Psychological vs Psychiatric Evaluation And Treatment

Psychology and psychiatry are both concerned with how the mind works, and they share many principles and practices. This commonality often makes differentiating between the two difficult. Some people may assume the two fields are one and the same, which results in the common habit of using the terms interchangeably.

However, while psychology and psychiatry are similar and often work in tandem to provide the best patient care, they do have several key differences. Below, explore a comparison between psychology and psychiatry to see how these differences affect an individual's evaluation, diagnosis, and treatment.

What's the difference between psychology and psychiatry?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), one in five adults in the U.S. live with a mental health condition. The fields of psychology and psychiatry are both integral to the treatment and evaluation of these prevalent challenges. There are a number of differences between psychologists and psychiatrists, as well as differences in their respective evaluations.

There are also a number of similarities between psychologists and psychiatrists. Both specialists work to help individuals overcome mental and emotional obstacles to living happy and healthy lives, and they often work together to achieve this goal.

The BetterHelp platform is not intended to provide any information regarding which medication or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. Do not take any action (including starting, stopping, or changing medications) without consulting a qualified medical professional.

What is psychology?

The American Psychological Association (APA) defines psychology as "the scientific study of individuals' behavior and mental processes." Psychology focuses on society as a whole and on interactions between individuals.

What is psychiatry?

The American Psychiatric Association defines psychiatry as being "focused on the diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders." In other words, psychiatry is a medical science that considers the social and biological context of individuals.

Similarities and differences 

Below are some similarities and differences between psychology and psychiatry: 

• Both fields require a doctorate, though psychiatrists must also have a medical degree (MD) 

• Both fields involve intensive study and training
• Both professionals have some of the same diagnostic tools
• Psychologists usually have experience in an array of talk therapies
• In most states, only psychiatrists can prescribe medication
• Psychiatrists can use physical treatments, such as shock therapy
• Psychiatrists often handle the most severe mental health cases

Education and training

Psychiatrists are medical doctors who have received the distinction of Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.). Psychologists, on the other hand, have completed a doctoral degree that entitles them to be addressed as "doctor" and have received either a Doctor of Philosophy (Ph.D.) in Psychology or a Doctor of Psychology (Psy.D.) degree. 

Psychiatrist education path

Psychiatrists complete the same medical school education as all other medical doctors. They learn all about the different systems in the body, including various illnesses that can affect these systems and how these illnesses can be identified and treated. They take courses in anatomy, behavioral science, biochemistry, neuroscience, and psychiatry, among many other areas. In addition, they're exposed to working in a minimum of six specialist areas. 

To specialize in psychiatry, doctors also spend at least four years focusing on psychiatry in residency training. During residency, they train in various medical settings with patients of all age ranges, gaining exposure to the diversity of psychological conditions that patients face. Upon completion of their residency, most opt to apply for certification with the American Board of Psychiatry and Neurology. 

Psychologist education path 

Psychologists follow a different route. They must first complete doctoral studies, typically earning a Ph.D. or a Psy.D. Following graduation, psychology graduates are required to fulfill a one to two-year residency. This residency provides psychologists with a practical setting where they can gain experience in psychological treatment methods and problem-solving techniques.

Different states have different requirements for psychologists. In some states, they must work an extra one to two years under the guidance and supervision of an authorized mental health psychologist before being fully recognized as a psychologist. In summary, when it comes to education and training, the main difference between the two is the focus of their studies. However, psychology and psychiatry are concerned with why people think and behave the way they do.

Psychological vs psychiatric evaluation and diagnosis methods

A mental health professional must conduct a thorough evaluation before treating a patient. There may be a vast difference in the way that psychologists and psychiatrists diagnose patients’ mental health challenges, mainly because of the differences in their education and training. Based on their studies, a psychiatrist often looks for physical symptoms or chemical explanations, while a psychologist may look for social or personal explanations. 

