Psychiatrist Questions Psychotherapy

Can I go to a psychiatrist instead of a psychologist?

Can I visit a psychiatrist without being prescribed medication? If I am looking to speak with a therapist, should I look for psychologists only?

23 Answers

I recommend seeing a psychologist over a psychiatrist. As a matter of fact, I recommend you see a marriage and family therapist over a psychologist. Yes, most psychiatrists are oriented toward medications and the medical model. Most believe genes instruct behavior to some significant extent, even 50%. Unfortunately, this trickles down and more and more psychologists adhere to a medical model, as well. I am a psychologist and a marriage and family therapist. I got my better education as an MFT, because it focused on experiences within the family as causes for behaviors. Therefore MFTs are more oriented toward natural cures, as well as prevention. Unfortunately, the medical model is trickling down into that discipline as well.
Psychologist and psychiatrists have different specializations. Psychologists attend an accredited APA graduate school: earn a masters in psychology and complete the requirements for a doctorate in psychology. The emphasis in training for a psychologist is typical the administration and interpretation of psychological and intelligence test, learn understand and treat different psycho-pathologies and personality disorders such as depression and anxiety. Psychiatrist attend a medical school and complete the requirements that apply to all medical schools. they then do a residency in psychiatry and the primary focus is on prescribing psychiatric medications. Both must complete an exam that provides them the license to provide psychological treatment in their respective fields.
Psychiatrists are MD'S and often oriented towards the utilization of prescribed medication.However there are psychiatrist who want to engage the patient in therapy and refrain from prescribing unless absolutely necessary.
A good psychiatrist should be interested in both prescribing medication and psychotherapy. There has been a trend in psychiatry supported by insurance companies to limit the number of visits to a psychiatrist, that can make doing psychotherapy difficult. You can ask the psychiatrist if they can do psychotherapy in your situation. Many people do psychotherapy, you should ask about their training and after 5 or so sessions ask yourself what am I learning? You should be learning something about yourself that you can apply towards getting better- getting rid of symptoms that bring down your life experience. If you are not learning you should talk with your therapist - and perhaps find another therapist. A rent a friend is soothing but may not teach you anything useful.
Some psychiatrists provide therapy as well as prescribing medications. Other psychiatrists only do medication management and other medical procedures. When scheduling an appointment, you can be clear you are looking for a consultation about a certain issue and not currently seeking medication. Ask if the psychiatrist has other ways to help you manage that problem.

If you are seeking therapy, then you should be sure the psychiatrist, other other mental health provider performs that service. Most providers are willing to have a brief phone conversation to discuss what you are seeking help with. That phone conversation would be a good opportunity to ask about therapy and what they provide and the costs.

There are a number of professionals who provide talk therapy, including many psychologists. Except for a very few states, only psychiatrists and other medical doctors can prescribe medicine. If you are looking for a combined approach, therapy with medication, then a psychiatrist might be a good match for integrated treatment.

If you only want to do talk therapy, you would have a much wider set of professionals available. The main distinction between psychologists and other talk therapy providers is the length and kind of training. Most licensed psychologists are required to have a doctoral degree which usually means at least 4-5 years of university training. Most other licensed professionals have a master's degree with about 2-3 years of graduate education, although some non-psychologist therapists also have a doctoral degree.

Issues like cost, insurance coverage, whether they specialize in your particular concern, and distance from your home or work may be additional factors you may want to consider when selecting a therapist.
Yes, but note that today most psychiatrists tend to spend 15 minutes per patient because they can see four in an hour that way, and they tend to prefer prescribing medications in that 15 minutes rather than spend 50 minutes with one patient (except for the first intake interview). It's not as financially rewarding either to see only one patient in an hour rather than four an hour. And if you've ever waited in a psychiatrist's waiting room, you'll see that they're often overbooked and crowded, so spending 50 minutes per person isn't efficient in terms of serving a patient population. Psychiatrists also don't tend to be as well versed or trained in various psychotherapies as psychologists, who spend 50-60 minutes per session and spend a lot of time in graduate school learning therapy techniques under a lot of supervision. Of course this depends on the psychiatrist as well, some will do longer psychotherapy sessions without prescribing medications, depends on their training in medical school and residency, and whether they take a more holistic approach, so you'll have to experiment a little and find out about that psychiatrist's preference. Today psychiatrists may prefer to refer out cases to psychologists if they feel that a patient wants more time to talk or that a psychologist is better trained to handle certain issues. 
Some psychiatrists do provide psychotherapy as part of their practices. If you start with a psychiatrist, he/she will provide you with a complete diagnostic evaluation and make recommendations for treatment. Medication can be very effective for certain conditions, and psychotherapy can be equally effective for certain conditions. You have the right to choose what type of treatment you feel most comfortable with. If a psychiatrist recommends psychotherapy, he/she may refer you to a therapist for ongoing treatment.
There are different types of therapy and different types of therapists with differing amounts and types of education and experience, so sometimes it is helpful to obtain a referral to try to help connect you to an appropriate therapist.
Many psychiatrists provide excellent psychotherapy, but you should ascertain that the person you are considering does therapy as a major part of his or her practice.
Yes that will work. He or she can then refer you if needed
Psychiatrists are trained in therapy techniques as a major focus of their residency and also in post graduate programs. I personally see some patients for therapy only without prescribing, if there are no clinical indications for medications.


