The difference between a psychologist and a psychiatrist

Published in European Business Daily on December 22, 2017.

(This article is has been translated from Chinese)

Psychological counseling, psychological consultation, psychotherapy, psychologist, clinical psychologist, psychologist, psychiatrist... With so many different titles, what exactly do they all mean? Many readers likely share this question. Mental health has a significant impact on our quality of life, and different countries have slightly different definitions and standards for these professions. This introduction focuses primarily on the situation in the UK.

Psychological counseling, psychological consultation, and psychological counseling are all the same. In Chinese, the terminology varies depending on the region, while in English it's simply "Counselling." Similarly, psychotherapy and clinical psychology are also called "Psychotherapy." The work covered by these two terms overlaps, making it difficult to determine which is superior. If a difference must be pointed out, one might say that counseling is shorter-term while therapy is longer-term. Therapists typically possess master's degrees or higher and have a competitive advantage in the workplace. I read a report about how counselors in China are legally prohibited from practicing psychotherapy, which I find puzzling; since conversation itself is a form of therapy. In the UK, counselors and psychotherapists perform the same work.

As for "psychologist," I believe everyone now has a basic understanding: it's a general term, not a real one. It's a specific term that arose within the context of Chinese culture, encompassing both psychological counselors and psychotherapists. Some people in this profession hold doctoral degrees, and it's understandable that some might address them as "psychologist" out of respect.

Psychologists are scholars who conduct psychological research, studying why humans think and act in the way they do. To practice counselling, they must undergo specialised professional training. Local counseling courses include psychology, anthropology, sociology, and a rigorous supervisory internship system, emphasizing both theory and practical experience; extensive psychological theory alone is insufficient for this. Clinical psychologists, on the other hand, mostly work in hospitals or large mental health institutions, responsible for diagnosis, treatment, or teaching. Their training includes counseling components, and some also practice in private practice.

A psychiatrist, as the name suggests, is a physician specializing in mental health. They possess medical training and a medical degree, and provide assessment and diagnosis for patients with mental illnesses, tailoring treatment plans to individual needs, including medication prescriptions and psychotherapy arrangements. They are the only physicians in the field of mental health who have received full medical training and can prescribe medications, but they do not perform counseling or psychotherapy.

There's a story behind this: Sigmund Freud, the founder of psychology, established psychoanalysis in the late 19th century, which was quite famous at the time, attracting scholars from all over the world to Vienna to study under him. These scholars later developed many different schools of thought, which occupy a very important position in the development of psychology and psychiatry. At the time, these psychiatrists were all trained doctors, and Freud himself was quite supportive of having people without medical training do psychoanalysis. He believed that medicine and clinical psychoanalysis were two completely different things, which led to a group of psychologists without medical backgrounds, including his daughter, Anna Freud. In 1913, Ernest Jones brought Freud's psychoanalytic theories back to England. He thus continued Freud's preference for employing people other than doctors in this field. This practice has continued to this day; most professionals in the UK engaged in psychoanalysis, psychotherapy, or counselling are not trained in medicine.

In the next article, I will explain how to advise a family member or friend who is experiencing emotional distress, or where to seek help if you feel something is wrong but can't quite put your finger on it.