The differences in a psychiatric and psychological evaluation are particularly evident in the diagnostic tools each professional can utilize. Psychiatrists are medical doctors who can draw upon diagnostics tests, including medical laboratory tests and computerized tomography (CT) scans. A psychiatrist can also perform a physical exam as part of a comprehensive evaluation. In order to specifically label a psychological condition, psychiatrists rely on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Within this manual are descriptions of the various mental disorders and the criteria used to diagnose each psychological illness.

Both use a variety of tests and assessments for psychological evaluation. Psychologists, however, usually receive extensive training in administering and interpreting these tests. Psychologists also use the DSM-5 in their work. Typically, both types of evaluations involve an interview with the patient. A psychologist or psychiatrist may ask the individual about their medical history, day-to-day life, and family history—as well as the symptoms that caused them to seek psychological treatment. A psychology or psychiatry professional may also speak to other people in the patient’s life with their permission, including their partner or other family members. 

Psychological treatment options

Below are three of the most common psychological treatment options. Often, psychiatrists and psychologists work together to create a treatment plan. 

Medication

As trained medical doctors, psychiatrists are legally authorized to prescribe psychological medication. Much of the work they do with patients centers on treating chemical imbalances in the brain and managing medication. Their medical training means that psychiatrists may also take other factors into consideration. Through physical evaluation and possible tests, they try to eliminate other possible causes for a patient's condition before prescribing a course of medication.

In most states, psychologists who want a patient to begin medication or reassess their current dosage must refer the patient to a psychiatrist or another medical doctor. However, there are currently states where psychologists have prescribing powers for certain psychiatric medications. There is also a push for more states to follow suit and widen the scope of treatments psychologists can offer their patients. Many common emotional and mental psychological disorders are effectively and efficiently treated with a combination of psychotherapy and medication. However, some people choose not to or cannot take medication. 

Psychotherapy assessment

Psychotherapy, which is also known as talk therapy, involves talking with patients about the concerns they're facing and helping them to:

• Identify circumstances in their lives (such as divorce or the death of a loved one) that are contributing to their mental health concerns.
• Become aware of any behaviors or emotions that are contributing to their condition.
• Make use of behavior modification techniques.
• Develop healthy coping strategies and appropriate problem-solving techniques.

It's not uncommon for a psychiatrist to refer patients to a psychologist so they may benefit from the other's specific area of psychotherapy expertise.

Types of talk therapy psychologists utilize to support patients

Below are some of the types of talk therapy that a therapist might use. 

Psychoanalysis

Psychoanalysis focuses on helping clients discover, examine, and learn to cope with repressed thoughts and emotions that may be buried deep in their unconscious minds. It's an in-depth method that has been proven effective for patients dealing with depression, personality disorders, persistent relationship issues, emotional challenges, and trauma, as well as self-destructive behavior patterns.

Cognitive behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT) seeks to change how clients behave in difficult situations by changing their thought patterns. This approach is often used to treat current problems individuals face, such as anxiety, stress, anger, and eating disorders. Due to its effectiveness in many studies, CBT is considered the most widely used type of talk therapy. 

Cognitive analytic therapy (CAT)

Using cognitive analytic therapy, a psychotherapist aims to help patients identify early experiences that may be contributing to their current mental health challenges. For example, overly controlling parenting often leads to an overly rebellious nature in adolescence or adulthood. Clients in CAT are typically actively involved in the process, helping develop strategies to curb their maladaptive behaviors.

Gestalt therapy

Gestalt therapy is a client-centered form of psychotherapy often used for clients who are experiencing relationship difficulties, depression, anxiety, and low self-esteem. This method has also been shown to have positive effects in cases where patients' emotional stress is manifested physically through migraine headaches and back spasms. Gestalt therapy encourages bringing possibly painful concerns to the surface using methods like drama or art so they can be addressed positively in an environment where clients are safe. 

Hypno-psychotherapy

Some psychologists use hypnosis to augment psychotherapeutic interventions. This treatment is meant for the treatment of deep psychological challenges and psychiatric illness through selective attention and suggested experiences. Hypnosis is also often combined with CBT in a treatment known as cognitive-behavioral hypnotherapy (CBH).

