If you want to know the differences between psychiatrists, psychologists, social workers, counselors, and other mental health professionals, here’s an overview. Practicing psychologists go through years of education and supervised training before they’re able to practice. That makes psychologists some of the most highly trained mental health professionals, steeped in evidence-based techniques and research, explains Lynn Bufka, PhD, a licensed clinical psychologist and associate chief of practice transformation at the American Psychological Association, where she works on healthcare policy issues and improving mental health care delivery. Obtaining a graduate degree in psychology (two years for a master’s degree or four to six years for a doctoral degree) typically involves courses in human behavior, development, personality, research, statistics, psychotherapy, assessment, and ethics. Before becoming licensed, psychologists are typically required to complete approximately 2,000 hours of supervised clinical experience in most states, Dr. Bufka explains. In some states, psychologists can get licensed to prescribe medication for mental health, but in many other states, psychologists cannot prescribe medication. What Degrees or Education They Need In most states, psychologists must hold a doctor of philosophy (PhD) in a field of psychology, a doctor of psychology (PsyD), or doctor of education (EdD) in order to be eligible for a license to practice independently as a clinical psychologist. Some states allow people with master’s degrees in psychology to use the term “psychologist.” What Licensures They Need To practice psychology, you need to become licensed through your state’s licensing board. Aside from educational requirements, you must pass a 225-question multiple choice test that covers core areas of psychology, such as assessment and diagnosis, and social and biological bases of behavior. Where They Work Most practicing psychologists manage their own private practice or work with a group of other psychologists or healthcare providers. Psychologists can also work in schools, colleges, universities, hospitals, medical clinics, prisons and correctional facilities, veterans’ medical centers, mental health clinics, businesses, nursing homes, and long-term care centers. Psychiatrists are doctors by training, explains Christine Crawford, MD, associate medical director at the National Alliance on Mental Illness. In addition to mental health, psychiatrists are trained in the physiology of how the body works and in psychopharmacology (or medication management for mental illness), she says. “We understand underlying medical issues that can have psychiatric manifestations,” says Dr. Crawford, who is also an adult and child psychiatrist and assistant professor of psychiatry at Boston University School of Medicine. Because of their medical training, psychiatrists are able to order tests for those potential underlying medical issues. And because of the psychopharmacology training, they’re able to prescribe medication that’s appropriate given people’s underlying health conditions, she says. What Degrees or Education They Need To become a psychiatrist, you must complete medical school and become a doctor of medicine (MD) or a doctor of osteopathic medicine (DO) and complete a four-year medical residency, specializing in training in the field of psychiatry. A residency typically includes rotations in several key areas, such as neurology and internal medicine. What Licensures They Need After completing a psychiatry residency program, you must take the American Board of Psychiatry and Neurology certification examination and receive board certification to become professionally certified as a psychiatrist. Where They Work Psychiatrists work in a variety of settings, such as private practice, general and psychiatric hospitals, university medical centers, community agencies, courts and prisons, nursing homes, government offices, the military, schools and universities, rehabilitation programs, emergency rooms, and hospice care. A key distinction between them and other mental health professionals is that social workers are trained to specialize in helping clients who face disabilities, life-threatening diseases, or a social problem, such as inadequate housing, unemployment, substance abuse, or domestic conflict (though you don’t need to be facing one of these issues to seek help from a social worker). Social workers are trained not only to focus on the person they’re working with and their mental and emotional health but also the environment contributing to that person’s well-being, explains Liz Morrison, LCSW, a Manhattan-based psychotherapist and owner of Liz Morrison Therapy. “We provide therapy, but we can also help with other resources, like connecting patients with other providers in the community to help influence better outcomes.” A social worker’s areas of specialty in talk therapy will depend on where they received their training and what modality they’re trained in, according to Morrison. What Degrees or Education They Need To be eligible to become licensed to practice social work in clinical settings, an individual must earn a degree of master of social work. What Licensures They Need To become licensed to practice social work, someone must meet the licensing requirements in their state. Those designations can include licensed clinical social worker (LCSW), licensed independent social worker (LICSW), or a credential from the Academy of Certified Social Workers (ACSW). The requirements vary by state, but generally to become licensed a social worker must have first earned a master of social work degree, logged many hours of clinical experience and supervised training, and completed the licensure exam. Where They Work Social workers are employed