People get confused.  I get confused.  Can one always remember the difference between an optometrist and an ophthalmologist, an astrologist and an astronomer, or a podiatrist and a pediatrician?  When you don’t work in a specific field, or people tend to use certain words interchangeably, meanings get blurred.

I may not be able to tell you about other fields, but I can explain the field that I work in. 

I work in a field that people refer to in many different ways.  This is a perfect example of using words interchangeably: Counselor, therapist, psychologist, psychiatrist, mental health provider, behavioral health provider, family therapist, or marriage counselor.

People who don’t work in the field can refer to any of us in the above ways, and we are fine with it- as long as you understand our intent is to be of assistance.  However, just for the record, I want to point out some specific differences that may be helpful to you if you or a family member are trying to make a decision on who can best assist you.

Let’s start with mental health and behavioral health.  The word “behavioral” refers to how one behaves or acts, while “mental” refers to something to do with how one thinks. Both of these terms are used in the profession synonymously.  Many prefer to use the “behavioral health” term because of the previously strong stigma attached to the word “Mental”. Many facilities that used to be termed “Mental Health” are now “Behavioral Health”, allowing people to seek relief without the feeling like they will be labeled “crazy” just because they need to talk to a counselor. 

Let’s move on to who’s who:

Psychiatrists are the only ones in this field who can write prescriptions.  Regardless of what you have seen on TV or the movies, if you see a Psychiatrist in most states, you will not be able to have an hour session of therapy.  Specifically, there is a shortage of Psychiatrists in the whole state of NC.  Although it is possible your first session will be 30 min to an hour, follow up sessions will usually be 20 min or less.  Psychiatrists usually only have time to manage a person’s medication.  Psychiatrists are Medical Doctors who are specialists in the field of Psychiatry and are experts in the area of psychotropic medicines (antidepressants, anti-anxiety meds, etc.)  Psychiatrists are able to make an appropriate diagnosis of a person’s symptoms, and choose from a vast array of medicines that will assist a person to function better.  Many general practitioner Medical Doctors (MD’s) refer depressed or anxious people to Psychiatrists so that they can get the best medicine, dosage, etc for the symptoms they are experiencing.  A Psychiatrist is not only able to prescribe the meds, but also tell you the proper dosage to start with, the time of day to take the medicine, and other important factors that makes the medicine work better for you.

 Note:  Many psychiatrists prefer that while you are on a psychotropic medicine they have prescribed that you see one of the following professionals:

Psychologists are those who usually have a PhD or PsyD.  This means they are Doctors, as in having a Doctorate degree- but they are not Medical Doctors and they cannot prescribe medicine. PhD Psychologists have been educated in clinical practice, research, training and assessment. PsyD Psychologists are trained primarily in clinical practice (counseling). All Psychologists have an average of 5-7 years of education beyond their Bachelor’s degree.  Licensed Psychologists have at least two years of supervised work and have passed a National Exam.   In addition to counseling services, Psychologists may provide personality, IQ, and other evaluative testing.

Licensed Clinical Social Workers (LCSW) have earned a Masters in Social Work and have completed the licensing requirements of the state they practice in, which usually includes two years of work supervised by an LCSW and passing the very extensive Licensing exam.   Social Workers are trained in working with groups… from the small group of two to the larger societal groups and everything in between.   Social Workers are trained with culture sensitivity and with client focus.  LCSW’s provide couples, family, group, and individual counseling.

The Licensed Marriage and Family Therapist (LMFT) has graduate training in Marriage and Family Therapy and at least two years of clinical experience before they take their state licensing exam.  LMFT’s specialize in treating their clients within the context of marriage, couples and family systems.

Licensed Professional Counselors (LPC’s) have either a Masters degree or a Doctorate Degree in counseling or a related field.  They have passed the National Counseling Exam and meet the requirements for licensing in the state in which they practice.  LPC’s work with all populations.

Pastoral Counselors are trained both in psychology and theology.  Pastoral Counselors provide spiritual guidance in addition to their counseling services.  They usually have a Masters in Divinity Degree in addition to other academic work.  Currently, Pastoral Counselors are licensed in some states (to include NC) and certified in others.

There you have it!  So now, even though you might have to Google what an astronomer does, you will already know who to call should you need assistance.

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