Dance/movement therapy (DMT)

Dance therapy is an expressive therapy; in some instances, it's referred to as movement psychotherapy. Dancing for therapy draws on the well-researched relationship between movement and emotion. Dance/movement therapy is sometimes applied in the treatment of eating disorders and poor self-image.

Art therapy

Art therapy is another expressive form of therapy in which art is used to release emotions. The art that clients produce is often evaluated by the therapist for underlying signs of a mental health condition. However, art can also be free-form, created in whatever way the client wants and without meaning. Art therapy is often used to treat children and adolescents, but it has also proven effective for adults.

Integrative or holistic therapy

Some psychologists practice integrative therapy, which believes that a fusion of different therapies is the best approach for a particular individual. Holistic therapy is a patient-centered approach, focusing on each client's unique needs and using multiple modalities and tools. 

Physical treatment options

As medical doctors, psychiatrists are trained in diverse physical treatments that can be used with patients. However, these are most often reserved for severe cases of mental illness, and some treatments are known for being controversial. Below are some of these potential treatments: 

• Electroconvulsive therapy (ECT): Also known as shock therapy, ECT involves the use of electrical currents to the brain to induce small seizures to treat severe depression, catatonia, and mania.

• Transcranial magnetic stimulation (TMS): This treatment entails the noninvasive use of a magnetic field generator to stimulate certain areas of the brain. TMS has been used effectively in those whose severe depression does not respond to medication.

• Deep brain stimulation (DBS): In this treatment, a neurostimulator (i.e., a brain pacemaker) is implanted in the patient's brain. Electrical impulses are then used to treat conditions like obsessive-compulsive disorder (OCD).

• Vagus nerve stimulation (VNS): This is another treatment where electrical stimulation is applied to the brain to treat medication-resistant depression.

• Light therapy: This relatively new technique is used to treat both seasonal and nonseasonal depression.

Psychological or psychiatric: Which mental health therapy is right for you?

When you're trying to decide between using psychiatry and psychology to treat a mental health concern, there are two important factors to keep in mind: 1) severity and type of mental health condition and 2) the approach with which you’re most comfortable.

Severity and type of mental health illness

Psychiatrists often treat the most complex mental illnesses. These conditions can include schizophrenia, severe depression, highly irrational thoughts, and bipolar disorder, as well as conditions that are physically disabling for the patient. Individuals who are suicidal, whether they're having suicidal thoughts or have attempted suicide, may also be treated by a psychiatrist instead of a psychologist. However, in the case of behavioral problems, mild forms of depression, anxiety, phobias, or learning difficulties, the skills of a psychologist may be the most appropriate. Often, individuals visit both a psychiatrist and a psychologist separately, as therapy and medication combined can be a helpful approach for severe mental illness. 

Psychological vs psychiatric evaluation and diagnosis methods that suit you

The difference in how psychologists and psychiatrists approach treatment means that some people may be more comfortable with one than the other. For instance, people who are cautious about the side effects of medication or about taking medication in general may gravitate toward the services of a psychologist. Also, treatment by a psychotherapist is usually more time-intensive because it often requires weekly sessions, which are normally longer than those with a psychiatrist. Psychiatrists generally see individuals for shorter sessions on a weekly or monthly schedule to focus on medication management.

Online therapy with mental health professionals

Many people struggle to find therapy due to their geographic location and ability to pay. In these cases, online therapy may be an option, and pricing can be the same or lower than some insurance co-pays for therapy.

If you or a loved one is experiencing a mental health challenge, you don’t have to face it alone. Your course of treatment may involve working with a psychologist, a psychiatrist, or both. If you're interested in talk therapy, consider a service like BetterHelp. Research has found that online therapy is just as effective as in-person therapy in most cases, and it offers the convenience of being able to talk with a therapist from the comfort of your home in a format that you prefer. You can connect with a licensed therapist via phone or video chat, in addition to contacting them in between sessions via in-app messaging.