by schools, hospitals, mental health clinics, senior centers, private practices, prisons, military, corporations, and in public and private agencies, according to Morrison. They can diagnose mental illness, but they cannot prescribe medication. Many specialize in addressing a particular issue, such as substance abuse, sexual abuse, marriage and relationships, or family counseling. What Degrees or Education They Need Someone must first earn a master’s-level degree (or higher) in counseling. What Licensures They Need To practice as a counselor, someone must become licensed in their state. Licensures and the requirements for them vary by state; they can include licensed professional counselor (LPC), licensed professional clinical counselor (LPCC), and licensed mental health counselor (LMHC), among others. Obtaining a license often requires first earning a master’s degree in counseling or a counseling-related field and completing a required amount of supervised counseling work. Therapists with a National Certified Counselor designation have a master’s degree in counseling and are board-certified on a national level. Where They Work Like other therapists, counselors work in a variety of settings, including private practice, hospitals, within the legal system, and in educational system or group homes. Some treatment is one-on-one; in other cases, couples or family members go through therapy together. Marriage and family therapists can diagnose and treat mental illness, but they cannot prescribe medication. (Other types of mental health professionals, including psychiatrists and psychologists, may choose to undergo training to specialize in family therapy, too.) What Degrees or Education They Need To become a marriage and family therapist, someone must first earn a master’s or doctoral degree in marriage and family therapy or a related field, such as psychology, psychiatry, social work, nursing, pastoral counseling, or education. What Licensures They Need To get accredited as a licensed marriage and family therapist (LMFT), practitioners must have a master’s degree or doctoral degree and at least two years of post-degree supervised clinical experience, as well as pass their state’s licensure exam. Specific licensure requirements can vary by state. Where They Work Marriage and family therapists can work in various settings, such as a private practice, outpatient centers, hospitals and in-patient care facilities, schools, substance abuse and addiction treatment centers, and medical centers. They are trained to help people with less severe mental health concerns, including stress and burnout, coping with major life transitions, and indecisiveness or feeling stuck in life. They are not, however, able to diagnose mental health conditions or prescribe medication, says Wendy Nickerson, PhD, professor of psychology at Calsouthern University in Arizona and founder of the Nickerson Institute of Integrative Health Training, which provides mental health coaching certification that’s accredited by U.S. and Canadian regulatory bodies. Americans should seek help from mental health coaches if their concerns aren’t severe. If you’re grappling with severe depression, post-traumatic stress disorder, suicidal thoughts, or trauma, Nickerson and O’Neil-Hart suggest that you seek help from a clinician, such as a psychologist or psychiatrist. And be aware that the coach will let you know if, after meeting with you, what you’re dealing with falls outside their area of expertise. What Degrees or Education They Need This is an unregulated field, so there are no prerequisites to go into mental health coaching. Unlike other therapists, anyone can call themselves a mental health coach. There is training provided to those who want to get properly accredited and registered. This coursework is typically done over about eight months, according to Nickerson. Nickerson says individuals who pursue mental health coaching training usually have an undergraduate degree at baseline, a passion for mental health awareness, and some work experience in helping others. What Licensures They Need Because mental health coaching is an unregulated field, you are not required to get licensed or registered to practice in the United States. If mental health coaches complete their training from an organization recognized by the American Association of Drugless Practitioners, Health Coach Alliance, or International Coaching Federation, they can voluntarily apply to be a registered coach in their state. Where They Work Most mental health coaches run their own private practice, according to Nickerson, or they’ll work for organizations, such as Lyra Health, that provide online telemedicine. Trained mental health coaches also work in various settings, such as schools, hospitals, outpatient centers, and social work settings.
Psychiatric or Mental Health Nurse Practitioners These experts can provide assessments, make diagnoses, and provide therapy for mental health conditions or substance abuse disorders. In some states, they’re qualified to prescribe and monitor medications, sometimes under the supervision of a licensed psychiatrist.Pastoral Counselors Pastoral counselors are members of the clergy with training (a master’s or doctoral-level degree) in clinical pastoral education. Whether you’re religious or not, you can turn to these mental health professionals who can both diagnose and provide counseling.
It’s also worth noting that sometimes your primary care physician or a family nurse practitioner may be involved in your mental health care. Both typically provide general medical care and preventive healthcare. Sometimes they can help connect you with mental health specialists, prescribe medications for mental health, or monitor ongoing medications prescribed for mental health by another provider.
