A common point of confusion when seeking care from a mental health professional is the difference among psychiatrists, psychologists, social workers, and counselors. While there is some overlap among the professions, here’s a quick run down of who does what and in what way.
Psychiatrists are medical doctors (M.D. or D.O) trained in the diagnosis and treatment of mental illness. They have attended medical school and are able to prescribe psychotropic drugs in the treatment of some mental disorders. Psychiatrists often have a keen eye for diagnosis, especially differential diagnosis between physical and mental illness. They are also the best resource for monitoring medication effectiveness and side effects over time. Primary care physicians may also prescribe psychotropic medications, although PCPs will generally manage medications only for patients with fairly straightforward mental health issues. More complex or long-term cases often warrant referral to a psychiatrist. Psychiatrists do not typically provide counseling aside from medication counseling.
Psychologists are mental health providers who have earned a doctoral degree in psychology (Ph.D. or Psy.D.). Often, psychologists are the best trained professionals to administer assessments and conduct psychological research. Many are trained in counseling psychology and also provide counseling to individuals, couples, and families. A psychologist’s expertise in counseling often varies depending on the focus of their doctoral work. Psychologists do not prescribe medication.
Licensed clinical social workers hold masters degrees in social work and are the most similar in training to professional counselors, with some distinctions. Traditionally, social workers have been trained in case management to assist individuals with meeting their basic needs, but social workers are also able to help individuals with personal needs via counseling. LCSWs can provide counseling services to individuals, couples, and families. They cannot prescribe medication.
A professional counselor holds a graduate degree in counseling. The training of professional counselors allows them to diagnose and treat mental disorders and relational problems in families and couples. Because the bulk of a counselor’s education derives from counseling theory and technique, the counseling process is more of a focus for professional counselors than diagnosis, assessment, or connection with resources, although a counselor is familiar with these skillsets. Professional counselors can provide counseling services to individuals, couples, and families. They cannot prescribe medication.
Please refer to the ACA’s Professional Counseling Fact Sheet for more information.
Many counseling practices experience a significant increase in calls around this time of year. Despite choruses of comfort and joy, the holidays often bring feelings of loneliness, stress, sadness, and relational discord. The way we are supposed to feel as depicted in commercials and movies causes us to experience dissonance when we realize how we are actually feeling in comparison. Something is amiss.
We would do well to view that realization as a gift. In essence, God is shining a light on the brokenness so we can yearn for something better. And isn’t that the central idea behind Advent? We hope for that which is better. Within ourselves, we seek peace, joy, grace, love, faithfulness to win out against our frenzied, sad, self-righteousness, begrudging, and fickle hearts. Within our world, we long for Jesus’ grace to captivate our souls and for His Kingdom to restore all things. Advent is about hoping and longing for that which is better.
If you have noticed that something is amiss in you this holiday season and you long for a way of being that is better, call a counselor. Make an appointment. Don’t live another year stuck in the same patterns of thinking, behaving, and relating. God desires for you to hear His good news of grace and restoration again and again. He longs that you experience freedom from captivity and release from darkness (Isaiah 61). If you have not yet done so, carve out time to intentionally celebrate Advent and yearn for Christ’s coming- both in your life and in those among you. The Advent Project by Biola University offers one beautiful way of pilgriming through Advent that features Scripture, written reflections, music, and visual art to help engage our senses as we “earnestly contemplate the wonder and mystery of Christ’s coming to earth.”
The introduction to the afore-mentioned Advent Project reads, “The frenetic activities of the holidays tend to work us up, while the spiritual practices of Advent quietly focus our souls.” Take time this Advent to intentionally and deliberately focus your soul and consider the ways God might desire to lead you out of captivity and darkness as you prepare for a new year ahead.
It’s been said that counseling is both art and science. Indeed, walking with people through pain and suffering combines the finesse and intuition of a seasoned craftsman with the ardor and precision of a rigorous practitioner. I find that this aphorism resonates with many counselors, and my hunch is that it does so because of the way it speaks to how God is at work in our lives. He reveals Himself to us as the Potter, the Master Sculptor, the One who cultivates beauty from ashes. Yet at other times, our senses are heightened to the brilliance of his meticulous sovereignty at work. We stand amazed at his genius. His work is both art and science.
The fruitful counselor grasps this balance as she partners with God in his restorative work in clients’ lives. There is a particular quality to skillful counseling that can neither be described nor taught. It is art in its truest form- intuitive, creative, perceiving what is and what could be. Yet there is also the rigor of good science- the commitment to following what God has revealed to be empirically true about the way the human mind, soul, heart, and body interact, change, and flourish.
My prayer is that my work would reflect this delicate balance and its fruit would honor the One who artfully and brilliantly knit us together and loves us despite the ways we have fallen apart.