Who is a clinical psychologist and how is he different from a psychiatrist?

© Narrated by Andrey Arkadyevich Shmilovich

, Doctor of Medical Sciences, doctor of the highest category, head of the Department of Psychiatry and Medical Psychology, Russian National Research Medical University named after. N.I. Pirogova, chief physician of the Alter clinic:

If you are reading this post, then you are interested in the topic of mental health. Perhaps now you or your loved one are feeling bad and you don’t know what to do about it or where to turn. I will tell you what types of psi specialists there are and how not to make a mistake with your choice.

Let's start with the fact that most people do not fully understand the difference between a psychiatrist, psychologist, psychotherapist and psychoanalyst. But which of them you get to first is of key importance. Let's sort it out in order.

Psychiatrist

If a specialist calls himself a psychiatrist, you should understand that you are going to a doctor. He is first of all a physician, just like a surgeon, ENT, gynecologist or ophthalmologist, to whom you contact with a specific complaint: pain in the heart, discomfort in the abdomen, heartburn, double vision, and many other symptoms of the disease.

You expect that such a specialist will listen to you carefully, collect a so-called anamnesis, analyze your medical history and prescribe some examination methods, prescribe medications or refer you for surgical treatment that will relieve you of your illness. It’s absolutely the same story with psychiatry, only they don’t cut anything, there’s no scalpel, unfortunately there aren’t as many instrumental diagnostic methods as in surgery that can visualize the disease on a monitor screen.

However, a psychiatrist has his own advantages and unique diagnostic methods. In a normal dialogue, the psychiatrist conducts a thorough assessment of how you think, how you react, what emotions, feelings, experiences you experience, he tries to record all this, build it into a certain diagnostic structure, in order to further determine your illness and begin to treat it. Or tell you the good news that you are healthy and do not require treatment. So, the main goal of a psychiatrist is to catch the symptoms, diagnose and cure the disease.

Now a psychologist

This is a specialist with a completely different diploma and a completely different way of thinking. He is not competent to provide medical assistance, he cannot provide treatment, he is primarily determined to study your personality, your psyche and your life in its psycho-social aspect. It is aimed at understanding the structure of your worldview, your principles, to see your temperament, resource characteristics, to evaluate your vision of a particular situation and, through an assessment of your psychological parameters, to help you organize your life in a difficult situation.

This situation may be related to work, family, relationships with friends or enemies, and perhaps only to your internal psychological and mental processes. Or it may be related to illness. But in these cases, the task of the psychologist is to detect this in time and establish cooperation with the psychiatrist, and with the patient to deal not with eliminating this disease, but to find options for adapting to the life that has developed in connection with the disease. This is very important, but not enough to get rid of the disease.

About the duration of treatment

Having understood the difference between a psychologist and a psychiatrist that exists today, it is worth paying attention to the topic of the duration of treatment from the presented specialists. Of course, the duration of the treatment period depends only on the patient’s individual indicators. Typically, simple therapy lasts several weeks. But if we are talking about some kind of psychoanalysis, then treatment can last for years.

Here it is worth noting another important difference between specialists such as a clinical psychologist and a psychiatrist. What is the difference regarding the duration of treatment? Sessions with a psychologist almost always last less. The reason for this is the voluntary nature of visiting this specialist. In the case of a psychiatrist, everything is exactly the opposite: patients do not come to him of their own free will, and therefore often interfere with treatment. Because of this, the duration of the course increases.

There are also psychotherapists

Officially, such a specialist is primarily a doctor who also has a medical diploma and is aimed at treating, identifying and diagnosing the disease. But he is different from a psychiatrist. The psychotherapist heals with words. He does not use pills, no biological correction methods, he works with the help of words. This word can be wrapped in different shells, in different methods of psychotherapy. There are a wide range of psychotherapists who, having mastered different techniques, can use one or another, depending on the patient’s personality.

However, a psychologist can also be called a psychotherapist. And many psychologists quite rightly call themselves this, although this cannot be officially the case. Nevertheless, we admit the possibility of psychotherapeutic correction by a psychologist, if the goal of this psychotherapy is to heal the soul, but not the disease, not the body. And of course, in this situation, a psychotherapist-psychologist will differ from a psychotherapist-psychiatrist in that his main goal will not be the treatment of the disease, but the correction of the personality.

Specializations

To finally understand how a psychologist differs from a psychiatrist, let's look at the different types of these specialists. The professions under consideration differ radically in their specializations, which require additional in-depth training in the chosen direction.

Psychologist

Psychologists do not have to have a medical education; they are trained at the psychological faculties of various universities (humanities or technical). In this case, the following areas of psychology are possible:

1. Pedagogical
   .
   Specialists in this area are able to work with children and adolescents. They are distinguished by their good knowledge of issues of modern education, behavior correction and solving problems that arise in relationships between students of different institutions.
2. Social Psychology
   .
   Specialists in this field are more focused on working with adults experiencing crisis situations or having problems adapting to new conditions.
3. Clinical
   .
   This area deals with the psychological preparation of people for difficult treatment or risky operations, as well as assistance during the rehabilitation period.
4. Legal
   .
   Specialists in this area work with difficult teenagers who are on police records.
5. Family
   .
   This direction helps people solve personal problems (relationships between lovers, spouses or parents and children).

