Psychiatrist vs. Therapist: What’s the Difference?

A psychiatrist is a medically-trained doctor who specializes in treating issues of mental illness using therapy, pharmaceutical, and even surgical methods, while a therapist is a mental health professional trained entirely in non-medical psychological methods of treatment. Therapists are master’s-trained and most often specialize in couple and family counseling. Both roles are licensed and can help people with mental health issues.

Concerned female doctor comforts young woman. The doctor is discussing a difficult diagnosis.

Although people who work in psychology find these differences crystal clear, to the average person, it’s not always obvious what the differences are between therapists vs psychiatrists vs psychologists vs counselors. Even more confusing, therapy, as a process, is something that any one of those professions can perform. There is also real overlap between the types of conditions that each of them can treat.

As you’ll see, the gap between therapists vs psychiatrists is one of the largest in the field, however. They have very different paths to licensure, options for treatment, and perspectives on treating mental health issues.

Whether you are making the choice of which type of mental health professional to see for your own issue or deciding between a career path in psychology, you’ll want to fully understand all those differences first.

Education Differences Between Therapists and Psychiatrists

The educational gap between therapists and psychiatrists is vast.

Therapists typically have at least a master’s degree, which amounts to a total of six years of college education: four to earn a bachelor’s degree, and two more in advanced studies in therapy. By any measure, that’s a high level of education, and it is part of what makes therapists the respected professional resource they are today.

But the training required to be a psychiatrist blows all that out of the water. Psychiatrists have to undergo specialized training in psychological studies just like therapists do, but before that, they go through the full program of training and education required to become a medical doctor. That includes a bachelor’s degree in pre-med or a related field, medical school, and residency at a working healthcare facility.

The twelve years or more required to become educated as a psychiatrist is at least double the six or so years needed to become a licensed therapist.

One thing they have in common, though, is that you can start off on either path with a degree in psychology.

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When it comes to training, what’s the difference between a therapist and a psychiatrist?

The differences in training between a therapist and psychiatrist are found both in topics and intensity. Six years versus twelve years of education tells you a lot of what you need to know. Psychiatrists just have more training, period, in all aspects of mental healthcare diagnosis and treatment.

But they also have significant training in the medical bases of mental health issues and in medical interventions, ranging from neurosurgery to pharmacology. With the same training as any medical doctor, their understanding of physical issues is as well-honed as their knowledge of mental health conditions.

Therapists are educated in mental health diagnosis and treatment, but the treatments are all psychotherapeutic in nature. Their training is in counseling and unraveling biopsychosocial impacts on mental health.

Just as important, the emphasis in therapist education is on interpersonal situations in psychology. They are taught how to evaluate not just individuals, but social dynamics and structures that impact the welfare of couples and families.

For Treatment, Should You Go with a Therapist or Psychiatrist?

There’s no one right answer for you if you should see a psychiatrist vs a therapist in most cases, but there are some factors to consider:

• Is the mental health problem the result of a physical issue? Examples would be certain chemical imbalances or depression or anxiety resulting from a physical illness or injury. In these cases a psychiatrist, with the ability to prescribe medications, is a better choice. Because of their medical training, they also have a better understanding of any treatments or the course of a disease you are undergoing physically and can better coordinate their care.
• Is the mental issue between or because of a relationship? Any conflict within a couple or family, or issues resulting from family disruption, such as depression due to a divorce, is right on the home field of a therapist. Their experience and specialized training in interpersonal psychological issues makes them a better choice for treatment in these matters.

It’s important to recognize that mental health issues can impair your ability to seek out and select the best treatment options in the first place. So, if you are feeling the pressure to choose between a therapist and a psychiatrist, your best bet is just to get the ball rolling. Book an appointment with whichever provider you can get access to most easily.

The entire mental healthcare system in the United States is designed to get you to the most appropriate type of treatment for your issues. Don’t be afraid to ask for assistance!

Are psychiatrists therapists?

From the perspective of patients, either a therapist or a psychiatrist may offer therapy. In that sense, both are therapists. But from the professional perspective, therapists are a separate type of job with different licensing and training requirements from psychiatrists. No one would call a licensed therapist a psychiatrist. The type of treatment options are very different. In the same way, a psychiatrist would not usually be called a therapist, since it would mis-represent their training, skills, and authority.

How do you know if you need a therapist or a psychiatrist?

The best way to know if you are better off with a therapist vs psychiatrist is to consult with your current healthcare provider. They can offer referrals to whichever profession they feel is more appropriate to handle the psychological issues you are experiencing.

Because both therapists and psychiatrists are professionals, however, you can also simply go in for an initial appointment with either of them and rely on them to make their own judgement about their capability to treat you. Like all healthcare workers, they are interested in the best outcomes for patients. If a different provider can offer you more appropriate care, they will quickly refer you to them.

Is it better to see a psychologist or a psychiatrist for anxiety?

Anxiety is a condition that can have many different causes, and there can be different types of treatment that are most appropriate for each cause. In some of those cases, the kind of psychotherapy offered by a psychologist could be the best answer. In other cases, prescription drugs might be the preferred method of handling anxiety issues, which would make a psychiatrist the better choice. There’s no single correct answer without a more established diagnosis.

Psychiatrist vs. Therapist Career and Salary Differences

The difference between therapist and psychiatrist careers is wide. Therapist careers focus on psychotherapeutic treatments from one or more of the many branches of psychological theory.

Psychiatrists are doctors with additional psychological training, so their practice areas will usually fall more on the medical side of the field. They also conform to the typical track of medical careers, with residency placements determined by national matching programs, with a possibility of a fellowship to offer more specialized training afterward. They have very limited latitude in where they end up and consequently who they learn from.

On the other hand, that also puts them on track for the big bucks and high level of respect that come to doctors.

Therapists will never make as much money as a full medical doctor, but they do have far greater flexibility in their training, location, and specialization. Therapists often go into independent practice, so they have the freedom to decide where they will practice and what clients they will choose to work with right after they graduate and earn their licenses.

One other big bright spot for therapists is the projected job growth over the next decade. The Bureau of Labor Statistics (BLS) projects that employment in the marriage and family therapy sector will grow by 14% through 2031. Employment for substance abuse, mental health, and behavioral counselors (a group that includes therapists) is expected to grow by 22% in the same period. That says a lot about the continuing demand for the services skilled therapists provide.

BLS doesn’t have an independent measure of job growth for psychiatrists specifically, but they estimate a 9% increase in employment for psychiatric aides through 2031 indicating a need for more highly-trained professionals, as well. While that level of growth is slightly more modest, it’s still almost double the 5% average growth the BLS predicts for most industries.

Do psychiatrists get paid more than therapists?

Psychiatrists have a much more challenging educational and training path than therapists, so it only makes sense they get paid a lot more. According to the BLS, as of May 2022, the median annual salary for psychiatrists is $226,880. That’s actually the level where BLS stops counting exactly, so it could be even higher.

Various types of therapists, on the other hand, have a median yearly income of $60,800 according to the BLS.

2022 US Bureau of Labor Statistics job market trends and salary figures for psychiatrists, psychiatric aides, counselors, marriage and family therapists, and therapists (all other) are based on national data, not school-specific information. Conditions in your area may vary. Data accessed June 2023.