Psychotherapist vs. psychologist vs. psychiatrist: which one should you choose?

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Psychotherapist vs. psychologist vs. psychiatrist: Which one is right for you?
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Psychotherapists, psychologists and psychiatrists may overlap in the areas they cover, but there are differences among each profession and what they can offer.

While Canada has a range of professionals available through private practices, community programs or institutes like hospitals and schools, finding the right expert for you means understanding exactly what you need.

Dr. Desi Brownstone, psychiatrist and president of the Ontario Psychiatric Association, says whichever option you choose, always be aware of the person’s training and background.

“Be confident the person is well-trained and know what they are doing,” he tells Global News.

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Psychiatry is that branch of medicine that involves the study of the etiology, assessment, diagnosis, treatment, and prevention of mental, emotional, and behavioural disorders alone or as they coexist with other medical or surgical disorders, the Royal College of Physicians and Surgeons of Canada notes.

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What can I expect? Brownstone says psychiatrists can work with patients on a biological and psychological level. They look at factors like past traumas, family history and can offer advice on how to move forward.

Psychiatrists cover off a range of topics in mental health, addiction and substance abuse, and can help people with both sudden issues like panic attacks or thoughts of suicide, to more long-term feelings of sadness or anxiousness.

Unique differences: The main difference between psychiatrists and the other professions, Brownstone adds, is that psychiatrists are medical doctors and are the only ones who can prescribe medication. “If someone has a stroke and are depressed, [psychiatrists] have an understanding of both.”

However, Brownstone says one ongoing issue with seeing psychiatrists is the wait time. “It’s a long-neglected problem,” he says. On average, the wait time to see one can be up to a year.

How much will it cost? In Ontario, for example, Brownstone says psychiatrists are not allowed to bill you outside of The Ontario Health Insurance Plan. In B.C., for example,  BC PharmaCare offers the No-Charge Psychiatric Medication Plan that covers the cost of medication based on your income.

If you are unsure of insurance or coverage, talk to your health-care provider.

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How to find someone: Brownstone adds it is not mandatory to go through your doctor, but most people go through one for a referral. Most patients, he says, do their own research on the psychiatrists online before contacting them.


A psychologist studies how people think, feel and behave from a scientific viewpoint. Psychologists apply this knowledge to help people understand, explain and change those behaviours, the Canadian Psychological Association (CPA) notes.

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Some can work as researchers, while others are practitioners in hospitals, schools, clinics, employee assistance programs and private offices, the association adds. Dr. Karen Cohen, chief executive officer of the CPA, says some psychologists also work at a consulting level and provide assistance for doctors and nurses.

What can I expect?  Cohen says psychologists can cover a range of topics through their research or practice, and this can include mental health issues, developmental disorders and relationship stress.

Cohen says there is also a focus on testing, assessments and research. “If your child is has a learning problem or developmental disorder, testing can clarify what that is and what it looks like,” she tells Global News.

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Unique differences: Although they are not able to prescribe medication, a psychologist holds a master’s and/or doctoral degree in psychology, and some clients choose to get medication through a family doctor or even a psychiatrist.

“The training is in academics… they have the understanding how to add research and ensure the testing and treatment is evidence-based and effective.”

Cohen says there is also a strong focus on managing your disorders or health concerns, as well as improving the symptoms and coming up with practical strategies that work with the individual and/or family.

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And unlike psychiatrists, wait times to see a psychologists are much less, Cohen says, but they can also be long depending on the type of service you need.

How much will it cost? There is no set cost to see a psychologist. Cohen says this differs from province to province, and sometimes it can be covered by insurance.

How to find someone: Cohen says make sure the psychologist is licensed and once you have a consultation, talk to them specifically about their experience in working with cases like yours. You don’t need a doctor’s referral either.


Psychotherapists and counsellors (although these titles cannot be interchanged) offer a variety of therapies and offer a diverse range of services.

Carrie Foster, director for Quebec at the Canadian Counselling and Psychotherapy Association (CCPA), says the association itself has 6,300 members that work in areas of the government, private practice and community organizations.

Foster says they cover a range of topics including career counselling, marriage counselling, family therapy and cognitive behavioural therapy.

“Currently there is no legal requirement for therapists to be licensed in most Canadian provinces with the exception of New Brunswick, Nova Scotia, Quebec and Ontario. However, it is wise to choose a therapist who is a member of a credible professional body and who is insured to practice,” the CCPA notes.

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What can I expect? Because there are so many types of therapists and counsellors, the approach will depend on their practice, Foster says.

“I could be a mother at home raising three kids and now I want to go back to work, I can see a career counsellor,” she says.

Therapy can come in a group setting, individual setting or families, she adds. And like psychologists, psychotherapists and counsellors do not prescribe medication.

READ MORE: Depression leads to shorter lifespan: Canadian study

Unique differences: The biggest difference between this practice is the range of types of therapies, Foster says. Therapists can offer art, music, drama therapy or more one-on-one sessions with an individual. She adds creative types of therapies may be helpful for people who may have a hard time speaking about their traumas.

How much will it cost? Again, costs vary. Private practices can set their own costs and some services could be covered by company insurances, Foster says.

Some community organizations may use sliding scales: the rate can change depending on your financial situation. Always consult the price before you talk to a therapist.

How to find someone: CPPA has a list of questions you should ask a therapist when you go in for a consultation. You don’t need a referral from a doctor and most people find therapists through a simple search online.

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