Learn the differences among counseling, therapy, psychology, and psychiatry, and what to consider to make career decisions like psychologist vs. therapist.
Counseling, therapy, and psychology share a common focus on treating mental, emotional, and behavioral health conditions. However, each field offers a distinctive approach with varying education and licensure requirements. In this Psychology.org article, you can find out the key differences before choosing which mental health career path works best for you.
Counselors, therapists, psychologists, and psychiatrists occupy unique niches in the mental health field, although the job titles are often used interchangeably. All these professions require graduate study and advanced supervised training. Significant differences in education, licensing, and practice exist between these practitioners.
Similarities
These mental health careers all require state licenses, though the specific requirements vary by state. All also offer support for mental health and well-being through applied psychology. Each requires at least a master's degree that includes extensive supervised work. While you must have a master's degree or higher to work in these roles, most master's programs do not require a specific undergraduate degree.
Differences
Each career requires at least an undergraduate and graduate degree that includes an internship or practicum, typically six years for full-time students. Your undergraduate major rarely matters as long as it includes at least some coursework in the social sciences, though psychology is one of the most common choices. You will learn specific techniques in your graduate study, which include a master's degree for counselors and therapists, a doctoral degree for psychologists, and a medical degree for psychiatrists.
Counselors
Counseling graduate studies comprise human development, different counseling techniques, and how to deliver effective and culturally competent counseling to groups and individuals. Some counseling specialties, such as substance use disorder counseling, may require less education but have a smaller scope of practice. You need at least a master's degree, including a practicum and internship, and you must practice under the supervision of a licensed counselor before earning your independent license.
Therapists
The master's program covers issues in human psychological development, different approaches to psychotherapy, identifying mental health issues, and how to deliver culturally competent therapy. After you graduate, you must work under the supervision of a licensed therapist for a set period before you can practice independently.
Psychologists
Psychologists must earn a doctorate in psychology, either a Ph.D. or a Psy.D. to practice. A Psy.D. generally focuses more on applied psychology practice, while a Ph.D. program emphasizes research in psychology and pedagogy. Depending on whether you attend full time and the program's pace, it typically takes 3-5 years to complete a doctorate. These educational requirements can affect the psychologist vs. therapist vs. counselor decision.
Psychiatrists
Unlike the other professions in this guide, psychiatrists are medical doctors who specialize in mental health. They go through the most extensive education and training of all of these careers, following the standard medical school education and completing a psychiatry residency after they graduate.
All of these mental health careers require state licensure to diagnose and treat mental health conditions based on the DSM-5. The specific licensing requirements vary by state, specialty, and job function.
For example, psychiatrists are licensed to prescribe medication in all states and must have a medical degree. Some states have different licensing requirements for substance use counseling than general mental health counseling. In many states, mental health licenses require passing a jurisprudence examination to demonstrate knowledge of the practice laws. License titles also vary by state and by level.
To become a licensed professional counselor, therapist, or psychologist who can practice independently, you must have a set number of experience hours practicing under a licensed professional, often around two years of full-time experience or the part-time equivalent.
Counselors
The National Counselor Examination (NCE) is a 200-item multiple-choice examination that must be completed within 255 minutes. The passing score varies slightly by year, based on difficulty. Your state may instead require the National Clinical Mental Health Counseling Examination (NCMHCE), a set of 10 counseling simulations you must complete within three hours, plus an additional 15 minutes of administration time. Both exams cost $275.
Therapists
Depending on your state's requirements and specialty, you may need to pass the NCE, the Association of Marital and Family Therapy Review Board's Marital and Family Therapy National Examination (MFT), or some other examination. The MFT fee is $365. It takes four hours to complete and comprises 180 multiple-choice questions.
Psychologists
Most states require a passing grade on the Examination for Professional Practice in Psychology (EPPP) for psychologists to earn licensure. Passing grades vary by state, but test-takers generally need a 70% score. The EPPP includes 225 multiple-choice questions and takes four hours and 15 minutes to complete. The exam costs $600, and the Pearson Vue testing site requires an additional $91.88. Many states also require a separate jurisprudence examination.
