Psychologist vs. Psychiatrist

As a psychologist in London Ontario, one of the most common questions that I am asked is to define the difference between a psychologist and psychiatrist.  To answer this question, we have to look at standard definitions as well as differences that exist in practice across different geographical locations.  For example, in London Ontario, there are increasingly fewer psychiatrists in private practice resulting in very little psychotherapy being offered by psychiatrists outside of hospital settings.  High demand and little supply means that resources covered by OHIP must be spread quite thin.  Nevertheless, there are some standard differences between the two professions that apply across all of Ontario.

One of the biggest differences between a psychiatrist and psychologist is that a psychiatrist has a degree in medicine and a psychologist has a doctoral degree in psychology.  In practical terms, a psychiatrist has obtained a medical degree and then completed four years of residency in psychiatry.  In contrast, a doctoral degree in psychology requires 5-7 years of post-graduate training including a minimum of one year in a full-time clinical residency program.

As a result of the difference in degrees, psychiatrists are able to prescribe psychotropic medication and are covered by OHIP.  Psychologists cannot prescribe medication in Canada (although that is increasingly changing in the United States) and are not covered by OHIP.  However, psychological services are often coverd by extended health insurance as well as various third party payors including motor vehicle insurance for those injured in car accidents and the W.S.I.B. for those injured at work. In addition, government sources of funding for psychological services are available for various groups such as veterans.

While most people are interested in understanding the difference between these two professions, it is also important to understand the similarities.  Both psychologists and psychiatrists specialize in the assessment and treatment of mental health issues.  Both are also legally allowed to make a diagnosis with respect to psychiatric conditions.  This is an important privilege because while other professions are able to provide psychotherapy, only medical doctors and psychologists are able to provide a formal psychiatric diagnosis.

Some additional facts that may assist a consumer in deciding whether to seek the care of a psychologist or psychiatrist:

  • Psychology focuses on the full range of human emotion and behaviour including the normal and abnormal while psychiatry tends to only focus on abnormal emotion and behaviour.
  • Psychologists tend to use the biopsychosocial model to understand emotional difficulties which can include one’s environment, past and present experiences, personality, relationships, physiological factors, learned behaviours,and thinking patterns. In contrast, psychiatrists tend to view emotional difficulties through the medical model which identifies problems as an abnormality in physiology.
  • No referral is needed to book an appointment with a psychologist.  Conversely, to see a psychiatrist, a referral from a family doctor is necessary.
  • Finally, a psychologist and psychiatrist can often work together to provide a more comprehensive set of services to clients requiring both medication and psychotherapy.