Patients with psychological or emotional problems are often confused about whether to start by seeing a psychiatrist or a psychotherapist. The first thing to realize is that either type of professional will refer you to the other type if that is what you need. Some problems are best treated with medication alone, some with psychotherapy alone, and some are best treated with both.
This website includes sections on different kinds of problems and illness, and these sections discuss which treatment is generally best for each one. You should read the section about whatever problem you are experiencing to get an idea of whether to start with a psychiatrist or psychotherapist.
It is important to understand that psychiatrists and psychotherapists do different things. A psychiatrists’ job is to ask a large number of questions and assemble a lot of data into a diagnosis and treatment plan, all in the first session. Some patients accustomed to an exploratory type of therapy find this unsettling because the psychiatrist asks questions that evoke emotional responses and then doesn’t always explore these emotional reactions any further, instead moving on to a completely different topic.
While this may feel strange and uncomfortable, this technique is normal, necessary, and is actually good psychiatric practice. The psychiatrist’s goal is to find the right medication for you as quickly as possible, and that’s what they’re doing. In order to treat you properly, a psychotherapist needs to create a good relationship with you, but a psychiatrist needs to get as much complete and accurate information about you and your case as fast as possible.
Psychotherapy, also called talk therapy, involves working with a trained professional to understand emotions, thoughts, behaviors, and life challenges. It can help people develop coping skills, understand recurring patterns, and make changes that improve their emotional well-being. Psychiatry is a medical specialty focused on evaluating, diagnosing, and treating mental health conditions. Psychiatrists are medical doctors who can prescribe psychiatric medication and may also provide psychotherapy. Depending on a person's needs, treatment may involve psychotherapy, medication, or both.
A psychiatric evaluation may be appropriate if you are considering medication, have significant or persistent symptoms, or need further assessment of a possible mental health condition. A psychiatrist can evaluate your symptoms, consider relevant medical and psychological factors, and discuss treatment options, including medication when appropriate. Seeing a psychiatrist does not necessarily mean you will not need psychotherapy. A psychotherapist may also be a suitable starting point and can recommend a psychiatric consultation when needed.
Yes. Some people benefit from seeing both professionals as part of their treatment. A psychiatrist may evaluate symptoms and manage medication, while a psychotherapist provides ongoing treatment focused on emotions, thoughts, behaviors, relationships, and coping strategies. When both forms of care are appropriate, coordination between the professionals - with the client's consent - can help support a consistent treatment plan.
No. Some people benefit from psychotherapy alone, while others may benefit from medication alone or a combination of medication and psychotherapy. The appropriate approach depends on the person's symptoms, circumstances, preferences, treatment history, and clinical needs. Medication is not automatically required when someone seeks psychotherapy, and decisions about starting, changing, or stopping medication should be discussed with a qualified prescribing professional.
Psychotherapists generally do not prescribe medication solely by virtue of providing psychotherapy. Psychiatrists are medical doctors who can prescribe psychiatric medication. Other qualified medical or prescribing professionals may also be authorized to prescribe medication, depending on their credentials and applicable state requirements. If you think medication may be helpful, ask your therapist about obtaining a psychiatric or other appropriate prescribing evaluation.
An initial psychiatric appointment generally involves discussing your symptoms, concerns, medical and mental health history, current medications, and other factors that may affect your well-being. The psychiatrist may ask detailed questions to help assess your situation, consider possible diagnoses, and develop a treatment plan. Depending on your needs, the plan may include medication, psychotherapy, further assessment, or referral to another professional. You can also discuss your questions, preferences, and concerns about treatment.
Psychotherapy usually involves regular conversations with a trained professional in a private, supportive setting. The therapist works with you to understand the concerns that brought you to treatment, identify goals, and explore thoughts, emotions, behaviors, or experiences that may be contributing to difficulties. Depending on the therapist's approach and your needs, sessions may involve discussing current challenges, recognizing recurring patterns, developing coping strategies, and practicing new ways of responding to problems. Treatment is individualized and progress is reviewed over time.
The appropriate treatment depends on your concerns, their severity and duration, how they affect your daily life, and your treatment preferences. Options may include psychotherapy, psychiatric medication, or a combination of approaches. The level of care may also vary, from routine outpatient appointments to more intensive treatment when additional support is needed. A qualified professional can help you consider your options. The Types of Mental Health Treatment page provides an overview of treatment approaches and levels of care.
The right professional depends on the concerns you want to address and the type of care you are seeking. Consider the provider's education, credentials, experience, treatment approach, availability, fees, and insurance arrangements. Psychiatrists, psychologists, social workers, counselors, and other professionals may provide different services depending on their training and licensure. The Types of Mental Health Professionals page explains the roles and qualifications of different providers to help you make a more informed choice.
Choosing between psychotherapy and psychiatry is one part of finding appropriate mental health care. It may also help to understand the different types of treatment, professional qualifications, insurance coverage, and options for obtaining care if you do not have insurance. ITI-NJ's How to Find Professional Help overview brings together information about these topics and links to additional resources to help you explore your options.
In our work with children, teens, parents, and adults, we strive to meet the needs that everyone has for validation and support while helping them to expand their self-awareness and the range of skills they employ to work out solutions to the problems they face in life. Our mission at ITI-NJ is to improve psychotherapy outcomes for all clients and families in the communities we serve and to provide excellent, quality care with compassion and respect for all we serve.
Visit our Therapy Services Overview page for more information.
