What is the difference between a Psychologist and a Psychiatrist?
Psychologists and Psychiatrists complete different study pathways in Australia. I have been involved in the training programs for both Psychology and Psychiatry in Queensland.
Psychologists complete a 4 year undergraduate degree which focuses predominantly on the statistics of human behaviour. After completing a 4 year degree Psychologists complete another 2 years of a masters degree or a 2 year internship. Psychologists then may complete another couple of years of study to become a doctor. A psychologist who has doctorate will usually have a PhD in Psychology.
Psychiatrists are always medical doctors, and they need to complete the requirements for being a medical doctor before embarking on several years of specialist training within a hospital setting to become a psychiatrist. Both Psychologists and Psychiatrists can have a doctorate, but usually psychologists have a doctorate in psychology and psychiatrists in medicine.
Psychiatrists are therefore experts in treatment of conditions that require medications as they can prescribe medication. Psychiatrists work with more serious health conditions and mental health problems as they have a medical background. Psychiatrists will often have roles such as the director of a public hospital’s mental health ward or work in private practice.
Psychologists are frequently recognised as the statisticians of human behaviour and some psychologists will choose an academic/research pathway and not treat clients. While Psychologists are recognised as specialists in statistics, it is those stats that help psychologists and other professions to choose what counselling therapy to use. Psychologists differ from other counselling professions because of the number of years of undergraduate study in statistics and the minimum number of years of training till they are fully registered (i.e. 6 years). While 6 years is nowhere near as long as the minimum number of years needed by psychiatrists (i.e. more than 12 years), it is much more than is needed in other professions such as social work and counselling.
What is Psychopharmacology?
Psycho-pharmacology is the study of medications that are used to treat mental health disorders. Psychologists may learn basic levels of psycho-pharmacology in a postgraduate course, or under the training of someone with expertise in medication. Therefore psychologists cannot prescribe but will often have knowledge on the medications, side effects and purpose of the medications used for mental health disorders. This is where it can be confusing for our clients. Psychologists learn about medications but only if they choose that as part of their learning plan. All Psychiatrists have more than a decade of training in the use of medications and in all health conditions, not just mental health conditions.
What is Psychotherapy?
Psychotherapy is a term used to describe counselling therapies that work at at deeper level. In some countries (i.e. Europe) Psychologists can do further training beyond their 6 years to become a psychotherapist. In Australia we have no registration or limitations on this word so in theory anyone with no training can become a psychotherapist, but in the psych world the term is used to describe long term therapies for complex mental health issues. Both Psychologists and Psychiatrists would view themselves as psychotherapists if they provided deep long term therapies as part of their services.
Psychologists in our country (Australia) tend to favour using evidence based therapies such as IPT and CBT. One reason for using such therapies is that they are highly effective and able to be delivered in 10 sessions. In Australia Psychologist’s clients can only gain Medicare rebates for up to 10 sessions a year for counselling/psychotherapy. The limitation of sessions has a long term impact on how we choose what we provide to clients. Brief and targeted counselling has become the trend in our current economic climate in Australia.
Psychiatrists are funded by our Medicare system to provide weekly sessions for a year (i.e. about 50), therefore psychiatrists are more appropriate for those clients that fall into the category of needing long term therapy or more than 20 sessions each year. Psychiatrists often work in a hospital, so psychiatrists are appropriate for highly suicidal clients as they can provide services in both inpatient and outpatient facilities.
*Please note: while Medicare rebates Australians for counselling by psychologists and psychiatrists, the total cost of a session of counselling will usually cost more than the rebate unless the psych has agreed to bulk bill! Psychologists usually charge around $200 hr and Psychiatrists around $300 hr.
Psychotherapy and Psychopharmacology?
So this is confusing and I realise that you must be keen to know more if you’ve read this far!
So both Psychologists and Psychiatrists provide counselling/psychotherapy and both have knowledge of medications. Psychiatrists have extensive knowledge of all medications because they are doctors and are funded in Australia to provide long term counselling/psychotherapy. Psychologists have extensive knowledge on the mathematics that is behind the counselling strategies used. Psychologists tend to provide therapy for normal stressful events like life transitions, less serious mental health disorders, relationship problems and family issues because rebates allow for briefer number of sessions.
