A question that frequency arises is whether to instruct a psychologist or psychiatrist for a case. There are many overlaps in training and experience between psychiatry and psychology. The expertise of individual clinicians can often depend on their specialist training and fields of work after qualification. Both professions undergo a similar duration of training, although this differs largely in the focus. Psychiatrists train in generic medicine, whilst psychologists complete an undergraduate degree providing a broad base in infant development, social and family influences and the biological / neurobiological contribution to psychology. Both professions go on work clinically either as an assistant psychologist or in foundation, core and higher psychiatry training before going on to complete a 3-year doctorate in psychology (i.e. DClinPsych) or psychiatric exams (MRCPsych). Only top candidates will achieve chartered status as a practitioner. Post-qualification, continued supervision and professional development training is mandatory.
How do psychologists and psychiatrists reports differ?
Both clinical psychology and psychiatry are sciences, using evidence-based research to evaluate the effectiveness of interventions. An important and often misunderstood fact is that both professionals diagnose mental health problems by employing scientific, evidence-based assessment tools. Psychologists can also use ‘formulation’ to establish the aetiology, course and factors influencing mental health problems, rather than classifying people by disorders.
The key difference between the professions is the medical training of psychiatrists and their unique understanding of the relationship between physical and mental health. Unlike psychologists, psychiatrists can prescribe medication to patients and medical interventions are the cornerstone of their clinical practice. Psychiatrists often have a more stringent and scientific reporting style. This clear and concise presentation is often viewed as useful for the Courts. Psychology, on the other hand, spans the gap between social and biological sciences. Psychologists report on the multiple factors influencing mental health problems, basing their understanding of the disorder on childhood experiences and family influences. Consequently, their reporting style can be lengthier and cover more areas that affect and the individual’s difficulties. Psychologists often recommend mixed-model interventions, responding to multiple presenting problems which can deliver beyond pure therapy or medication treatment options.
In personal injury cases, psychologists assess a broad range of severe and catastrophic harm to the individual. They will not only differentiate between traumatic events and complex or developmental trauma, but also consider the social and family factors which may contribute to the severity of symptoms. This holistic view makes psychologists well-placed to diagnose the repercussions of a traumatic incident and offer a comprehensive overview of predictable outcomes. Conversely, psychiatry is better able to recommend and assess the effectiveness of medical interventions.
What is the difference between a psychologist and a psychotherapist?
There are a number of routes to becoming a psychotherapist. Most commonly, psychotherapists complete post-graduate training in one or more model of therapy, such as Cognitive Behavioural Therapy (CBT). The length of training depends on the type of therapy. This differs greatly between specialisms, for example, psychoanalytic psychotherapy, cognitive analytic therapy and counselling. These training routes lead to accreditation by organisations such as the UKCP or the BACP. Training to become a psychotherapist is shorter than for both psychology and psychiatry and does not require such broad-based training. Psychotherapists are, however, skilled in specialised models of psychotherapy. Often, psychologists and psychiatrists will go on to become accredited psychotherapists in specific models of therapy after their baseline training.
In recent years, psychotherapists (such as Cognitive Behavioural Therapists) have been increasingly instructed to give evidence to the Courts about therapeutic interventions and their outcomes. Psychotherapists are well placed to make recommendations about an individual’s capacity to engage in treatment, deliver therapy, and assess change over the course of treatment.