Psychologist, Psychotherapist, or Psychiatrist? Which is for you?

If you’re considering investing in your mental health care in Ontario, you’ll see that there are different licensed health care providers who all sound like the same thing. Psycho this, psycho that. It can be confusing, but don’t worry. We got you, boo! I’m here to help.

Psychotherapists, Psychiatrists, and Psychologists can sometimes offer the same services. The simplest way to help you understand which one you may need when you’re looking for great counselling help in Ontario is to look at the differences between the expertise and credentials of each of these professions.


TL;DR here


What is a Psychologist?


Psychologists are trained through programs that require Doctorate degrees in Psychology. They’re licensed to diagnose and treat disorders of thought, behaviour, and mood.


In Ontario, some Psychologists are registered alternatively based on having had a registration as a Psychologist in another province, and the training and schooling they were required to have there may have been different (for example, the standard to register as a psychologist in Saskatchewan is to have a Master’s degree in Psychology, and the Ph.D. is just a bonus but not a requirement). So, you’ll notice that some psychologists use the title “Dr.” if they have a Ph.D., and those who don’t use it may be registered with a Master’s degree from outside of Ontario.

Clear as mud, right?


Psychologists work with problems from an approach that focuses very much on alleviating your distress and moving you into a state of emotional regulation. They typically use talk-based therapy and other adjunct treatments (e.g., Brainspotting, EMDR, relaxation, behavioural change, cognitive therapies like (Cognitive Behavioural Therapy and Cognitive Processing Therapy - known usually as CBT and CPT respectively - exposure or Prolonged Exposure Therapy (PE), hypnosis, etc.) to make the desired changes happen for their patients.


Psychologists generally have the most training of all these professions in the research into, development of, verification of, and expert application of drug-free treatments for treating mental health conditions and emotional distress. This is because of the extent of training requirements (courses, practicum placements, and a year-long pre-doctoral residency) that is necessary before they may apply for a doctoral level license, to be followed by an additional minimum of 2000 hours of care provided under another psychologist’s direct supervision. Many Psychologists also complete post-doctoral training, as well!


Psychologists are often the people who train students of psychotherapy (i.e., in any of these three professions, and more) in the foundations and fine art of how to be a good therapist. These days in Ontario, there is a shortage of Psychologists, similar to what is happening with Psychiatry. There are not enough treatment providers to meet the demand for services in our communities.


Working with a psychologist usually follows a one-appointment-per-week model, and most talk therapy appointments tend to be about 50 minutes in length. This is called “the 50-minute hour,” as your appointment will be booked for one hour, you will meet with the psychologist for 50 minutes, and they will use the remaining time in the session to complete their record-keeping activities about your appointment. Some psychologists use different appointment schedules, and this can vary. An example of how this can vary is the Therapy Intensive model that Limestone Clinic offers with Kingston Psychologist, Dr. Kris Boksman (read more about it here).

At the present time in Ontario, Psychologists are not yet licensed to prescribe medications, though this may change over the next few years given the phenomenal successes of prescribing Psychologists in the United States of America. In the future, it may be possible to see a psychologist for “one-stop shopping,” where you can benefit from their expertise in talk-therapy, assessment, and prescribing in one visit. For now, those who are seeing a Psychologist for treatment are prescribed their medications by their family doctor or psychiatrist.


Even though they many are “doctors” and they provide licensed health care services, Psychologists’ fees are not covered by our Ontario Health Insurance Plan (OHIP). Many people have extended health benefits that help to offset the cost of seeing a Psychologist.


What is a Psychiatrist?


Psychiatrists are trained through programs that offer degrees in Medicine with follow-up specialty training in mental health. Psychiatrists are licensed to diagnose and treat disorders of thought, behaviour, and mood, and Psychiatrists are unique in that they are permitted to write medication prescriptions for drugs that help change moods and thinking - called psychotropic medications. These days, the majority of, but not all Psychiatrists tend to work with individuals through a medical model, where medications are prescribed to help solve the problem.


Many psychiatrists have also invested considerable time and energy into learning more about talk-based modes of care and this can also be an offering. In Ontario, so many people are interested to consult with psychiatrists about mood-changing medicines and treatment options, that it can be difficult to find a Psychiatrist who has talk-therapy time available on a regular basis.


Psychiatrists’ schedules, offerings, and preferences can vary widely, from 15-minute medication consultations that occur monthly or quarterly, to once-per-week 50-minute-hour sessions, as well. These appointments are considered to be medical in nature, since Psychiatrists all have medical licenses. For this reason, Psychiatry appointments are covered by OHIP.

What is a Psychotherapist?


