What kind of therapist do I need?

A psychiatrist, a psychologist or a psychotherapist?

Common questions and concerns that individuals and couples have when choosing a therapist:

  • How to differentiate between all the terms and designations when seeking help in therapy?
  • What are the differences between therapists?
  • Who will my extended health care coverage accept?

Let’s make it simple.

In dentistry there is a dentist, a dental surgeon, a dental assistant and a hygienist.

In medicine there are GPs-general practitioners, specialists – surgeons, physician assistants, nurse-practitioners, nurses, etc.

In law there are judges, lawyers, court room lawyers, legal assistants, paralegals and more.

As you can see, in each area, whether it be dentistry, medicine or law, there is significant overlap in each specialization. So it is in psychological roles and services.

So, when it comes to mental health care, designations are divided into areas of specialization.

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Psychiatrists form a branch of medicine focussing on assessment, diagnosis, treatment, and prevention of mental, emotional, and behavioural disorders alone, or as they coexist with other medical or surgical disorders.


The main difference between psychiatrists and other mental health professionals is that psychiatrists are medical doctors and are the only ones who can prescribe medication. If someone has a cancer and is depressed, a psychiatrist has an understanding of both. The good news is that it is covered by OHIP.


Unfortunately, the bad news is it can be up to a year to receive a referral. Secondly, while they may practice pharmacological therapy (i.e., diagnosis and prescribing medicine) most do not practice therapy to address cognitive, emotional, and relational impairment.

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A psychologist’s expertise is more focused on how a person behaves, thinks and feels from a scientific perspective. Like psychiatrists, psychologists can assess and diagnose disorders; however, they are not a medical doctor so they cannot prescribe medicine. They provide psychological services which may be in the role of a consultant for medical, education, legal or insurance issues. They may also be practitioners in private practice working with clients through their various issues.


Psychologists can provide diagnosis necessary for insurance companies, courts or education. The service is not covered under OHIP but may be covered under various extended health care insurance plans offered by employers.


While the wait time to see a psychologist is not as long as one to see a psychiatrist, it is likely to be more difficult to get in to see a psychologist in a timely manner. In addition, their fees are higher than a psychotherapist’s fees.

However, insurance companies often will allow a psychologist to supervise your treatment in order to make care more assessible and affordable.

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Like psychiatrists and psychologists, psychotherapists are regulated by a college, for training and accountability. Psychotherapists are the hands-on practitioners that carry out the therapeutic work, face to face with the clients. They usually work with children, teens, adults, or couples and families. They may also specialize in focussed areas such as trauma, attachment disorders, marriage, learning, emotional regulation, ADHD, anxiety and depression, and much more. Because there are so many types of therapists and counsellors, the approach will depend on their practice.


The advantage of the psychotherapist is that if you do not need a diagnosis for medical, work or legal reasons, it is much easier to book an appointment when you need it, and it is much more cost-effective.

Since the beginning of 2019 many insurance companies are recognizing the quality of training and care that is provided by a psychotherapist and will cover them under work policies. In addition, many other extended health insurance policies (through your employer) that insist on the involvement of a psychologist will often accept a psychologist supervising a psychotherapist to provide the psychological services. This allows greater access to you, the client, and, hence, much better care.


The main disadvantage is that their care is not covered by OHIP and is covered by a fewer number of extended health care providers. In addition, they cannot diagnose or prescribe medication.

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Unique Differences of Mental Health Professionals at a Glance

Psychiatrist Medical & Mental Health Specialist Chronic – Severe Mental Health OHIPUp to 1-Year waitCan Diagnose & Prescribe Medication Service is Free
Psychologist Consultant to assess for education, insurance, courts. Provides psychological services Specialized for various issues Fee for service or co-pay with Extended Health Care InsuranceFees usually at higher rates. A longer wait timeCan Diagnose. Extended Health Care Insurance covered
Psychotherapist Conducts the therapeutic treatment face to face. Specialized for various issues Fee for service or co-pay with Extended Health Care Insurance Cannot diagnose or prescribe medicine Quick availability Lower Fees Since 2019 it is covered by many Extended Health Care providers
Social Worker Conducts the therapeutic treatment face to face. Specialized for various issues Fee for service or co-pay with Extended Health Care InsuranceCannot diagnose or prescribe medicineQuick availability Lower Fees

Three Steps to Find Your Therapist

So, what should a person do to determine what they need?

First: You need to choose the practitioner first, based upon health and safety. The more the risk or chronic the issue, the more a medical doctor and/or a psychiatrist is needed. If it will take months to see someone, begin working with a psychotherapist or psychologist alongside your doctor.

Second: If you need a diagnosis but there is less risk and/or you cannot wait to see a psychiatrist, find a psychologist. Also, if you have extended health care coverage from your work, call your HR department and ask if you need to see a psychologist face to face, or if they will accept a supervised practice or a psychotherapist.

Third: If you need to work with a therapist after a diagnosis from a doctor, psychiatrist or a psychologist, and/or you have situational, mental, emotional, spiritual, or relational issues you need to overcome – call a psychotherapist.

I hope this is helpful.

P.S. As always, when you recognize a problem, early detection and treatment lessens future consequences.

Also be sure your care provider is licensed and well-trained and does not work in isolation.

Most people who find a therapist that fits well with them, report experiences that are both helpful and satisfying.

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