Psychiatrists
Psychiatrists are trained medical doctors who have earned a medical license by passing either the United States Medical Licensing Examination (USMLE) for M.D.s or the Comprehensive Osteopathic Medical Licensure Examination (COMLEX) for D.O.s.
A license to practice psychiatry requires a four-year post-medical school residency and an acceptable score on the American Board of Psychiatry and Neurology (ABPN) examination. The ABPN exam, which takes 8.5 hours to complete, comprises 425 multiple-choice questions. The exam does not specify a pre-determined passing score, and the test standards are not norm-referenced. Test-takers pay an exam fee of $1,945.
All mental health professionals apply the principles of psychology to help clients address their mental health needs. However, there are significant psychiatrist vs.psychologist vs. therapist vs.counselor differences, especially within their scopes of practice.
Counselors
Counselors provide advice and psychological counseling to clients, often to address a specific issue, such as dealing with grief or making career decisions. They help the client understand the nature of their problem and find the best way to solve it. Counseling can be short- or long-term, depending on the client's goals and needs.
Therapists
Therapists provide similar services to counselors, primarily by applying psychotherapy, often to patterns or ongoing problems rather than a specific issue. Psychotherapy helps clients identify the psychological issues behind mental health or behavioral health concerns and to remedy the underlying issue. Therapy can take 1-2 years to achieve results, depending on the client's needs and progress.
Psychologists
Depending on the state regulations, only psychologists and psychiatrists can perform official psychological testing and diagnoses across the range of psychological disorders. Clinical psychologists specialize in diagnosing and treating mental health conditions, while counseling psychologists focus on counseling specifically. Psychologists and psychiatrists treat patients with more serious mental health issues, given their more extensive training. Psychologists may specialize in particular populations, such as children, or particular conditions or types of treatment.
Psychiatrists
Psychiatrists are medical doctors who can prescribe medications and often specialize in conditions that require medication or a combination of medication and counseling, such as depression. A counselor or psychologist may refer patients with more complex or serious needs to a psychiatrist, especially if they consider the patient may be in danger.
Your professional goals and personal interests can help determine the right mental health profession for you. How much time do you want to invest in your education? What are your financial goals? These are some distinctions to consider between psychiatrist vs. psychologist vs. therapist vs. counselor.
There are common specialties among mental health professionals. For example, you can work with people dealing with substance use as a counselor, therapist, psychologist, or psychiatrist.
Careers in Counseling
Careers in Therapy
Careers in Psychology
Careers in Psychiatry
Is there a difference between counseling and therapy?
The difference between counseling and therapy is not always distinct. Still, in general, counselors help address specific issues, usually in the short-term, with advice and counseling. Therapists help clients identify the underlying psychological roots of behavior through psychotherapy methods, and therapy tends to be longer term.
Is being a therapist emotionally draining?
Being a therapist can be emotionally draining. During your education and fieldwork, you will learn techniques to minimize the emotional toll it takes on you. Depending on your personality and background, you may also find some branches of therapy more or less emotionally draining.
Can psychologists, counselors, or therapists prescribe medication?
In most states, psychologists, counselors, and therapists cannot prescribe medication; only physicians, physician's assistants, or advanced practice registered nurses can. A few states allow psychologists to become prescribing psychologists, typically requiring extensive advanced training in medication and prescribing. This is one of the main psychologist vs. therapist differences, as therapists cannot prescribe in any state.
What separates a good therapist from a bad one?
The skills and attributes separating a good therapist from a bad one are a major part of the counseling curriculum. To be a good therapist, you must develop strong listening and observational skills, uphold patient confidences, communicate effectively, demonstrate cultural competence, and understand and maintain ethical standards. You should be able to maintain self-control in emotionally charged situations and show consistency and reliability.
This story was produced by Psychology.org and reviewed and distributed by Stacker Media.