Psychotherapists are the newest licensed mental health care providers on the scene in Ontario. Given that the demand for services has not been adequately met by Psychologists and Psychiatrists, it makes sense to regulate others who were already providing counselling services in Ontario, and make sure it is up to a standard of excellence. Psychotherapists are trained through programs that offer Master’s degrees in a therapy-related field (these days this is usually Counselling Psychology), or, these individuals may have been “grandfathered” into this relative new license arena through foundational training and years of experience that occurred before the Psychotherapist license category was available.


Psychotherapists are also mental health care providers who assist people with disorders of thought, behaviour, and mood, such as burnout and stress, trauma, depression, anxiety, insomnia, and addictions. Psychotherapists offer talk therapy and additional complementary strategies, just like Psychologists, to help their clients shift and change negative feelings, thoughts, and behaviours, into more helpful and healthful patterns. Psychotherapists are by nature helpful, interested, compassionate and motivated to support their clients through difficult times. Psychotherapists work by connecting with, listening to, and teaching their clients how to change for the better.


At the time of this article was written, Psychotherapists working in Ontario, Quebec, New Brunswick, and Nova Scotia are required to have health care licenses in order to offer professional psychotherapy services to the public. Many other provinces are working on regulating those who provide counselling who do not fall under the umbrellas of the fields of Psychology and Psychiatry.



How to Hit the Right Target for You.


It’s a good idea to confirm that the Psychologist, Psychiatrist, or Psychotherapist you are considering working with is a licensed health care professional. Most have been grandfathered into an agency by this point but not all. So check that they are in good standing with their regulatory agency and they have up to date malpractice insurance. If you do not know about their experience, training, or what kind of license they have - ask!


To really find the right provider, you will want to meet them and get a feel for how they work, as well as get a sense about whether or not they have experience and expertise in the sort of problem for which you are seeking help (e.g., depression, anxiety, trauma, crazymaking relatives, etc.).


Optimally, the professional you decide to work with will have the type of approach you are seeking (e.g., if you want medication for your PTSD, but you are not very interested to engage in talk therapy sessions on a regular basis, it would likely be a mismatch to work with a Psychologist). How you feel about your therapist is important, and you should optimally have a “good feeling” about them as a person (e.g., do you like them? Do you feel good with the idea of talking to them about your personal challenges?), and you should feel confident that they have the skills needed to assist you.


A free therapy consultation in Kingston, Ontario


As you explore the options available through a Kingston-based Google search, or one of the many paid therapy resource websites that offer listings of psychologists, psychotherapists, and counsellors, you may want to ask for a free consultation to help you get a good “feel” for whether the therapist you are considering has the personality you are drawn to, the “trustworthiness” factor you need, and the skills and knowledge to help you reach your goals. Even a brief conversation can help you get a great sense about a therapist, and help you feel comfortable pressing “go” on the next chapter in your wellness plan


I really hope that the above information helps you get a good idea about which type of therapist is for you here in Kingston. Of course, we would be delighted to assist you if we can - Please consider yourself invited to call Limestone Clinic at (613) 877-4148 to set up a free 15 minute phone consultation to help you find the treatment provider for you.


If you are looking for more help with understanding why all therapists are not created equal and to learn even more about how you can determine a therapist’s skills and suitability for working with you, you can read more about how the therapists at Limestone Clinic help in our blog.


TL;DR


A psychologist is someone who helps people make changes to their mental state without the use of drugs. Sometimes this includes talk therapy and sometimes it means they use other therapies that are more rapid.


A psychiatrist is someone who is medically trained to help body and mind, mostly with medicine instead of therapy but they can use both.


A psychotherapist is someone who has been grandfathered in and regulated into being a mental health provider because they previously provided these services under different means.


About the Author


The Grand Poobah, herself, Dr. Kris is a licensed Doctoral level Clinical Psychologist, a Kingston Ontario resident, Limestone Clinic's founder, and she leads the crew with laughs and an encouraging learning environment.

Mom to two loud little (and not so little!) boys, and a husband who would rather hit himself with a hammer than talk about his feelings, she escapes the pressure of lockdowns and running a clinic with swimming, napping, painting, embroidery, reading fantasy novels, and thinking up her next new hairdo. 🏊‍♀️ The connection she derives from providing her clients with emotional relief is energizing and life-affirming.

Therapeutically, she specializes in helping folks who suffer with anxiety and depression, or those who have experienced narcissistic abuse and general trauma through Brainspotting - a method of therapy that allows for intense, quick resolution of underlying issues. Dr. Kris also helps high achievers and people under hellacious pressure get back to living healthful and enjoyable lives. Always an out-of-the-box thinker, Dr. Kris leads the region in offering a special Intensive Service model of care instead of the more typical weekly sessions traditionally offered.


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