Psychiatry versus Psychology

[pointingbeggar]

I desire to be involved in a psychiatric/counseling system in a vocation. I am curious for any advice for how to understand if I should pursue med school or should just pursue a PsyD/PhD. I am not sure of the pro's/con's of each. From any with experience in the field, what would you advise? Besides pay, what does the degree decipher in job differences? I know some institutions are allowing counselors to provide medicine after receiving a psychopharmacology degree.

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[hamstergang]

I desire to be involved in a psychiatric/counseling system in a vocation.

What is it that you actually hope to do, and what is your exposure to either field?

 

[Fan_of_Meehl]

I desire to be involved in a psychiatric/counseling system in a vocation. I am curious for any advice for how to understand if I should pursue med school or should just pursue a PsyD/PhD. I am not sure of the pro's/con's of each. From any with experience in the field, what would you advise? Besides pay, what does the degree decipher in job differences? I know some institutions are allowing counselors to provide medicine after receiving a psychopharmacology degree.

I cannot speak to the experience of being a psychiatrist (as I am a psychologist) but I really enjoy getting the opportunity to have what I consider to be a sufficient amount of time (up to an hour) during regular visits with patients who are seeking help for mental health issues. Unfortunately, if you're doing medication management, you're talking about 20 min per patient which I would find both frustrating (and overwhelming) considering the number of patients you'd have to see during a shift. Psychology has its own issues including competition from social workers, 'licensed professional counselors', etc. into the practice of psychotherapy so, outside certain settings (for now, the VA system), the model of being a psychologist primarily providing direct psychotherapy services may be waning in feasibility. At the same time, issues related to mental health and mental disorders are increasingly part of the public discourse. Unfortunately, this has not (as of yet) translated into a significant bump in psychologist salaries (so, don't go into the field to 'get rich' or anything) but it does appear that there is an increase over time in public interest in mental health issues. Of course I am biased, but I think that a doctoral degree in clinical psychology from a good university puts one in an optimal place to be well-informed on such issues and capable of applying that knowledge in practical ways that truly benefit people. And, if nothing else, I find it to be a 'pure mission' (providing therapy services to people) in an increasingly cynical and corrupt society.

 

[Fan_of_Meehl]

I cannot speak to the experience of being a psychiatrist (as I am a psychologist) but I really enjoy getting the opportunity to have what I consider to be a sufficient amount of time (up to an hour) during regular visits with patients who are seeking help for mental health issues. Unfortunately, if you're doing medication management, you're talking about 20 min per patient which I would find both frustrating (and overwhelming) considering the number of patients you'd have to see during a shift. Psychology has its own issues including competition from social workers, 'licensed professional counselors', etc. into the practice of psychotherapy so, outside certain settings (for now, the VA system), the model of being a psychologist primarily providing direct psychotherapy services may be waning in feasibility. At the same time, issues related to mental health and mental disorders are increasingly part of the public discourse. Unfortunately, this has not (as of yet) translated into a significant bump in psychologist salaries (so, don't go into the field to 'get rich' or anything) but it does appear that there is an increase over time in public interest in mental health issues. Of course I am biased, but I think that a doctoral degree in clinical psychology from a good university puts one in an optimal place to be well-informed on such issues and capable of applying that knowledge in practical ways that truly benefit people. And, if nothing else, I find it to be a 'pure mission' (providing therapy services to people) in an increasingly cynical and corrupt society.

I should also add (but this is also just my personal opinion/bias) that if you are interested in prescribing medications for treating mental health conditions--you should get an M.D. and do a psychiatry residency (and become a board-certified psychiatrist)...alternatively, I suppose you could go the advanced nurse practitioner or physician assistant route. I would not go down the pathway of getting a doctorate in psychology if I thought I had an interest in being a practicing psychopharmacologist.

 

[Doctor Bagel]

Psychiatrists are physicians who have to complete medical school. It's not a good path if you don't have interest in being a physician.

 

[pointingbeggar]

What is it that you actually hope to do, and what is your exposure to either field?

From my research, I have seen that the two are becoming closer and closer. Traditionally, I have seen that Psychologist take a more therapeutic and counseling approach, while Psychiatrists attempt to prescribe medicine. With states now allowing psychologists to prescribe medicine, I am not sure of the differences. I am willing to go to med school, but I honestly desire to counsel. I also have an interest in medicine, so that leaves me unsure.

 

[pointingbeggar]

I should also add (but this is also just my personal opinion/bias) that if you are interested in prescribing medications for treating mental health conditions--you should get an M.D. and do a psychiatry residency (and become a board-certified psychiatrist)...alternatively, I suppose you could go the advanced nurse practitioner or physician assistant route. I would not go down the pathway of getting a doctorate in psychology if I thought I had an interest in being a practicing psychopharmacologist.

