What’s In a Name?

Psychiatrists, clinical psychologists, counseling psychologists, educational psychologists… the list goes on and on! A particularly troublesome question for many first-time mental health care users is: “Who do I turn to for help?” There are so many different mental health providers out there and it is nearly impossible to tell who is who without a basic understanding of each of these terms. In the following discussion I will attempt to highlight the differences between each of these professions to help you make informed decisions regarding your treatment needs. As a starting point, I will differentiate between the two main fields, namely: psychiatry and psychology.

Psychiatrist versus Psychologist:

A psychiatrist is a medical doctor who specialises in the treatment of mental health disorders from a biomedical perspective. According to the biomedical model, mental health conditions are caused by anomalies in the biological or genetic makeup of an individual. These anomalies account for the symptoms associated with the aforementioned conditions and may be corrected through chemical treatments (i.e. Medications). Thus, the aim is to address neurochemical imbalances through evidenced-based pharmaceutical treatments. Psychiatry constitutes a crucial link in the mental health care chain and is seen as the primary mode of intervention for conditions such as schizophrenia, major depression and bipolar disorder.

Psychologists on the other hand, are primarily concerned with treatment from a psychotherapeutic standpoint. Often referred to as talk therapies, the purpose is to instigate change through dialogue by learning new and adaptive ways of dealing with problematic thoughts, feelings, and behaviours. Although interventions may differ depending on the theoretical orientation of the therapist, there are certain commonalities across all forms of psychotherapy. For instance, all therapies acknowledge the objective, supportive and non-judgmental nature of the therapeutic relationship. Similarly, most therapies emphasize collaboration, commitment and introspection on the part of the client. From a mental health perspective, psychotherapy is seen as the preferred treatment modality for mild to moderate depression, anxiety disorders, adjustment disorders, and personality disorders.

It is, however, important to note that the fields of psychiatry and psychology are not directly opposed to each other, but rather complimentary in nature. Let us look at the following example:

A client suffering from a depressive episode may seek the services of a psychiatrist to help cope with the symptoms associated with depression. Based on all available information, the psychiatrist may conclude that the depression is caused by a neurochemical imbalance (i.e. Neurotransmitters) and prescribe an antidepressant to alleviate the aforementioned symptoms. Over time the antidepressant may take effect and lead to improvement in the client’s overall condition. Yet, the medication in itself does not address the reactive (situational) nature of most depressions nor the psychological fall-out following such an experience.

Let me explain. Current thinking suggests that depression is caused by a combination of genetic and environmental factors. Simply put, some individuals may be more susceptible to depression due to hereditary factors (e.g. a family history of depression), but genetics alone do not induce depression. Typically speaking, most depressive episodes are triggered by environmental factors (i.e. stressful life events such as the loss of employment, a relationship, or a loved one) – hence the term reactive depression. From a psychological point of view, we may even take it a step further by asserting that it is not the event that causes a us to become depressed, but rather our interpretation of the event (i.e. how we think about the event – such as believing that we will never find love following a romantic breakup or believing that we are utterly worthless after loosing our job). In keeping with this line of reasoning, we may conclude that our thinking patterns, or the way in which we view situations, play a crucial role in the formation of depression. But how do we deal with these negative thought patterns? Well, the answer is quite simple. Through psychotherapy. Research suggests that the most effective way of treating depression is through a combination of psychiatric and psychological interventions. Thus, the two fields are not competing against each other, but aid one another by addressing different aspects of the same condition.

Clinical Psychology vs Counseling Psychology:

Now that we have differentiated between psychiatry and a psychology, it is time to look at two related professions within the field of psychology, namely clinical psychology and counseling psychology.

A clinical psychologist is probably what you have in mind when thinking of the classical depiction of psychotherapy, i.e a client lying on a couch with the therapist in an armchair taking notes. Though this picture may be somewhat outdated, the primary duties of clinical psychologists have remained largely unchanged over the years, namely the diagnosis and treatment of psychological conditions. Clinical psychologists have no restrictions in terms of the conditions they may treat. They are trained in, and well equipped to deal with severe mental disturbances (psychopathology), but are equally adept at treating healthy individuals with every day life challenges (i.e. anger management). Apart from therapy, clinical psychologist are also qualified to administer and interpret psychometric tests, such as intelligence, aptitude, and personality assessments.

Counseling psychologists, in contrast, tend to focus exclusively on less pathological conditions (i.e. stress, marital conflict, and adjustment issues). That is not to say that counseling psychologists are incapable of treating more challenging cases. Generally speaking, the two fields show a great degree of overlap with similar academic requirements for both professions. The only tangible difference relate to practical training where clinical psychologists are required to complete an additional community service year (usually at a hospital or community clinic) prior to registration as licensed practitioners.

Educational Psychology:

And finally, let us take a look at a related branch of psychology that also deserves mentioning, namely: educational psychology. Educational psychologists specialises in conditions pertaining to early human development. They are experts in the field of learning with an emphasis on the identification of factors that may impede a child’s ability to learn, be it cognitive, behavioural or social in nature. Given their specific area of focus, educational psychologists are frequently employed in educational settings or youth-based programmes (i.e. schools). The often work in close collaboration with various stakeholders (i.e. parents, teachers, social workers, etc.) and play an instrumental role in the development and implementation of effective learning strategies for students with learning disabilities. As a general rule, educational psychologists do not provide psychotherapeutic services for mental health conditions falling outside the contexts of learning and/or development.

Well, this concludes our discussion on the different fields within the mental health care profession. I hope that you have found the information helpful and I would love to hear from you. Please send all comments or insights to psychology@elbertdewit.co.za Or visit my website, elbertdewit.co.za, for further information. Thank you!

Elbert de Wit
Licensed Clinical Psychologist

4 Herold Street,
Stellenbosch,
7600

Tel: 073-417-3554

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