That's a great question! Sometimes, with all of the mental health providers out there it can get confusing on who to see. Many psychiatrists are skilled talk therapists. However, there are psychiatrists who choose to practice medication management only, which means no therapy. Visits are generally brief in this case. If you don't feel the need for meds, I'd recommend a good licensed counselor, psychologist, or MFT (marriage, family therapist) in your area. The most important thing is to make sure that you work with someone who you have a rapport with. If not, then it's a waste of time for you as you will not feel comfortable with that person and no progress will be made.

I hope that helps. Please let me know if you need any other assistance.

Take care,
Psychiatrists have 0 training in doing therapy. If they advertise otherwise, they are being fraudulent. Their job is to prescribe medicine, not to do talk therapy.
While a psychiatrist is an MD.and can prescribe, he may be a skilled psychotherapist and can rely on talk therapy, if he and you agree.
Most psychiatrists are far too overbooked and too expensive to provide traditional talk therapy on a consistent basis. The key difference between a psychologist and psychiatrist is the ability to prescribe medications (and they hold different degree types). A psychologist is a better bet for that very reason; however, a well-versed licensed clinical social worker, licensed marriage and family therapist, or licensed professional counselor who is familiar with the issues you want addressed may suffice.
Psychiatrists prescribe medicine. Many, maybe even most, also do psychotherapy. Psychologists only offer psychotherapy interventions. If you want to stay clear of medications, starting with a psychologist can be a good idea. For a core understanding of the main emotional difficulties (depression, anger, anxiety, addictions) and what you and/or a therapist can do to relieve them, you might want to check out my website and book called Prescriptions Without Pills
Most psychiatrists I work with don't do therapy. If you are looking for therapy only, I would suggest looking for a psychologist.

Some psychiatrists do psychotherapy and don't only prescribe medication. Some psychiatrists only prescribe. Inquire before you make the appointment. Psychologists only do psychotherapy ( and testing).

Psychiatrists used to be trained solidly in both general medicine and psychotherapy, as I was. Now, most Psychiatrists do mostly medication treatment. I suggest you call around to find a Psychiatrist who does both, and get a solid evaluation. You may very well be surprised to find that both psychotherapy and medications are appropriate, but you would never know that if you go to a Psychologist for a specific treatment, instead of an evaluation.
When we look back we see that in the late 1890's & early 1900's most mental health providers were in fact physicians. Psychoanalysis was invented by a neurologist, Dr. Freud, Lacan was himself a psychiatrist. Many psychiatrists are psychoanalytically oriented and provide the "talking cure." Therefore, i believe the most important consideration is not whether it is a psychiatrist or a psychologist, but whom you feel more comfortable speaking to, and feel you have established rapport with.
Some psychiatrist also do therapy. But it will be better to have a psychologist for therapy.
You certainly can. A psychiatrist will not recommend meds if the patient s symptoms do not require such.
Psychiatrist are usually very busy and will see you only for a short time. Many complain about Psychiatrist over therapist or Psychologist. Psychiatrist are medical doctors and specialize in psychiatrics, but Psychologist are doctors of the behavioral side of the human brain. They are better equipped with mental health and psychotherapy. Just don't tell them I said that. lol....They are better at the medical departments of the human body then myself, but I am a doctor of psychology and they are a doctor of medicine.
I would recommend starting with a psychologist or licensed clinical social worker. If that person determines that medication would be helpful, he or she will refer you to a psychiatrist.