More than 1 in 5 adults in the U.S., which is about 51 million people, have experienced mental illness. However, 13 million of these have serious mental illness. In light of overwhelming stresses, the need for mental health services is increasing, requiring more psychiatry and psychology professionals. Many eschew and stigmatize psychiatric and psychological care, but the truth is taking care of mental health has an overwhelmingly positive effect on physical health.
There are various categories of mental health professionals that can fill these unmet needs, and it’s important to understand how they do it. There are significant differences between a practicing psychiatrist and licensed clinical psychologist. For the benefits they can provide, it’s important for anyone contemplating a career in either field to understand the requirements.
Differences in degrees between a psychiatrist and a clinical psychologist
Becoming a clinical psychologist versus becoming a psychiatrist requires different educational paths, because they serve different purposes. Psychology is the study of the mind and how it affects behavior, while psychiatry is the study of mental illness and abnormal behavior. Because psychiatry is about dealing diseases of the mind, all psychiatry professionals must attend medical school.
Their educational foundation comes from coursework in human biology and anatomy along with medicine. Students also have hands-on practice in pharmacology and pathology, enabling them to prescribe psychotropic drug medications as treatments. After thousands of hours of practicum, along with a residency, their total education takes about eight to 11 years.
There are some psychiatry subspecialties that may require deeper training. For example, neuropsychiatrists and behavioral neurologists specialize in behavioral, psychiatric, and psychological issues derived from brain injuries and disease. Neuropsychiatrists must follow up their years of psychiatry residency with a year-long neuropsychiatry fellowship. Behavioral neurologists must do a three-year neurology residency followed by a one-year behavioral neurology fellowship.
Psychologists, on the other hand, don’t have to go to medical school but must go through anywhere from five to eight years of education that’s focused on human development and behavior. To get a master’s degree or doctorate requires thousands of hours of clinical internship, not residency, along with deep analysis and examination of research within their field.
There are dual clinical psychology master’s/doctorate programs that take a total of 5 years to complete for full-time students. In the first year, students will complete the 120 hours for a master’s degree, and their final year is the doctoral internship.
Difference between a PsyD and a PhD
Psychology students have the option of choosing between two different doctoral paths: PhD, Doctor of Philosophy, or a PsyD, Doctor of Psychology. A PhD is the traditional approach for those who favor research or want to understand more about a particular health issue.
The benefit of a PhD is in the funding. Psychology professionals are trained to be scientist practitioners, so a PhD program tends to have far fewer peers. Programs with 10 candidates are considered full. Doctoral students get financial support in the form of a stipend for being an assistant or money to cover tuition. Some receive both, which reduces or eliminates their graduate school debts.
By contrast, PsyD students have larger classes and no stipends, so they must find whatever aid and scholarships are available. Because they are focused more on clinical work, PsyD graduates get to work one year earlier than their PhD counterparts.
What is a psychiatry DO?
Many psychiatrists who attend traditional or allopathic medical school will have a “MD” suffix. However, those who attend an osteopathic medical school will have a “DO” suffix. Osteopathic medicine tends to focus on a more holistic approach to treating the patient with extra training on hands-on techniques that incorporate both traditional and non-traditional treatments.
Osteopathic psychiatrists are still medical doctors and are trained to take a more cognitive approach, where the body structure is reciprocally interrelated to its function. Taking a look at the whole human instead of separating mind and body leads to at least 200 hours additional training. While allopathic and osteopathic psychiatry professionals are similar, the differences between them derive from screening and the differential diagnosis processes which lead to treatment techniques such as osteopathic manipulative treatment, OMT, for relieving musculoskeletal tension.
What you can do with a masters in clinical psychology?
In clinical psychology, the emphasis is typically on obtaining a doctorate. Those with a master’s degree can become practicing therapists, consultants for corporations, or work for government institutions. A masters in clinical psychology provides sound job prospects, and for those wishing to pursue a doctoral degree later on, the practical experiences can count towards that objective.
Some job ideas include:
- Social work: A licensed clinical social worker, LCSW, works in non-profit agencies or even youth organizations, and in this profession, you will develop a deep understanding of human behavior. LCSW earns an average of between $55,000 and $60,000 per year.
- Psychometrics: While educational institutions tend to favor doctoral degrees for their school psychologist positions, those with a master’s can become psychometrists. These professionals specialize in psychological testing. This is a fast-paced career that requires continually learning about new tests, along with a lot of paperwork. Psychometrists not only work in schools but also for private organizations and can earn an average of almost $47,000 per year.
