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Articles by Dr. Dubey on mental health.

Psychologist – Psychiatrist: What’s the difference?

What does a clinical psychologist do, and what does a psychiatrist do?Psychologist- Psychiatrist: what’s the difference?

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As someone I know put it simply: clinical psychologists are like software professionals, and psychiatrists are like hardware professionals. Clinical psychologists work with people with a wide range of mental health difficulties and sometimes with people who have no major problems at all but are keen to further grow and explore their human potential. The problems that clinical psychologists help individuals deal with include relatively less severe problems, such as, dealing with stress/dissatisfaction at work, or adjustment difficulties due to a recent relocation, as well as more severe problems, such as, severe depression, or panic attacks that look like heart attacks. Clinical psychologists help individuals, couples, and families solve their problems through talk therapy rather than pharmaceutical interventions.
Psychiatrists, on the other hand, step in only when mental health problems become more severe, which includes severe anxiety, depression, schizophrenia, etc. They focus on treating the chemical imbalances in the brain that accompany specific mental health conditions. Treatment is symptom based. So, the psychiatrists are the ones who will determine if medication is required, the kind of medication, and the dosage, whereas clinical psychologists will try to bring about change via changes in thought processes, behaviours, and emotions. Needless to say, psychologists need to work more regularly with their clients and often for longer durations than psychiatrists do. It is important to remember, however, that medicines alone cannot treat mental health conditions, at least not as effectively, or on a long term basis. Psychotherapy or Counselling is required in order to help individuals make long term and sustainable changes in their way of thinking so that they are better able to deal with various stressors in their lives, and lead more happy and fulfilling lives.
What are the qualifications of a psychiatrist?
A psychiatrist is a medical doctor. In India, to become a psychiatrist, a person has to earn an MBBS degree, followed by an MD in psychiatry or a DPM or DNB credential. Child psychiatrists specialize in the treatment of children and teenagers who suffer from a mental disorder and need medication, such as ADHD, depression, OCD, schizophrenia, etc. Psychiatrists typically see their patients once or twice a month for follow up. General practitioners also sometimes prescribe psychiatric medication but they are not trained in this field and may not have the knowledge or experience to distinguish between the various mental health conditions to be able to make the correct diagnosis. Also, psychiatric medication needs regular follow up in order to ensure that the dosage is accurate. For example, weight gain or weight loss would require modifications to be made to the dosage as the dose prescribed earlier will not work in an optimal manner. Also, side effects need to be monitored.
What are the qualifications of a clinical psychologist?
In the US, clinical psychologist is a title that persons who have completed their doctoral degree in clinical psychology (PhD or PsyD) can use after they have cleared the licensing exams. Psychotherapist or therapist is a title that can be used by people who have completed their MA in Clinical Psychology, MA in Social Work, etc. It is a more widely and generally used title and does not require a person to have cleared any licensing exam.
Counselling degree is usually a separate degree in the US. People can do their Masters or Doctorate in counselling.

 

The difference between a counselling degree and a clinical psychology degree is that counselling is more short term and focused on solving immediate problems, whereas clinical psychologists do more in depth and long term work with individuals. Also, clinical psychologists are the only ones trained to conduct comprehensive psychological assessments, including administering various IQ and personality assessment measures. For example, only a clinical psychologist would be able to conduct a comprehensive psychological assessment to determine whether speech delays in a child were due to learning disability or autism.

 

Marriage and Family Therapy is taught at a few places separately as a Masters or Doctoral level program. However, marriage counselling or couples and family therapy is also taught as part of clinical psychology programs.

 

In India, however, clinical psychology training is in its nascent stages. There is no professional regulation in this field; hence, anyone can use any title with little or no training. “Clinical psychologist”, “counsellor”, “therapist”, “marriage counsellor”, “child psychologist”, etc., are all terms that are used interchangeably and often have little to do with a person’s formal training. The most important aspect of clinical psychology or psychotherapy training is the practical aspect, and that is often missing in most programs of study in India. The diploma in counselling programs often either do not have a supervised practical training component or it is just not rigorous enough. Even the MA and PhD in Psychology programs are largely academic and do not focus on supervised practical training. Most of these programs also do not have a very strong specialization component wherein students could be exposed to the latest theory and practice methods in how to work with children and teenagers or with couples. Hence, it is very important that you ask your child’s therapist or marriage counsellor about their training, qualifications, and experience before you decide to work with them.

(Originally Posted January 22, 2012 in enricheducation)

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