Why did the psychiatrist visit the farm?
- To study moo-d swings!
How many psychologists does it take to change a lightbulb?
- One, but the lightbulb has to want to change.
What did the psychometrist say to the clock?
- Your time is up!
While these cringe-worthy jokes may have gotten a chuckle, many people actually confuse psychiatrists with psychologists and vice versa. And most people have never even heard of a psychometrist! All are valuable players on a mental health team, and each contribute their expertise to inform psychological diagnoses, recommendations, and treatment. But where do you start when seeking mental health services? Who does what and why? Let’s start with the medical experts.
Psychiatrists
Psychiatry is the diagnosis, treatment, and prevention of mental health conditions, primarily with prescription medications. A psychiatrist is someone who went to medical school, earned a medical degree (MD or DO), and specialized in psychiatry. They must pass exams to become licensed and then board-certified. They work in a variety of settings, like hospitals, clinics, private practices, medical schools, prisons, military settings, rehabilitation programs, emergency rooms, and hospice programs. Physician assistants (PAs) and nurse practitioners (NPs) can also specialize in psychiatry and provide medication and treatment.
Meeting with a Psychiatrist
At your first appointment, a psychiatrist will usually begin by getting to know you. Most will request that you complete a questionnaire before the first appointment, asking about your background, health history, family and social life, employment, education, stressors, past trauma, substance use, and current concerns and symptoms. Once the psychiatrist has a good understanding of your daily functioning, they can make recommendations for medications, therapy, or other treatments for your diagnoses.
Just like other doctors, psychiatrists require follow-up appointments to monitor your health. Many psychiatric medications come with side effects, so be sure to tell your psychiatrist about any side effects you’re experiencing during these follow-ups! Your psychiatrist can order additional psychological testing, lab tests, and change doses accordingly.
The medications your psychiatrist recommends will depend on many factors, including your diagnoses, age, physical health, history, side effects, and more. Antidepressants, mood stabilizers, stimulants, sedatives, anxiolytics, and antipsychotics are commonly prescribed psychiatric medications. Your psychiatrist can also recommend treatments such as electroconvulsive therapy (ECT), deep brain stimulation (DBS), or transcranial magnetic stimulation (TMS) if needed.
Many psychiatrists refer clients to psychologists or other licensed mental health professionals for therapy, but some are trained in evidence-based therapy treatments and provide individual or group therapy.
Psychologists
Clinical psychologists and neuropsychologists provide comprehensive mental and behavioral health services for individuals, couples, and families. They may also provide psychological assessments to evaluate memory, personality, learning, attention, processing speed, academic skills (e.g., writing, reading, math), and behaviors to assist them in making proper diagnoses and treatment recommendations. Psychologists frequently evaluate people for autism spectrum disorder, ADHD, and learning disorders, as well as mood, anxiety, and trauma-related disorders. Many psychiatrists, doctors, and mental health professionals refer their clients to psychologists for testing or therapy.
Although clinical psychologists do not attend medical school, they do carry the title of “Dr.” A psychologist completes five to six years in a doctorate program to earn a PhD or PsyD, and then one to two years of additional training before passing a licensure exam. Licensed psychologists can work and provide services in nearly any setting.
Generally, psychologists cannot prescribe medications. In Louisiana, New Mexico, Illinois, Iowa, and Idaho, however, psychologists can be trained and certified to prescribe psychiatric medications, but this practice is relatively uncommon. Most psychologists prefer to leave the prescription drugs to psychiatry.
Meeting with a Psychologist
Your first appointment with a psychologist will include them asking you many questions. You may be asked to complete questionnaires about your mood, sleep, anxiety, stress, and trauma history. When your psychologist understands your history and current problems, they can make a diagnosis and recommend steps to move forward, like psychological testing, therapy, or a referral to see a psychiatrist. (You see, it really is a team!)
Psychologists can also provide evidence-based therapies, such as Cognitive Behavioral Therapy (CBT), Eye-Movement Desensitization and Reprocessing (EMDR), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Prolonged Exposure Therapy (PE). Your psychologist can and often does double as your therapist!
While therapy is an excellent option for many people, it can also be intimidating for newcomers. Some people prefer to start with a psychiatrist and try medication first. Others prefer to start with therapy and then see a psychiatrist for medication if needed. Everyone is different, but the best place to start is with your primary care physician or family doctor.
Psychometrists
If you’re being assessed or tested by a psychologist, you’ll probably also meet with a psychometrist. Assessment can be a brief process with only one session, or quite lengthy with multiple sessions. A psychometrist is much like a psychologist’s assistant—they administer and score the tests. While psychometrists are not required to earn certification, most organizations require them to have a bachelor’s degree.
After testing is complete, psychometrists pass along the scores to the psychologist, who interprets the numbers. After this, you’ll meet for a “feedback session,” during which the psychologist provides a written report, diagnoses, recommendations for therapy, work or school, and referrals for additional care.
The "Psych" Team
Psychiatrists, psychologists, and psychometrists work closely together to help their clients, creating the ultimate “psych” team with the help of other health workers, social workers, therapists, counselors, and teachers. No matter which “psych” you meet with first, know that each of these professionals are dedicated to helping you feel better and meet your goals.