- Industrial-organizational (I/O) psychology: While a master’s degree won’t give you the official title of company psychologist, your ability to study how certain work factors influence employee behavior and management will sharpen your research skills and put you in a position to advise managers about employment trends and improving hiring practices. I/O psychologists make an average of $80,000 per year
Certifications required to practice psychiatry versus clinical psychology
Psychiatrists need to pass the Psychiatry Board Examination. Those with an MD degree must also pass the National Board of Medical Examiners, NBME. Psychiatrists with a DO need to take either the United States Medical Licensing Examination, USMLE, or the Comprehensive Osteopathic Medical Licensing Examination, COMLEX. Additionally, psychiatrists with certain subspecialties, such as forensic psychiatry or pain medicine, require certification from the American Board of Psychiatry and Neurology, ABPN.
To become a licensed clinical psychologists, professionals need to pass the EPPP, Examination for Professional Practice in Psychology, as well as the licensing exams from their state licensing exams. For subspecialties, such as forensic psychology or clinical neuropsychology, specialty certifications are conducted by the American Board of Professional Psychology, ABPP.
Differences in treatment methods by psychiatrists and clinical psychologists
How to know if someone needs a psychiatrist vs clinical psychologist
It’s common for clinical psychologists to refer patients to psychiatrists and vice versa. Those struggling with mental health may come to any professional that they feel can help them. However, there are a few quick guidelines for understanding when a patient needs a clinical psychologist versus a psychiatrist.
- Issues: There’s something happening at home or at work, and patients need to work through it. In this case, a one-on-one session with a psychologist is a better fit.
- Lack of control: Being sad or irritable is normal under certain circumstances. If it gets to the point where those emotions are persistent or too hard to handle or control, then a psychiatrist can guide patients through managing their emotions, so that they’re not triggered.
- Relationships: Relationships with loved ones can be challenging, while stress at work can be overwhelming. Experiencing both at the same time causes friction. A session with a psychotherapist provides insight to help someone navigate these issues safely.
- Unexplained sickness: A recurring, vague ache that you can’t quite place or a stomach pain that just comes out of the blue often are the kinds of unexplained illnesses that require a medical professional. Physical ailments with no discernible cause mean a psychiatrist would be able to ferret out the root and help the patient solve the problem.
Signs of mental illness
Two of the previous examples were just a couple of the ways emotions can disrupt daily life. Other signs of possible mental illness include:
- Reduced ability to concentrate
- Noticeable withdrawal from friends, family, and other social networks
- Problem reaching or maintaining deep restorative sleep, which further exacerbates mental issues
- Paranoia, hallucinations, or other symptoms of being seriously detached from reality
- Suicidal ideations
These are just a few of the mental health symptoms that manifest as physical ailments, and as medically trained professionals, psychiatrists are in the best position to understand that brain/body connection and take the necessary medical steps to solving the issue.
What approach do psychiatrists take to diagnose and treat their patients?
While many laypersons claim to be able to immediately identify illnesses, such as anxiety or depression, psychiatric professionals need to consult the DSM-5, Diagnostic and Statistical Manual of Mental Disorders, which lists the criteria for diagnosing someone with a particular mental disorder. However, there’s much more that goes into the assessment and diagnostic processes than just consulting a manual.
The main steps of taking an individual’s psychiatric history include:
- Identifying the patient and the source of patient data: Patients’ name, gender and ethnicity are some basic identification data, but it’s also important to know who is providing information, particularly if it’s not the patient.
- Main complaint: This is where the individual or guardian states the reason why they are at this point, whether it’s due to suicidal thoughts, persistent anxiety, or other complaints.
- HPI: The history of present illness, HPI, is where the patient describes their feelings, and what precipitated any episodes they experienced. Details include their location, stressors, medications, or any other concerns.
- Past psychiatric history: Any past psychiatric diagnosis, behaviors, and responses, no matter how remote, are important to understanding the current state and coming up with a proper plan.
- Social history: Any and all details about the patient’s past and present situation, including trauma, disabilities, relationships, legal situations, and even sexual history.
- Past medical history: There are some medical diseases that cause psychiatric symptoms, including diabetes, lupus, and even vitamin deficiencies.
- Family history: Understanding family history can better inform the pharmacological plan as there is an established relationship between mental illness and genetics and family history.
- Obstacles encountered: Another valuable part of the process is noting the obstacles involved in taking the history. This means assessing deception, increased levels of anxiety, or mania. The state of the patient during assessment gives the process better context.
Psychiatrists have a few treatment options available such as:
- Psychotherapy: Also known as talk therapy, this can be done individually, as a family, or within a group setting. It explores how past experiences affect present behavior. Psychoanalysis is an intensive form of psychotherapy that can go on several times a week for many years.
