Therapist vs. Psychologist
Therapists & Psychologists
Yes, a therapist can diagnose you.
It’s common that patients will struggle with the question of whether they should do medication or therapy. The APA outlined a resource to help guide that decision.
For the most part, no. Only a psychiatrist, psychiatric nurse, or general medical doctor can prescribe. In states outside of Texas therapists and psychologists can go through specific training to prescribe certain medications associated with mental health. This is now allowed in Texas as of 2022.
There is very little difference between a psychologist and therapist in terms of how they perform clinical work. They both are trained mental health clinicians. Psychologists spend longer in school and often go on to do assessment, research, or teach. Therapists can also do this. As of 2022, Psychologists have come to an agreement that allows them to do online therapy with many states. For many other therapists their ability to do online therapy is limited by state lines at the current moment but boards in various states are also changing these rules to allow therapists to have similar abilities.
OCCUPATIONS & QUALIFICATIONS
Occupations & Qualifications
MFT’s have similar schooling to LPC’s but they focus on marriage and family therapy. Their programs are a similar length to LPC programs but they have a focus on their specialization. MFT’s tend to take 2-3 years after completing school to become fully licensed.
Licensed Professional Counselor’s go to school and their education focuses exclusively on how to be a therapist in private practice. Programs vary in terms of their focus but CACREP, a board overseeing a number of counseling programs certification programs, mandates a certain amount of hours, class focus, experience, and audits the programs for quality. Typically it takes counselors 2-3 years to get through their masters level classes and another 2-4 years to finish their clinical hours under strict supervision (can be as quick as 1.5 years in Texas) to get fully licensed. Counselors have a wide range of specializations, can become teachers with a PhD, and can also perform testing and research like psychologists. That said, most often they work in private practice and sometimes they are in hospitals, agencies, and schools.
Psychologists go to school for 5-6 years, graduate with a PhD, have one year of post doctoral work they must complete, and have clinical rotations while in their schooling. Regulation varies by state but typically after a year under a supervisor, they are fully licensed. Psychologists can work in roles similar to counselors in schools, doing testing, teaching, research, or doing therapy. In psychology programs, they require students to pick a track that is either clinical (client focused) or research focused. Many psychologists focus on research instead of having a clinical focus. One difference (as of 2022) is that psychologists have agreements in place between many US states to allow online counseling across state lines. Most other mental health professions are evaluating similar agreements.
Social work programs tend to be 2 years in length and allow students to focus on agency work and case management, administration, policy work, and clinical work. They spend several years underneath the supervision before they become fully licensed. Social workers are commonly found in agencies, schools, hospitals, and after they have clinical experience they often migrate to private practice. Social workers, like psychologists, can practice around the globe.
These are the people who provide medications and go to medical school. The overall time investment is easily 7+ years or more to be fully licensed. They may also do therapy in their practice. Psychiatrists tend to be in the most demand due to their ability to prescribe and the fact they are so few in number. In Austin, we have fewer than 300 for a population of almost 2 million. Psychiatrists tend to run their practice in several different models: some do therapy and medication and some focus solely on prescribing. Also, their approach will vary – some might be very holistic (mind and body – diet, exercise, etc) in their approach and others may only be focused on finding the right medication.