What are the differences between psychologists, psychiatrists, and social workers? If you are considering psychotherapy, you may be wondering about this question. Although all three may do psychotherapy, their training is quite different, and this may have important implications for their approaches to working with you.
Psychologists: Licensed clinical psychologists must have either a PhD or a PsyD in clinical psychology, and have state licensing. Their formal education generally involves 4-7 years of training after a bachelor’s degree, including course work and practicums which focus almost exclusively on the theory and practices of psychotherapy, psychological assessment, and diagnosis. It also includes a one-year psychology internship (often at a hospital or clinic), along with writing a dissertation in a specific area of psychology. The PhD includes a greater focus on research than the PsyD, so psychologists with a PhD may be better trained to question assumptions and may be less likely to take things at face value. Both the PsyD and the PhD are doctorate level degrees.
Clinical psychologists consider concepts such as the unconscious, symbolic interpretation, thought, feelings, and behavior, and will use these concepts in conjunction with psychotherapy to address their patients’ issues and emotional suffering. In general, psychologists tend to focus on the inner world of their patients – their thoughts and feelings — although some may focus more on the link between thoughts and behavior.
Psychiatrists: Psychiatrists complete 4 years of medical school after the bachelor’s degree, and receive their MD. Medical school training is focused exclusively on basic skills in medicine. To become certified as a psychiatrist, a medical doctor must then complete a psychiatric residency, which is like an internship with practicum courses, after which they can be board certified to practice psychiatry. In general, psychiatrists prescribe medications, make diagnoses, and perform procedures such as electroconvulsive therapy (ECT), and some may also do psychotherapy. Many psychiatrists function as psychopharmacologists, with a primary focus on treating mental and emotional suffering with psychoactive medication. Unlike a psychologist, a psychiatrist is licensed to write prescriptions for medication, conduct physical examinations, and order and interpret laboratory tests. Since a psychiatrist’s basic training is in medicine and the treatment of illness or pathology, psychiatrists are more likely to depend on the medical model when helping patients with emotional difficulties.
Social Workers: Social workers are trained to address issues of social welfare and social change, and typically have a master’s degree in social work (MSW), which involves 2 years of graduate school after receiving a bachelor’s degree. Clinical social workers have further experience with direct practice with individuals, families, and groups. To be a Licensed Clinical Social Worker (LCSW), they are required to complete approximately 3 years of supervised work experience related to diagnosis, psychotherapy and assessment-based treatment planning and gain state certification. An LCSW can pursue further training focused on the theory and practice of psychotherapy and receive LMSW (Master Social Worker) and LMSW-AP (Advanced Practitioners) degrees. Social workers who hold these advanced degrees for the practice of psychotherapy generally have an orientation more like psychologists than psychiatrists.
As a psychologist, I believe the general approach taken by many psychologists to understanding and treating their patients often provides the greatest opportunity for insight, change, and growth. Ultimately, of course, it is the relationship that develops between a psychotherapist and patient that correlates best with a successful outcome, whatever the training or orientation of the psychotherapist.