Psychiatrist

There are also specializations in psychiatry. First of all, we should mention such specialists as:

1. Child psychiatrist
   .
   Deals with minor patients (under 18 years of age). These specialists are highly qualified, since they need to work with children with the utmost sensitivity. They should also be able to explain to parents the essence of the problem and suggest how they can help their children with treatment.
2. Gerontologist
   .
   This is a specialist who deals with older people. Age-related changes in the brain are likely to lead to various cognitive and mental disorders. Therefore, doctors are needed who are well acquainted with the specifics of age-related mental illnesses.
3. Sex therapist
   .
   Deviations of sexual perception are quite widespread and can greatly spoil the quality of life of a person and his partner. Sex therapists help people get rid of the psychological causes of sexual disorders, improving the quality of their personal lives and life in general.
4. Narcologist
   .
   Specialists in this area work with addictions (alcohol, gaming, drugs, etc.).
5. Forensic psychiatrist
   .
   Provides an expert assessment of the mental state of defendants, witnesses and other participants in the process (if required). It often determines whether the accused receives a prison sentence or is sent to psychiatric treatment.

Psychoanalyst

This is a specialist who may be a psychotherapist or a psychologist-psychotherapist. Psychoanalysis

is a well-known technique that has existed for many decades and has long established itself as an absolutely proven technique in both psychiatry and psychology. Modern psychoanalysis can be called an independent discipline, based on the key principles of the architecture of the human psyche, discovered by Sigmund Freud and his followers and based on the theory of the unconscious. Once you see a psychoanalyst, you will have the opportunity to discover a lot of new things in the content of your mental life and direct its course in a direction that is comfortable for you.

So we figured out what kind of specialists these are. So, what is next?

How can I understand whether I’m sick and I need to see a psychiatrist, or whether it’s just a life collision and I should see a psychologist? Most people think like this. I’ll go to a psychologist first, listen to what he says, try his therapy, and if it doesn’t help, then I’ll go to a psychiatrist. Or, on the contrary, I’ll go to a psychiatrist, find out what the doctor says, and if anything happens, then I’ll refuse his treatment and go to a psychologist. This tactic seems logical. I'll try one thing, if it doesn't work I'll go do something else. But unfortunately, most often this path is never completed. And it turns out that a patient in need of medical psychiatric help receives only psychological support for a long time, and a mentally healthy person who most needs psychological support and psychotherapy comes to see a psychiatrist and does not receive qualified psychological help.

The only correct move in such a situation is to kill two birds with one stone and sign up for a joint consultation with two specialists.

You will immediately receive an answer to your main pressing question, whether you are sick or not, and you will immediately find out with whom you need to deal with your complex life problem.

Mental problems

It would seem that the course of history presupposes the constant evolution of society. Society is developing, and therefore people should have fewer problems. But is it really that simple? Not really. Modern man is at the mercy of a frantic rhythm of life, which, in turn, is fraught with constant stress and strain on the nervous system. There is probably not a single individual who has not been subjected to powerful mental stress.

Many people are used to dealing with their problems on their own. However, it is very mistaken to be completely confident that all difficulties can be solved without anyone’s help. Unfortunately, modern society has developed a stereotype about people who seek mental help from specialists as very weak people. A psychologist, psychiatrist or psychotherapist - all these persons are united by working with the human psyche. However, how do they differ from each other?

What is a joint consultation between a psychiatrist and a psychologist?

This is what most progressive psi specialists around the world strive for. Unfortunately, it is not always possible for psychiatrists and psychologists to find a common language, to find a consensus, because these, as you already understand, are completely different people, from different planets, who think and see people differently. Therefore, almost all attempts at professional interaction, unfortunately, turn out to be short-lived, often end in a break, and in the end, psychiatrists go to their lair, psychologists to theirs, and only occasionally transfer patients to each other. And, of course, this does not always benefit patients.

In 2015, we decided to realize our dream and unite specialists from two different areas in the Alter psychotherapeutic center. And we did it! Ultimately, over the years, very good connections have been developed, very interesting interactions; our psychiatrists and psychologists have formed professional duets and always work together at the initial appointment.

Patient coming to appointment

, sits down at the same table with such a pair of specialists and begins to communicate with them at the same time. Each of them asks their own questions. After such communication, the specialists leave the patient alone in the office for a few minutes with a cup of coffee, while they themselves go into the next room, discuss what they heard and return to report their judgment. The doctor reports his diagnostic conclusion, the psychologist talks about his psychological vision of the situation in your life. And the patient who comes to the appointment for the first time ultimately receives the most important information for himself: what is happening to him.

If the patient is mentally healthy

, but the problem still exists, then the psychologist takes the reins into his own hands and then the person understands that he does not need to be treated by a doctor and calmly continues to work with a psychologist or psychoanalyst.

If the doctor understands that the patient is seriously ill

and he now needs medical care with obvious dominance, then a psychiatrist begins to deal with this patient in the future, he prescribes medication from the very first dose and offers options for dynamic observation on an outpatient or semi-inpatient basis, and sometimes in an inpatient setting.

Or, as most often happens, both a psychiatrist and a psychologist find something different and offer therapy in parallel.

The psychiatrist meets with the patient as a doctor, monitoring his drug therapy, assessing his health, and the psychologist conducts sessions with him, solving other problems.

The effectiveness and practical advantages of such a union

We have learned from many years of experience. It is in this tandem of work of two different specialists that the effectiveness of the care provided to the patient doubles, if not triples, and we arrive at the desired result much faster.