- Medication: After psychiatrists have thoroughly evaluated the patient’s history, they can prescribe the type of medication that can effectively reduce the disorders, including mood stabilizers, anxiolytics, and antidepressants. Medication is often partnered with psychotherapy to maximize effectiveness.
- ECT: Electroconvulsive therapy, ECT, involves applying electrical charges to the brain. This treatment is for individuals with severe depression and haven’t responded to other treatments.
There are a host of other treatments that are used for certain medical disorders, including deep brain stimulation, vagus nerve stimulation, and transcranial magnetic stimulation.
How do clinical psychologists treat patients?
As a branch of psychology that deals with assessing and treating psychiatric problems and abnormal behavior, clinical psychology has several approaches and perspectives psychologists can use to help patients.
- Psychodynamic: The psychodynamic approach is rooted in Sigmund Freud’s belief about the role of the unconscious mind. Psychoanalysis uses certain techniques to investigate unconscious motivations.
- Cognitive behavioral: Cognitive behavioral therapy, CBT, looks at how feelings, behaviors and thoughts contribute to psychological distress.
- Humanistic: This is a holistic approach that is focused on self-actualization.
How to decide between a career as a clinical psychologist or a psychiatrist
What skills do you need as a psychiatrist?
Empathy, compassion and resilience are just a few of the soft skills psychiatrists need to handle the more challenging cases they encounter. Some of the others needed to provide patients with the best care include:
- Ability to recognize ethical conflicts: There are times when patient treatments yield good but different outcomes. As a medical professional, a psychiatrist may be able to judge which will be the better one for the patient and may be tempted to emphasize their preference. While the clinical outcome may be more obvious, the ethical question of who should decide requires more consideration. Not all ethical issues in psychiatry present themselves clearly, and as a psychiatrist you need to be able to look at all angles and recognize where there could be issues.
- Inductive and deductive reasoning: Inductive reasoning means forming logical generalizations based on facts and experiences. Deductive reasoning entails using specific scenarios to backup generalized statements. Psychiatrists need to be versatile in both, so that they can take the data provided to discern useful patterns.
- Stress tolerance: Stresses experienced by psychiatrists are intense and can range from a particularly physically challenging session with an agitated patient to shocking stories and experiences shared. Your ability to control yourself, your thoughts, and maintain a professional demeanor at all times is a skill that is highly valued, because it will be challenged daily.
- Oral and written communication: As a psychiatrist, being a good listener isn’t enough. You have to be keen at picking up on nonverbal cues more than the verbal ones. Your ability to turn all of these observations into reports and files that convey the kind of understanding that gives each case context is paramount.
What skills do you need as a clinical psychologist?
When it comes to being an effective clinical psychologist, compassion is at the top of the list, but that needs to be balanced with:
- Analytical minds: The ability to logically analyze facts from research to apply it to the issue you have at hand requires the ability to draw necessary conclusions.
- Lifelong learning: The field of psychology is always coming up with new techniques. As a clinical psychologist, you have to be committed to lifelong learning, because a new theory can possibly offer even better results for your patient.
- Communication: As a therapist and researcher, a psychologist must be able to glean information in order to come up with more effective treatments and plans. Also being able to communicate these plans to patients in order to get their buy-in.
- Great organization: The mountainous amount of information therapists need to deal with demands organization. Even with a good memory, psychologists need to stay on top of each patient’s information.
- Statistics: While it may not seem obvious, one other key skill clinical psychologists need is mathematics, specifically statistics. Being able to summarize and interpret research data helps them to understand how that information applies to what they do.
Demand for psychiatrists and clinical psychologists
In 2019, the projected demand for psychiatrists and psychologists was growing as fast as average. Because of the pandemic that rate has increased, but it still may not meet the intensity needed.
As many locations under prolonged lockdowns, the rise in anxiety and depression in both adults and children is sharp. In New York, calls to the city’s mental distress hotline increased 1,000 percent.
In addition to that, increases in domestic abuse and drug use also saw significant spikes along with families, and frontline workers trying to deal with overwhelming losses has exacerbated mental illness in unexpected ways.
The aging population and the expansion of health coverage are two other contributing factors. As more Americans get access to health care, they’re able to seek help for pre-existing conditions, including mental illnesses. Additionally as baby boomers get closer to retirement age, some may have to come to terms with the fact that it’s not how they expected it to be. They may need to draw on the therapy to reconcile with the difficulties that entails.