Why would you "not go down that pathway?" Have you noticed any differences in pay between psychopharmacologist and psychiatrist?

 

[PikminOC]

From my research, I have seen that the two are becoming closer and closer. Traditionally, I have seen that Psychologist take a more therapeutic and counseling approach, while Psychiatrists attempt to prescribe medicine. With states now allowing psychologists to prescribe medicine, I am not sure of the differences. I am willing to go to med school, but I honestly desire to counsel. I also have an interest in medicine, so that leaves me unsure.

I do therapy and or medication, depending on what is needed. My appts range from 15 mints to 2 hours at a time.

 

[Doctor Bagel]

Why would you "not go down that pathway?" Have you noticed any differences in pay between psychopharmacologist and psychiatrist?

Can we just not do this thread. Do a search -- tons of discussions on this issue.

 

[SmallBird]

From my research, I have seen that the two are becoming closer and closer. Traditionally, I have seen that Psychologist take a more therapeutic and counseling approach, while Psychiatrists attempt to prescribe medicine. With states now allowing psychologists to prescribe medicine, I am not sure of the differences. I am willing to go to med school, but I honestly desire to counsel. I also have an interest in medicine, so that leaves me unsure.

I'm not sure I would characterize the trend as the two becoming 'closer and closer'. On the contrary, psychiatrists used to do more therapy in many settings, and are increasingly focusing on psychiatric evaluations and medication management. It is an absolute minority of psychologists who are pursuing prescription rights. Both pathways will create opportunities for rich careers. Critically, to be a psychiatrist you must first become a physician and this is a considerable commitment (which is not to say that psychology isn't a large commitment also).

 

[hamstergang]

From my research, I have seen that the two are becoming closer and closer. Traditionally, I have seen that Psychologist take a more therapeutic and counseling approach, while Psychiatrists attempt to prescribe medicine. With states now allowing psychologists to prescribe medicine, I am not sure of the differences. I am willing to go to med school, but I honestly desire to counsel. I also have an interest in medicine, so that leaves me unsure.

Well, you didn't really answer my question well enough to help. Have you not seen either field in action, and therefore you only get ideas of what they are from reading online?

When you saying you want to do medicine and counseling, what do you mean by those? What do you think you'd want to do day to day, and what do you like about that?

Just to help a little, psychotherapy is a treatment that can be provided by psychologists or psychiatrists (as well as social workers and probably some others). Counseling is something else, not a treatment, but along with treatment to help inform the patient about what they should be doing. It sounds odd to say that psychiatrists "attempt" to prescribe -- do you think we're unsuccessful at writing on the pad? About 4 states allow psychologists to go through a course to have prescribing rights, but the doctoral psychology degree doesn't really set you up for that. Psychologists can do a lot more than therapy and treating patients.

 

[pointingbeggar]

Can we just not do this thread. Do a search -- tons of discussions on this issue.

It's quite difficult to find direct answers to specific questions without having somewhere to go to answer them. That is why I am here. I am sorry if this annoys you.

 

[pointingbeggar]

It is an absolute minority of psychologists who are pursuing prescription rights. Both pathways will create opportunities for rich careers. .

Interesting. Would the pursuit of a psychopharmacology degree establish me as a unique candidate in high demand? Or will I be pursuing a field that will only respect an MD thus placing me outside of the career field?

 

[pointingbeggar]

Well, you didn't really answer my question well enough to help. Have you not seen either field in action, and therefore you only get ideas of what they are from reading online?

When you saying you want to do medicine and counseling, what do you mean by those? What do you think you'd want to do day to day, and what do you like about that?

Just to help a little, psychotherapy is a treatment that can be provided by psychologists or psychiatrists (as well as social workers and probably some others). Counseling is something else, not a treatment, but along with treatment to help inform the patient about what they should be doing. It sounds odd to say that psychiatrists "attempt" to prescribe -- do you think we're unsuccessful at writing on the pad? About 4 states allow psychologists to go through a course to have prescribing rights, but the doctoral psychology degree doesn't really set you up for that. Psychologists can do a lot more than therapy and treating patients.

I have seen very minimal in action. I anxiously desire to watch in action, but am unsure in how to pursue this or which one to observe.

By medicine and counseling, I would like to meet with clients, discuss their reason for approaching psychotherapy, then create a plan based off of prescriptions along with social, religious, or physical (etc) methods to attempt to progress towards a solution. Dialogue is imperative to me. I would like to spend time with the patient and give them the attention they need. I firmly believe that psychiatrists are extremely educated and talented in making a correct diagnosis of medication. I apologize for the wording.

