Psychotherapy is delivered by practitioners with any number of clinical orientations and with a variety of training backgrounds. A psychologist is a doctoral-level psychotherapist or psychological researcher. A clinical psychologist earns a doctoral degree in clinical psychology, training for four to six years after completing their college degree. They study the biological, psychosocial, and environmental factors that contribute to mental illness. Their training qualifies them to work with people who have serious mental health problems or have faced significant traumas. A counseling psychologist receives similar training but is more likely to work with people suffering from life challenges such as divorce or job loss. In most states, psychologists cannot prescribe drugs. In the handful of states where they can, they must have additional training.
A psychiatrist is a medical doctor specializing in the use of drug-based treatments and psychotherapy for mental health disorders. They complete a psychiatric residency as part of their training and learn about pharmacology, neurology, and psychopathology. Although they learn about psychological treatments, psychiatry has evolved over time into a mostly medical approach that relies on drug treatment. Most psychiatrists do not act as therapists; they are often diagnosticians who prescribe medications for patients being seen by another type of therapist.
Psychiatric nurses assess and treat mental health issues and psychological disorders and generally work in hospitals and specialty clinics. They have advanced training, holding either a master's or doctoral degree. Clinical social workers focus on the client in their everyday environment when delivering mental health services. They may hold either a master's or doctoral degree in social work and are trained in psychotherapeutic methods.
Although the first psychoanalyst, Sigmund Freud, was a neurologist, not all psychoanalysts are doctors. To be accepted for full candidacy into a psychoanalytic training program approved by the American Psychoanalytic Association, a practitioner must have a medical degree or a PhD in psychology or other mental health discipline or must be a psychiatric nurse or clinical social worker. Most psychoanalytic programs require an additional four years of training at a minimum. While psychoanalysts generally have a Freudian orientation, there are a variety of psychoanalytic approaches.
Additional types of mental health practitioners include mental health counselors (who usually hold a master's degree), drug counselors, rehabilitation counselors, couples and family therapists, sex therapists, pastoral (religion-based) therapists, and mindfulness-based (meditation-based) cognitive therapists. Some of these (e.g., drug counselors and religious counselors) may or may not have traditional training. Paraprofessionals are not licensed mental health professionals but can run support groups and offer social skills training, such as in community health care settings.
Psychotherapy can be delivered one-on-one or in group settings, in which clients help facilitate one another's therapy. While most psychotherapy is delivered individually with only the client and the therapist, other types of therapy involve multiple clients. Family therapy is often conducted with various family members. Couples therapy generally involves two or more people in an intimate relationship.
Common Categories of Mental Health Providers
| Professional Title | Education | Common Work Settings |
|---|---|---|
| Psychiatrist | Medical school with psychiatric residency (eight years) | Administers medication to people with severe mental health problems in hospitals, clinics, and private practice |
| Clinical psychologist | PhD or PsyD plus internship plus postdoctoral fellowship (seven or more years) | Provides talk therapy to clients with mental health disorders in mental health agencies, private practice, and hospitals. Many conduct research in academic settings. |
| Counseling psychologist | PhD, PsyD, or EdD plus internship (five or more years) | Provides talk therapy focused on managing life problems in mental health agencies and schools |
| Clinical social worker | Master's in social work plus supervised experience (four years) | Helps clients obtain needed resources and build skills in clinics, hospitals, schools, government agencies, and private practice |
| Psychiatric nurse | Master's in nursing plus supervised experience (four years) | Administers medications to people with mental health disorders in clinics, hospitals, and private practice |
Mental health professionals work in various settings and with different client populations. The level of education required depends on the profession.