Counselor vs Psychologist vs Psychiatrist: Understanding the Differences in Mental Health Care
Many people are confused about the difference between a counselor, psychologist, and psychiatrist—and pop culture doesn’t always help. If you’ve ever seen an episode of Frasier, you might think a psychiatrist spends therapy sessions analyzing your childhood while you lie on a couch. Or maybe you’ve assumed only psychologists provide therapy, and that the word “psychologist” is just another name for counselor.
In reality, these roles are very different. Understanding who does what in mental health care can help you choose the right provider for your needs.
What Does a Psychiatrist Do?
A psychiatrist is a medical doctor (MD or DO) who specializes in mental health. They:
Attend medical school and complete residency.
Receive additional training in psychiatry.
Can diagnose mental health conditions.
Prescribe medications for issues like depression, anxiety, ADHD, bipolar disorder, and schizophrenia.
Psychiatrists typically do not provide talk therapy, but they often recommend it. In fact, research shows that the best outcomes usually come from combining medication management with counseling.
Because there is a nationwide shortage of psychiatrists, many people turn to their primary care physician (PCP) for prescriptions. While PCPs can prescribe antidepressants, stimulants, and anti-anxiety medications, they may refer complex cases (like bipolar disorder or schizophrenia) to a psychiatrist.
What Does a Psychologist Do?
A psychologist has a doctoral degree (PhD or PsyD) in psychology and is licensed to provide therapy. Psychologists are trained in:
Therapy and counseling for a wide range of mental health issues.
Psychological testing and assessments, such as ADHD evaluations, autism assessments, and personality testing.
Court-ordered evaluations and specialized assessments for schools, the VA, or other agencies.
Unlike psychiatrists, psychologists do not prescribe medication. But if you need a thorough psychological evaluation or specialized testing, a psychologist is the right professional to see.
What Does a Counselor Do?
A counselor (often called a Licensed Professional Counselor or LPC) holds a master’s degree in counseling. Counselors:
Diagnose and treat mental health conditions like depression, PTSD, trauma, and anxiety.
Provide therapy using evidence-based approaches.
May conduct certain assessments (such as ADHD or autism evaluations) with the proper training.
Counselors typically do not conduct intelligence testing or the full range of evaluations psychologists provide. However, they are highly trained in therapy itself and often more accessible and affordable than psychologists.
Which Mental Health Provider Should You Choose?
Need psychiatric medication? See a psychiatrist (or your PCP if access is limited).
Need a psychological evaluation or testing? See a psychologist.
Need therapy or counseling? You can see either a counselor or a psychologist—both are qualified to help.
The Bottom Line
There’s a lot of misunderstanding around the terms counselor, psychologist, and psychiatrist. But here’s what matters most: each of these providers plays a different role, and the best choice depends on your personal needs. Whether you’re seeking medication, testing, or therapy, understanding these differences helps you make informed decisions about your mental health care.