I believe it is IL, NM, and LA that allow psychologists to prescribe with the supplementary, post-grad work of psychopharmacology. How do you feel about this concept? Do you see this expanding to other states? Would you think that job opportunities will be in demand within the coming years?

 

[Fan_of_Meehl]

Why would you "not go down that pathway?" Have you noticed any differences in pay between psychopharmacologist and psychiatrist?

I wouldn't go down the pathway (at the inception of my graduate career) of earning a doctorate in psychology if what I really wanted to do, practice-wise, was prescribe medication. The M.D. (physician) route is more suitable for that kind of focus for obvious reasons. If you think you'll be interested in doing psychotherapy AND psychopharmacology, the M.D. would be a better path because I think it's a hell of a lot easier for an M.D. (psychiatrist) to practice psychotherapy than a psychologist to get the extra post-doctoral training (generally, sadly, an ONLINE master's degree in psychopharm plus some supervised cases) that would 'qualify' (according to certain states' laws (very few states at this time)) a 'medical psychologist' so designated to prescribe meds. In all 50 states, if you have an M.D., you can (if you think you have the appropriate training/qualifications) perform psychotherapy. And, of course, M.D.'s generally earn at least twice what a psychologist earns in salary. I trained with an M.D./Ph.D. (in psychopharmacology) psychiatrist who trained under Aaron Beck and was the first president of the Academy of Cognitive Therapy (Jesse Wright). So, you can certainly be a psychiatrist and receive (and provide) world-class training in psychotherapy.

 

[Doctor Bagel]

It's quite difficult to find direct answers to specific questions without having somewhere to go to answer them. That is why I am here. I am sorry if this annoys you.

There was a very recent thread about psychologists and prescribing rights. There have been numerous threads on that issue. It's a contentious topic and generally of low yield to discuss in this forum. The answer everyone here will give you is that if you want to prescribe medication, become a physician. If you want to do therapy and prescribe, again, become a physician. That's the gold standard.

 

[PikminOC]

I feel like op is a troll as sdn has a great search function. And there's a sticky on the psychology thread. And numerous similar threads on the links below this thread...
New acct, posts only on this...
:troll:

 

[pointingbeggar]

I feel like op is a troll as sdn has a great search function. And there's a sticky on the psychology thread. And numerous similar threads on the links below this thread...
New acct, posts only on this...
:troll:

I am new to the website. I post on a subject that I was searching for answers for. I apologize. I will definitely make sure I get your approval before posting again.

 

[PikminOC]

You don't need my approval. Just do a simple search

 

[catstevens]

I'm in the same boat. Both paths require a lot of money and time and are not interchangeable. It is a huge decision and it is scary to choose right now. Thank you for the thread and thank you Fan of Meehl for your most excellent information.

I'm going to make my decision after I volunteer more, but from what I've seen psychiatry doesn't hold you back from giving good psychotherapy, but it does increase your options. I'm guessing most psychiatrists don't have a passion for psychotherapy and that is where the stigma comes from.

 

[smalltownpsych]

I'm in the same boat. Both paths require a lot of money and time and are not interchangeable. It is a huge decision and it is scary to choose right now. Thank you for the thread and thank you Fan of Meehl for your most excellent information.

I'm going to make my decision after I volunteer more, but from what I've seen psychiatry doesn't hold you back from giving good psychotherapy, but it does increase your options. I'm guessing most psychiatrists don't have a passion for psychotherapy and that is where the stigma comes from.

No. it's not that psychiatrists don't want to or can't do psychotherapy. I think that pendulum is swinging back these days, to be honest. I also think a good psychiatrists should have solid training in psychotherapy regardless of whether they provide it or not and have discussed that in other threads. What I have seen is that psychotherapy doesn't typically pay as well as medication with or without psychotherapy. Also, since I can't prescribe medication and a psychiatrist can, employers want me to do the psychotherapy and the psychiatrists to do the medications. That is the practical aspect of it.

 

[Psychotic]

I'm going to make my decision after I volunteer more, but from what I've seen psychiatry doesn't hold you back from giving good psychotherapy, but it does increase your options. I'm guessing most psychiatrists don't have a passion for psychotherapy and that is where the stigma comes from.

Med school will increase your options, too, beyond psychiatry - you may find your calling elsewhere. It happens, a lot.

If you are determined to be a psychotherapist, and have little interest in the medicine side of it, or have little interest in the field of medicine, then I would recommend going the psychology route.

