Choosing the Right Professional for What You’re Dealing With
One of the most common questions people ask when they decide to seek help is surprisingly simple:
“Who should I see?”
The answer is not always obvious.
The words therapist, psychologist, and psychiatrist are often used interchangeably, but they represent different educational backgrounds, different training experiences, and different treatment options. Understanding these differences can make it much easier to find the care that best fits your needs.
Therapists
The term therapist includes professionals from several disciplines, including licensed clinical social workers, professional counselors, marriage and family therapists, and others.
Many therapists are exceptionally skilled at helping people navigate life’s challenges. They provide support during periods of stress, relationship problems, grief, anxiety, depression, and major life transitions. They help people develop insight, improve communication, learn healthier coping strategies, and build more satisfying lives.
For many individuals, working with a therapist is exactly the right place to begin.
Psychologists
Psychologists receive extensive graduate training in the science of behavior, psychological assessment, and psychotherapy.
Many specialize in psychological testing, which can be invaluable when evaluating learning disorders, ADHD, autism spectrum conditions, cognitive difficulties, personality structure, or diagnostic questions that require formal measurement.
Many psychologists also provide psychotherapy, often with particular expertise in specific evidence-based approaches.
Psychiatrists
Psychiatrists complete medical school followed by residency training in psychiatry. This medical foundation allows them to evaluate the interaction between psychological symptoms, medical illness, brain function, medications, sleep, hormones, neurological conditions, and substance use.
Psychiatrists can prescribe medication when appropriate.
Some psychiatrists focus almost exclusively on medication management. Others devote much of their practice to psychotherapy. These are very different models of practice.
Different Psychiatrists Offer Different Depths of Psychotherapy
During the past several decades, psychiatric practice has changed considerably. In many settings, psychiatrists are expected to perform diagnostic evaluations and manage medications in relatively brief appointments.
That model serves many patients well.
At the same time, there remains a tradition within psychiatry that emphasizes extensive training in psychotherapy. Some psychiatrists pursue additional education in psychodynamic psychotherapy, psychoanalytic thinking, family systems, supportive psychotherapy, and other therapeutic approaches. Rather than viewing medication and psychotherapy as separate treatments, they integrate them into a unified understanding of the patient.
That has been the focus of my professional career.
Over more than four decades, I have had the privilege of treating patients with medication, psychotherapy, and psychoanalytic approaches, often combining these methods when they complement one another.
There Is No Single “Right” Treatment
People sometimes ask whether they need medication or therapy.
Often, that is the wrong question.
The better question is:
“What is driving my difficulties, and what combination of treatments is most likely to
help?”
For one person, medication may produce a dramatic improvement.
For another, psychotherapy is the essential treatment.
For many, the combination is more effective than either approach alone.
The answer depends on the individual—not simply the diagnosis.
ADHD Is a Good Example
Many adults assume ADHD is simply a problem of attention.
In reality, executive functioning difficulties often intersect with anxiety, perfectionism, selfesteem, relationship patterns, work stress, sleep problems, and longstanding ways of adapting to life’s challenges.
Medication may improve attention remarkably. But medication alone may not address habits, emotional patterns, or unconscious assumptions that continue to interfere with success and satisfaction.
Understanding how these pieces fit together is often where experience matters most.
The Goal Is Not to Fit You Into a Treatment Model
Every clinician practices from the perspective of his or her education and experience. That is true in every field of medicine and mental health.
My approach begins with understanding the whole person before recommending treatment. Sometimes that leads primarily to medication. Sometimes psychotherapy is the central recommendation. Often both are helpful.
Rather than beginning with a preferred technique, I begin with curiosity.
The treatment should fit the patient.
The patient should never have to fit the treatment.