When Should I Choose a Psychiatrist vs. a Psychologist, CSW, or MFT for Treatment?

Summary: There are two times when you should choose a psychiatrist vs. a psychologist/MFT/CSW for treatment:

1. When you have a serious mental illness.
2. When you need psychiatric medication and a provider to manage psychiatric medication.

Key Points

• MFT stands for Marriage and Family Therapist and CSW stands for Clinical Social Worker
• The differences between psychiatrists, psychologists, MFTs, and CSWs are related to their level of education and training
• What most people think of as mental health treatment – i.e. psychotherapy or talk therapy – is often provided by psychologists, social workers, therapists, and/or counselors, rather than psychiatrists.
• Treatment for serious, disruptive mental illness requires medical monitoring for safety and, in most cases, psychiatric medication to stabilize symptoms

How to Choose Between a Psychiatrist vs. a Psychologist, CSW, or MFT

The decision to choose one type of provider over another depends on your unique needs as a patient.

It’s important to understand that psychiatrists, psychologists, clinical social workers, and marriage and family therapists are all professional mental health providers trained to support patients with mental illness.

It’s also important to understand that while psychiatrists are not the only providers who can treat people with serious mental illness – psychologists and therapists can provide psychotherapy and other modalities – the symptom profile and problems caused by serious mental illness often require psychiatric medication and medical support and monitoring only psychiatrists and some types of registered nurses are trained to provide.

Ten Questions to Ask When Deciding Between a Psychiatrist vs. a Psychologist, CSW, or MFT

1. Do I have a clinical diagnosis for a mental health disorder already?
2. If so, is there a specifier such as mild, moderate, or serious/severe?
3. How urgent are my mental health challenges and needs, i.e. how serious are my symptoms right now?
4. Will I need medication?
5. Do I want to engage in talk therapy to work through depression and sadness?
6. Do I want to engage in talk therapy to manage symptoms of anxiety?
7. Are my symptoms related to trauma?
8. Do I want medication and nothing else? No therapy/talking, no groups, no complementary support?
9. Do I want holistic treatment, i.e. therapy supported by things like mindfulness?
10. If I want therapy, medication (if my provider thinks I need it), and complementary support, i.e. all the above, what do I do?

If you ask yourself those questions, then collate your answers with the information in the summary above, and the information about the different providers, below, you should be able to approach an informed decision. However, we encourage you to make that decision only after making a list of potential providers, contacting them, and determining which provider or treatment center is the best fit.

If you don’t know the answer(s) to some of those questions, we encourage you to arrange a full psychiatric evaluation with either a psychiatrist or a clinical psychologist.

In answer to question #10, if you want all of the above, narrow your search to a treatment center or provider group with that has a complete medical, therapeutic, and support staff including psychiatrists, psychologists, therapists, counselors, and complementary/auxiliary treatment providers.

Defining the Differences Between Providers

To close this article, we’ll offer a brief description of the education and training each type of providers receive, starting with psychiatrists, who receive the most education and specialized training of all the providers on our list.

Psychiatrists:

Psychiatrists are medical doctors (MDs) with specialized training in mental health, behavioral health, psychiatric illness, and psychotherapy, which allows them to diagnose and treat mental illness and behavioral disorders, write prescriptions for psychiatric medication, and manage medication in psychiatric patients.

Psychologists:

Psychologists have doctoral degrees (PhDs) who obtain specialized training in mental health, psychiatric illness, and psychotherapy, which allows them to diagnose and treat mental illness and behavioral disorders, but psychologists can neither write prescriptions for more manage psychiatric medication.

Clinical Social Workers (CSW):

Clinical Social Workers have master’s degrees (MA or MS) in psychology, social work, or related fields, and participate in specialized training in mental health, behavioral health, counseling, and therapy, which allows them to treat mental illness and behavioral disorders.

Marriage and Family Therapists (MFT):

Marriage and Family Therapists have master’s degrees (in most cases, MAs or MSs) and participate in additional specialized training in mental health, behavioral health, and counseling, and therapy which allows them to treat mental illness and behavioral disorders.