Many psychiatrists and clinical psychologists can go into private practice, they may get jobs at government institutions, or work as consultants. Psychiatrists, depending on their specialization experience and location, can expect to earn about $150,000 on average, but there are plenty of positions that pay well over $200,000 per year.
With clinical psychologists, the job outlook is promising, but other than those who have their own practice there are some specializations experiencing fast growth.
- Social worker: Social workers serve in underserved communities and try to improve the lives of those populations through managing cases, crisis resolution, and psychotherapy assistance. While a bachelor’s in psychology we will get things started, a master’s offers opportunities in management and research. There are specific state licensing requirements, and the average yearly salary is about $50,000.
- Substance abuse, behavioral disorder, and mental health counselor: Conducting tests, administering treatment plans and collaboration with care teams are just a few of the responsibilities of professionals helping individuals who are dealing with one or more of these disorders. A bachelor’s degree may work, but a master’s degree is preferred. Average starting salary is $44,000.
- Marriage and family therapist: Couples struggling to resolve relationship issues and families dealing with difficult situations, such as domestic violence, rely on a therapist to help them manage. Most work in private practice, while others may choose to work in family care centers. Apart from a master’s in clinical psychology, they need state licenses and special certifications, such as an MMFT. Average salary is $49,000 per year, but those in private practice can earn more.
- Training and development specialist: Specialists help employees to improve their skills through customized education programs. They design training manuals, develop surveys, conduct interviews, and develop conflict resolution strategies. With a bachelor’s degree and certifications, they can earn about $61,000 per year.
Top degree programs for psychiatry and psychology
Before choosing a school, ensure that the clinical psychology program is accredited by a respected organization, such as the American Psychology Association Commission on Accreditation, APA-CoA, or subspecialty organizations.
What are the requirements for a psychology program?
Earning a bachelor’s in clinical psychology is no different than any other degree. When moving on to a graduate degree, a bachelor’s in psychology is not required for the master’s, but you do need to ensure that you have a B average in necessary prerequisite courses, such as statistics, research methods, and psychological theory.
In addition to the prerequisite courses, you’ll need your GRE scores, personal statement, reference letters, and resume showing that you have the necessary academic and research experience. For a doctoral degree program, psychology students need to submit a resume that demonstrates their volunteer experience as well as other work experience. PhD candidates need to demonstrate their research capabilities, specifically in prerequisite courses, such as research in scientific methods. PsyD candidates will need to ensure that they have the necessary prerequisite courses, such as psychopathology.
What colleges have the best psychiatry program?
Yale School of Medicine ranks in the top 10 for research, which is one of the cornerstones for its Department of Psychiatry. Some of the areas of study include neurochemistry, common genetics, psychopharmacology, and brain imaging. Students can learn at a variety of clinical settings, including the Connecticut Mental Health Center or the Yale-New Haven Psychiatric Hospital. Full-time tuition is close to $65,000 annually, and students can earn joint degrees such as MD/JD or MD/MBA.
Harvard Medical is ranked as the top school in research and top 10 in primary care. Faculty come from Beth Israel Deaconess and Boston Children’s Hospital, as Children and Adolescent Psychiatry is a specialization. Tuition is about $65,000 per year, and like Yale, students can also opt for joint degrees.
Johns Hopkins is ranked in the top 10 for research and is the top school in psychiatry. It makes a point to pair classes with clinical experience, and its specializations, includes adult psychiatry, substance use disorder, and adolescent psychiatry. Johns Hopkins receives funding from the NIH, among other institutions, and full-time tuition is $56,500.
Affordable accredited psychology programs
While all psychiatry students are classed as physicians with their specified path to and through medical school, there are a few accredited psychology programs that are affordable and offer dedicated specializations.
Converse College offers a master’s in marriage and family therapy, MMFT, that’s accredited by Commission on Accreditation for Marriage and Family Therapy Education, COAMFTE. This program requires 63 credits and can be completed within two to five years. The clinical practicum for this MMFT program is the EMERGE Family Therapy Center, where students will complete 15 months of practice. Classes are available online and on-campus for $416 per credit hour.
Old Dominion University, Norfolk State University, and Eastern Virginia Medical School comprise this APA-accredited Virginia Consortium Program, which offers a PhD in clinical psychology. Of all applications submitted, only six are chosen for this full-time five-year program. Tuition is just $222 per credit hour with financial aid available.
Accredited by CACREP, Council for Accreditation of Counseling and Related Educational Programs, Delta State University offers a Master of Education in school counseling and one in clinical mental health counseling. Those who graduate can sit for the National Counselor Examination which allows graduates to work all over the country. These specializations have state-specific licensing and certification requirements. Programs cost $334 per credit hour.