 

[Drrrrrr. Celty]

I'm in the same boat. Both paths require a lot of money and time and are not interchangeable. It is a huge decision and it is scary to choose right now. Thank you for the thread and thank you Fan of Meehl for your most excellent information.

I'm going to make my decision after I volunteer more, but from what I've seen psychiatry doesn't hold you back from giving good psychotherapy, but it does increase your options. I'm guessing most psychiatrists don't have a passion for psychotherapy and that is where the stigma comes from.

As mentioned before, if you go down the path of wanting to be a psychiatrist you need to also want to be firstly above all be a physician. If you cannot stomach the idea of spending 200-400 hours arms deep in a cadaver ( Alright it's more like hands deep), memorizing biochemical pathways, learning how to do surgery, doing 500 million joint and structural exams, and learning how to talk to and manage your patients who have medical issues then you're going to be miserable in medical school and in medicine.

So if you in your undergrad have never had any wowing appeal or interest in learning about the human body, pathologies not restricted to the mind, and biochemistry I would recommend you not go down the path of medicine. It's simply not going to be an experience you'll enjoy.

 

[Therapist4Chnge]

If you are determined to be a psychotherapist, and have little interest in the medicine side of it, or have little interest in the field of medicine, then I would recommend going the psychology route.

If the OP primarily wants to provide psychotherapy, a mid level counseling degree (MA/MS/MSW) is probably the best route. To be a psychologist you need to learn and be proficient in research, statistics, psychometrics, etc. Psychotherapy is only a portion of the training and it'd be a grind to slog through 4-6yr of research/stats if you want to only focus on psychotherapy. It's also a good route if you want to teach, research, be an administrator, etc.

 

[smalltownpsych]

As mentioned before, if you go down the path of wanting to be a psychiatrist you need to also want to be firstly above all be a physician. If you cannot stomach the idea of spending 200-400 hours arms deep in a cadaver ( Alright it's more like hands deep), memorizing biochemical pathways, learning how to do surgery, doing 500 million joint and structural exams, and learning how to talk to and manage your patients who have medical issues then you're going to be miserable in medical school and in medicine.

So if you in your undergrad have never had any wowing appeal or interest in learning about the human body, pathologies not restricted to the mind, and biochemistry I would recommend you not go down the path of medicine. It's simply not going to be an experience you'll enjoy.

I would have so loved doing all of that. Of course, there was a time in my life when I wanted to be a medical doctor of some type before I decided to become a psychologist. I still enjoy performing some amateur medicine from time to time, but I can only do that at home with my accident-prone wife.

I also used to really enjoy assisting my experienced and highly skilled nurse at the last program I worked at when we were making medical decisions. What was frightening was how often my MA level therapists wanted to ignore or overlook potentially significant medical issues; whereas, we were always covering our backsides by consulting the medical docs and following their recommendations. The midlevel counselors seem to have a tough time understanding what being a licensed medical professional really means and don't really see themselves as such either, but will act way beyond their scope and make medical diagnoses and recommendations all day long.

 

[Drrrrrr. Celty]

I would have so loved doing all of that. Of course, there was a time in my life when I wanted to be a medical doctor of some type before I decided to become a psychologist. I still enjoy performing some amateur medicine from time to time, but I can only do that at home with my accident-prone wife.

I also used to really enjoy assisting my experienced and highly skilled nurse at the last program I worked at when we were making medical decisions. What was frightening was how often my MA level therapists wanted to ignore or overlook potentially significant medical issues; whereas, we were always covering our backsides by consulting the medical docs and following their recommendations. The midlevel counselors seem to have a tough time understanding what being a licensed medical professional really means and don't really see themselves as such either, but will act way beyond their scope and make medical diagnoses and recommendations all day long.

I'm surprised at how many people in my class or in general in medicine don't tbh. I think it's one of the worst things about our medical admissions system. But that's a tangent for another day.

I think people either look too much at the whole person or too little these days. I suppose we should be happy that those MA therapists aren't advising that the patient's depression is due to their gut flora being off and that the internet says we should be doing a fecal transplant and probiotics to improve affect....

 

[smalltownpsych]

I'm surprised at how many people in my class or in general in medicine don't tbh. I think it's one of the worst things about our medical admissions system. But that's a tangent for another day.

I think people either look too much at the whole person or too little these days. I suppose we should be happy that those MA therapists aren't advising that the patient's depression is due to their gut flora being off and that the internet says we should be doing a fecal transplant and probiotics to improve affect....

You apparently haven't met very many of them then if you don't think that there are many who are advising way more wacky stuff than even that. Part of why I was hired as a clinical director at my last employer was to clean house and bring evidence-based practice because of the new-agey garbage that many in the residential treatment industry were doing.