Psychiatrists vs. Therapists

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Psychiatrists and therapists both provide psychological services, but there are plenty of differences, too.

Psychiatrists and therapists both provide mental health care for individuals and groups, often in conjunction with a team of psychology professionals, which is why people commonly confuse the two professions. However, there are key differences, mostly focusing on the type of care provided. To learn about psychologist vs. psychiatrist careers, check out our other guide.

The primary difference is that psychiatrists have medical backgrounds, having attended medical school and earned a medical doctorate. This means that they can offer diagnoses and prescribe medications for patients. Meanwhile, therapists usually have master's degrees in areas like sociology, social work, or counseling, and they are not allowed to prescribe medications, instead relying on talk therapy and other non-chemical treatments to resolve issues.

Because there are fewer educational requirements for therapists, they are more common than psychiatrists. Psychiatrists and therapists both need excellent interpersonal and communication skills to help them work with clients and colleagues, serving as listeners and collaborators in professional and clinical settings. Psychiatrists and therapists often specialize, working with specific demographic groups or treatment styles.

What Is a Therapist?

Therapists are psychologists with training in social work, family counseling, or a related field. The educational requirements to become a therapist vary by state, but most therapists need at least a master's degree.

Therapists can specialize in the demographics they work with, focusing on areas like:

  • Family therapy
  • Marriage counseling
  • Group therapy
  • Individual therapy

Therapists may also focus on specific techniques in their practice, such as:

  • Life coaching
  • Music and art therapy
  • Occupational therapy
  • Cognitive-behavioral therapy
  • Dialectic behavioral therapy
  • Psychoanalysis

Successful therapists have empathy, strong communication skills, the ability to listen, and can think critically. Therapists meet with patients regularly to discuss and address mental health disorders, diagnosing potential problems, developing treatment plans, and documenting progress. They can also serve as life coaches, community service workers, educators, or consultants.

Therapists may also refer patients and clients to a psychiatrist, particularly when medication is required.

What Is a Psychiatrist?

Psychiatrists are medical doctors who assess, diagnose, and treat people who are experiencing mood-related, behavioral, and cognitive issues. They address both the physical and psychological aspects of mental health, including treating chemical imbalances with medication. Psychiatrists may respond to acute, sudden mental health crises or provide long-term care. Many psychiatrists also work in research, studying treatment efficacy, prevention strategies, and the causes of mental illness.

Psychiatrists often work in conjunction with other medical and mental health professionals, so they need good communication skills, interpersonal abilities, and compassion. Psychiatrists also need intuition and patience to help them interface with patients.

Psychiatrists usually have specializations, focusing on specific demographics or mental health conditions. These include:

  • Child and adolescent psychiatry
  • Geriatric psychiatry
  • Substance abuse addiction
  • Forensic psychiatry
  • Medical psychotherapy

To practice as a psychiatrist, professionals must earn a medical degree and complete a psychiatry residency. This usually takes at least 10 years of undergraduate and graduate work, which includes lectures, practica, internships, and research work.

Therapist and Psychiatrist Snapshot

Duties

Therapist Psychiatrist
  • Diagnose mental disorders and develop treatment plans
  • Lead patients through talk therapy
  • Diagnose, assess, and treat mental health disorders
  • Prescribe and monitor medication

Education

Therapist Psychiatrist
  • Master's degree
  • Supervision hours
  • Medical doctorate
  • Psychiatry residency

Licenses

Therapist Psychiatrist
  • Varies by state
  • Specializations may require additional credentials
  • Varies by state
  • Specializations require additional licensure

Training

Therapist Psychiatrist
  • Practical and clinical hours completed during or after a graduate degree
  • Clinical hours completed during medical school and a four-year residency

Median Salary

Therapist Psychiatrist

Education

Educational pathways for therapists and psychiatrists diverge greatly. A therapist must first earn a bachelor's degree, then enroll in a master's program, usually in a discipline like psychology, social work, or counseling. During this master's degree, aspiring therapists complete two years of coursework, research, and practical requirements.

Specific coursework varies by program and specialty. Students pursuing school counseling careers may need to teach in a classroom, while rehabilitation counselors focus on fulfilling clinical hour requirements. Additional graduate degree options for therapists include forensic psychology, pastoral counseling, and substance abuse counseling.

