Do I Need a Psychotherapist or a Psychiatrist?

by Harley Therapy
Reviewed by Dr Sheri Jacobson

Confused by which type of mental health practitioner you need – a psychotherapist or a psychiatrist? It depends on what your mental health issues are, and whether or not you require medication.

A psychotherapist is a 'talk therapist'. They trained in advanced listening skills and human development. By working with a therapist, you learn to understand yourself and to troubleshoot your behaviours. This leads to improvements in your self-esteem, relationships, and choice-making. A psychotherapist could therefore be seen as someone who helps you manage your life. They do not prescribe medications but offer talking therapy which has been shown to help with many issues including anxiety and depression.

A psychiatrist is a trained medical doctor who decided to take additional training in mental health disorders.  By working with a psychiatrist you can learn if you have a diagnosable disorder and if so, will be given a treatment plan. This can include medication. Your psychiatrist will then monitor your treatment to make sure it is working. A psychiatrist could therefore be seen as someone who helps you manage your psychological symptoms.

Sometimes it's necessary to see both a psychiatrist and a psychotherapist

Your psychiatrist might recommend you to a psychotherapist as part of your treatment plan. Or your psychotherapist might think that medication would offer you the stability that could see you benefit more from therapy, so refer you to a psychiatrist. (Note that a psychotherapist is not licensed to prescribe you medication themselves).

But does it make sense to see both a psychotherapist and a psychiatrist?

Medication can only mask or temporarily alleviate symptoms. Therapy is required if you want to learn to change the thinking and behaviours that in some cases cause the symptoms. Therapy also helps you change the way you manage your condition. It is particularly recommended you try therapy if you intend to come off your medication in the future.

Should you see a psychotherapist first, or a psychiatrist?

If you are convinced you have a disorder and that your mental health is suffering to the extent you'll need medication, you could go straight to a psychiatrist. And if you are wanting to be tested for a disorder like adult ADHD or bipolar disorder, only a psychiatrist can carry out an official diagnosis.

But if you are not really sure about what is behind your low moods or erratic behaviours, then it can be cheaper and faster (some psychiatrists have long waiting lists) to see a psychotherapist first. A psychotherapist knows about all mental health disorders. They will be able to let you know if you need an official diagnosis and medication. If so, he or she can then refer you on to a psychiatrist. 

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