What else do Psychologists do?
I am a psychologist so I’m best to discuss “what psychologists do” because I am the Director of a Psychology Clinic with about 40 psychologists. Psychologists have many other career options apart from counselling/psychotherapy because of their skills in statistics and academic training. Psychologists with master’s degree and additional training beyond the 6 years can specialise in areas such as:
- Counselling Psychology: is the area of psychology dedicated to counselling therapies and process of counselling. Beyond the diagnosis or label attached various counselling methods are frequently beneficial to many conditions. The process of therapy is affected by our personalities, prior learning and world views. Counselling Psychologists will usually work in private practice and will work more in providing psychotherapy than perhaps other endorsed areas of psychology.
- Academic/Research Psychology: Due to the number of years of training in statistics, psychologists may choose an academic or research career. This may involve working with government departments and conducting research into how different treatments work, how our minds work or analysing the statistics generated by organisations who may want to know information like who will be next elected, or if a drug was better than a placebo. Some psychologists work in research and in private practice which can a demanding career as both roles are often full time commitments.
- Health Psychology: Is the area of psychology that crosses over most with the medical field and how the mental health of an individual can cause a medical conditions to be more serious. For example heart conditions are significantly affected by depression. Health psychologists help to work out if the mental health condition causes the physical disorder or the physical disorder causes the mental health condition. Health psychologists work with a range of health professionals such as specialists in the treatment of cancer, heart disease, psychiatrists, etc.
- Organisational Psychology: This is a area of specialist training in how organisations function and interventions that help. Just like a human being organisations can become “ill”. For example some organisations have a bullying epidemic or low motivation or decreasing performance. Organisational psychologists have interventions that may target problems with leadership training, change management strategies, workshops on stress management or provide EAP (employee assistance programs).
- Sports Psychology: Is a popular area within psychology but we have few endorsed sports psychologists in Australia. Sports Psychologists help individuals and teams perform in competition. Sports psychologists may help individuals or teams by providing individual or group interventions. Sports psychologists help individuals to focus their attention, overcome pain and injury, perform at the top level of their sport, overcome media attention, help with relationships given a demanding sport can take the focus off relationships. Sports psychologists are part of most elite sports teams providing stress management strategies, helping to manage sudden changes and building teams to work together so that goals can be won on the field.
- Development and Educational Psychology: Psychologists who specialise in the treatment of children will be able to both assess and treat complex disorders in children. Children and Teenagers develop quickly and often it is difficult to work out if a symptom is part of the growing process and a phase or if it is the sign of something serious. Psychologists will be able to assess mental health disorders in children, assess learning problems, work with families and schools and often run programs for children with special learning needs.
- Clinical Psychology: Is an endorsed area of psychology psychologists specialise in the diagnosis and therapies for more complex mental health disorders and will often be experts in diagnosis. In Australia clinical psychologists have a rebate that is higher than that of general psychologists in recognition of extra training at university for treatment of complex mental health disorders. Clinical psychologists and psychiatrists will usually manage complex mental health conditions together in private practice and a hospital.
- Forensic Psychology: Is the speciality area that works with those in the correctional system. Forensic Psychologists will often work in prisons, or high security mental health facilities. They are experts in managing aggressive or more dangerous mental health conditions where individuals have committed a crime. Forensic psychologists are highly skilled at writing reports on the mental health conditions and the implications on behaviour.
As you can see Psychologists have training in lots of areas that might be linked to counselling, health, diagnosis, training, statistics and organisational development. The reasons for needing a psychologist go far beyond the role of a counsellor or psychotherapist. Likewise Psychiatrists are experts in Medicine and many psychiatrists have completed further training in organisations or statistics as well. After many years of working as a psychologist or a psychiatrist it is easy to see why we usually work together!
If you are not sure about whether to book a psychologist or psychiatrist please book a free emotional health check up with one of our team. We can confidentially discuss your situation and provide help with working out if psychology or psychiatry might be better. Sometimes both are helpful for different reasons, sometimes neither!
Author: Vivian Jarrett, B Psych (hons), MAPS.
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