What type of mental health specialist should I see?
Learn about the different types of providers, what differentiates them, and their strengths and weaknesses.
Dr. Matthew Clyde
10/15/20234 min read
Often when I am first meeting clients, they will share with me that they weren’t sure what type of professional help they wanted to seek out, or they are confused after having seen previous professionals as to what we can and can’t do in session. It can be confusing when there is such an overlap in terms of the names, or with the sheer amount of professionals that exist currently. I thought as a starting blog post that I would try to provide some clarity (at least in the mental health field) to help you reach out and get the help you are looking for.
Broadly speaking, there are three main categories of professionals in this field of mental health care, those being: psychiatrists, psychologists, and psychotherapists. Let's explore what sets them apart:
1. Psychiatrists
A psychiatrist is first and foremost a medical doctor, in that they completed med school (typically 4 years), and then their residency training in psychiatry (typically another 3-4 years following that). These days, psychiatrists primarily specialize in diagnosis and treatment of mental health conditions, typically through prescription of medication. Psychiatrists usually work in hospital or community clinics, and in general require a referral to access (this typically needs to be done your family physician, a general practitioner, or another medical practitioner). A psychiatrist can also be consulted by your physician to help determine what is the right type and dosage for medications (medications for mental health diagnoses typically need 3-4 weeks before the effects are felt, and doses are typically increased over time to find the one that works for you).
While some psychiatrists do also do talk therapy, this is not usually the case. They might follow you for a short period (a few months when starting a new medication), or more long-term with infrequent appointments (to check-in and see how you are doing). Clients usually require a psychiatrist when they require medication to treat their problem. Therefore, its best to discuss this with your family physician or a general practitioner, who may also be able to prescribe these medications on their own.
2. Psychologists
A psychologist is someone who has underwent extensive training, usually having completed at least 6 years of university education (bachelor's degree and masters), and with the vast majority having done more than that to complete their doctoral degree (PhD), typically with an additional 6 years. The training of psychologists involves expertise in clinical diagnosis and assessment, program evaluation, and psychotherapy. These tenets are usually met through evidence-based treatment frameworks (learning interventions that are supported by science and reproduced in studies), and psychologists undergo extensive supervision by senior members of their field while training (requiring 1000s of hours of client contact and supervision to obtain their degree). Once licensed, a psychologist must be registered with a governing body, which in Québec is the Ordres des Psychologues du Québec (OPQ).
Psychologists, like psychiatrists, are able to complete comprehensive assessments, and therefore able to communicate and diagnose mental health conditions. Where the two specialties differ is treatment, as psychologists do not have the capacity to prescribe medication. The treatment offered by psychologists therefore calls in the psychotherapy spectrum, of which there are many different treatment approaches (for example, cognitive behavioural therapy, or CBT; emotion focused therapy; psychodynamic therapy). Psychologists typically try to work with your family doctor and/or psychiatrist collaboratively, to ensure that your treatment continues to move forward.
3. Psychotherapist
Psychotherapist is a general term that can encompass a wide range of mental health professionals, including counselors, social workers, and therapists. Their expertise usually lies in providing talk therapy and emotional support for clients experiencing a range of problems. In the province of Québec, certain acts (such as the capacity to provide a clinical diagnosis; the capacity to practice psychotherapy) are reserved. Therefore, anyone who identifies as a psychotherapist should be licensed as a psychotherapist, having undergone training in psychotherapy (with supervision) following their professional degree. This license is also governed by the OPQ. should also In order to be qualified as a psychotherapist,
Psychotherapists may therefore have different areas of expertise, and their qualifications can vary. It's crucial to research their background and qualifications when seeking help to ensure that they are not only the right fit, but also possess the experience in the area you are seeking help. Unlike psychiatrists & psychologists, psychotherapists are not able to formally diagnosis any mental health conditions, and as with psychologist are unable to prescribe medication.
Summary & Closing Thoughts (TL;DR)
Each of these 3 categories of professionals can be helpful, but its important to reflect on their strengths and weaknesses, as well as your goals when consulting. Only psychatrists are able to prescribe medication amongst the mental health professions. If you are seeking an official diagnosis or assessment to help you understand whats going on, both psychiatrist and psychologists can provide this service (diagnosing is a restricted act, as is the use and intepretation of comprehensive assessment tools). Finally, psychotherapists, which is a broad category made up of several professions (e.g., social workers, master level clinicians) are often trained in specific types of therapy, and can therefore help you work through issues using talk therapy.
I always encourage my clients to be open with me as a psychologist in terms of their treatment goals and concerns, and I hope to reflect the same to them. That includes informing them when I am not equipped to help them with their problems and not able to receive supervision. In these cases, my ethical duty as a psychologist is to try and help them by referring them to the appropriate professional. So if you aren't feeling that your therapy or provider is helping you, don’t hesitate to discuss with them, as it is your right as a consumer.
A few quick final thoughts. First a small note on psychotherapists – I mentioned they are unable to formally diagnose (as this is a protected act). While this is true, it is important to know that many psychotherapists are able to recognize different mental health concerns, and therefore still provide treatment and interventions that can help you. There are also many individuals who identify as “wellness coaches” and who offer services that typically overlap with both psychologist and psychotherapists. While these individual’s and the services they provide may be helpful, please keep in mind that there is no regulation or body that governs the quality of care or training that these individuals have completed.