Aspiring psychiatrists also start with a bachelor's degree, usually in psychology, biology, or another medical discipline, but then they must attend medical school. To gain admission to medical school, students must pass the Medical College Admission Test (MCAT). Medical school lasts four years, during which learners complete coursework, participate in clinical practice hours, and work alongside practicing psychiatrists.

After completing medical school, psychiatrists participate in residencies or comparable specialized training. During this time, candidates are designated as medical doctors, but they work under the supervision of a practicing psychiatrist. Individuals who want to focus on a specific type of psychiatry must complete further coursework and training.

A psychiatrist or therapist interested in research or teaching can also pursue a Ph.D. Doctoral psychiatry programs usually focus on specific types of counseling, such as family counseling or clinical psychology.

Licenses and Certifications

Licensure and certification requirements for mental health professionals vary by state and specialty. Generally, candidates must meet educational and clinical requirements and take a licensure examination.

For therapists, state licensing boards typically require a passing score on the National Counselor Examination or the National Clinical Mental Health Counselor Examination, which are both offered through the National Board for Certified Counselors. Some states use exams proctored by the Council for Accreditation of Counseling and Related Educational Programs. Exams may include supplemental questions on specific state regulations and laws.

Along with educational and exam requirements, state licensure boards may also require therapists to complete a specific number of practical or clinical hours. Therapists looking to specialize also may need to complete an exam in that area. Professionals who specialize in marriage and family therapy, for example, may need to complete an exam offered by the Association of Marital and Family Therapy Regulatory Board.

The licensure process is similar for psychiatrists, who must hold a medical license for the state where they intend to practice. The American Psychiatry Association oversees the Federation of State Medical Boards, which lists requirements by state. Psychiatrists can also earn certification in subspecialties, such as addiction psychiatry or child and adolescent psychiatry, through the American Board of Psychiatry and Neurology.

Licenses for therapists usually last 2-4 years, while psychiatrists typically maintain their licenses for 10 years. To renewal their licenses, both therapists and psychiatrists must meet continuing education requirements, which also vary by state.

Employment

With more than 66,000 therapists employed in the United States in 2019, the Bureau of Labor Statistics (BLS) projects a 22% growth in employment for marriage and family therapists from 2019-2029. Marriage and family therapists earned median salaries approaching $50,000 in 2019.

Similarly, psychiatrists will see a projected 16% increase in employment from 2018-2028. In 2019, the median psychiatrist salary rate was over $208,000.

Both therapists and psychiatrists are most commonly employed in medical settings, such as hospitals and physician offices. Local government, home health services, and schools rank among the highest-paying industries for therapists and psychiatrists.

Therapists

MEDIAN WAGE

$49,610

PROJECTED JOB GROWTH

22% (2019-2029)

Psychiatrists

MEDIAN WAGE

$208,000+

PROJECTED JOB GROWTH

16% (2018-2028)

Sources: BLS and Projections Central

Frequently Asked Questions

Do Psychiatrists Perform Therapy?

Some psychiatrists offer talk therapy, which requires training in psychotherapy, but it is more common for psychiatrists to meet with patients for clinical assessments and medication management.

Can a Therapist Diagnose?

A therapist can diagnose mental health disorders if they hold credentials as a psychologist. They can develop treatment plans and often work with other mental health professionals, including psychiatrists.

What Is the Difference Between a Psychiatrist and a Therapist?

Psychiatrists are medical physicians who specialize in mental health. They prescribe medication and monitor its effects. Therapists meet with patients and clients to discuss mental health concerns, but they cannot prescribe medications. Instead, they use talk therapy and other behavioral techniques to help patients.

How Many Years Will It Take to Become a Psychiatrist?

Becoming a psychiatrist takes a minimum of 11 years. Aspiring psychiatrists must earn an undergraduate degree, attend medical school, and complete a three-year residency.

Can You Make Good Money as a Therapist?

BLS data indicates that therapists earned an annual mean wage of $58,600 in 2019, which was on par with the national average for all occupations. Marriage and family therapists earned a slightly lower annual median pay in 2019, taking home just under $50,000, while school and career counselors earned about $57,000.

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