and family history to create a tailored treatment plan.

5. Are online therapy and telepsychiatry as effective as in-person care?

Yes. Numerous studies show that online therapy and telepsychiatry can be just as effective as in-person visits for many conditions, including depression and anxiety. Virtual care offers more flexibility and can improve access, especially in rural or underserved areas. However, in-person care may still be preferred for severe psychiatric conditions or when intensive observation is required.

6. How do I know if I need medication or therapy—or both?

This depends on your symptoms, diagnosis, and personal preference. If you’re experiencing persistent mood changes, thoughts of self-harm, or symptoms that interfere with daily functioning, an evaluation from a psychiatrist can determine if medication is appropriate. For stress, trauma, or relationship issues, therapy may be the better starting point. A combined approach is often the most comprehensive.

References:

1. The National Institute on Mental Health (NIMH): Mental Illness
2. NPR: Most Americans with mental health needs don’t get treatment, report finds
3. The American Psychological Association (APA): How Do I Choose Between Medication and Therapy?