The Three P’s: Psychiatrist, Psychologist and Psychotherapist

Having worked both in England and New Zealand as a Psychotherapist, I have a sense that sometimes people might feel a little confused on who they should see for what type of issue or condition. So, I thought a few words on who is who and what is what might come in useful. You might also like to do some research on the registering bodies for each type of therapeutic professional.

Psychiatrist

The Royal Australian and New Zealand College of Psychiatrists states that ‘Psychiatrists are specialist medical doctors who are experts in mental health’ and ‘They frequently encounter conditions such as schizophrenia, bipolar disorder, depression, personality disorders and a range of anxiety disorders.’ Being medically qualified, they can prescribe medication. I worked with psychiatrists as part of my mental health placement in the NHS. Here I observed psychiatrists treating patients, often prescribing medication for conditions such as schizophrenia, supported by mental health nurses carrying out the prescribed injections. 

Psychologist

There are several different scopes of practice for a psychologist. The New Zealand Psychologist Board identifies clinical psychologists as able to ‘Assist individuals and families with emotional, mental, developmental, or behavioural problems by using psychological assessment, formulation, and diagnosis, and therapeutic interventions.’ They also describe a Counselling Psychologist as able to ‘Assist individuals and families with personal, social, educational, and vocational functioning by using psychological assessments, interventions, and preventative approaches.’ 

The New Zealand College of Clinical Psychologists suggests that ‘people often consider psychological therapy when:

• They feel an overwhelming and prolonged sense of sadness and helplessness, and they lack hope in their lives

• Their emotional difficulties make it hard for them to function from day to day. For example, they are unable to concentrate on assignments and their job performance suffers as a result

• Their actions are harmful to themselves or to others. For instance, they drink too much alcohol and become overly aggressive

• They are troubled by emotional difficulties facing family members or close friends’

Psychotherapist

The Psychotherapists Board of Aotearoa New Zealand lists three different scopes of practice for a psychotherapist: in training, working with adults or working with adults and children. 

The New Zealand Association of Psychotherapists (NZAP) states that:

‘Psychotherapy provides an opportunity to understand who we are and how to make sense of our experiences and relationships with others. It is an effective choice to alleviate mental and emotional pain for depression, anxiety and the lasting effects of trauma and early stress. It is helpful in the case of loneliness, or emptiness, or because life is unfulfilling or relationships with others are difficult. Psychotherapy is not usually a quick fix. It does not make promises of instant recovery, unlike many so-called ‘self-help’ books. It can take some time, but it is worth it.’

What does this mean?

If you have a more challenging and recognised mental health disorder, you are likely to see a psychiatrist. Where you are not dealing with a mental health condition that might otherwise require medical interventions such as prescribed medications, then either a psychologist or a psychotherapist could be the right type of support for you. Typically, a psychologist will take a more directive approach, i.e. will recommend specific actions or steps for you to take for purposes of improving your personal situation. Again, typically working with a psychologist may be over a relatively short space of time.

If you are looking for a deeper level of understanding as to how you got to be as you are, with a less directive or measured approach, then maybe a psychotherapist is the right choice for you. As a humanistic and integrative psychotherapist, I do not tell people what to do as it is their life. Amongst other things this avoids the risk of creating a dependency between the client and therapist. Rather, I am curious with clients about what they are feeling, saying, behaving, and thinking. We often explore life experiences and how you personally relate to the world around you. This enables the person to uncover and discover what has brought them to where they are today, and to provide them with the space and environment to reach their own understanding around how they might move forward with their lives. And to do so in a way which is right for them. 

References

The Royal Australian and New Zealand College of Psychiatrists. 

Te Poari Kaimātai Hinengaro of Aotearoa. New Zealand Psychologist Board. 

New Zealand College of Clinical Psychologists (NZCCP).

Te Poari o ngā Kaihaumanu Hinengaro o Aotearoa. The Psychotherapists Board of Aotearoa New Zealand (PBANZ).

New Zealand Association of Psychotherapists. Te Rōpū Whakaora Hinengaro (NZAP).