The difference between psychological counseling and psychiatrist

The most essential difference between the two is their identity, qualifications and service boundaries - a psychologist is essentially a physician with psychiatric qualifications, has the right to prescribe, and can do both drug treatment and psychological intervention； Psychological counselors do not have the right to prescribe. Their core work is to carry out non-drug psychological intervention through professional psychological techniques and cannot involve medical diagnosis and medication recommendations.

In the 7 years I have been doing consulting, I have seen too many people go to the wrong door: There was a girl who had just graduated who was depressed for three months in a row. She couldn't eat and lost 10 pounds. She called a tertiary hospital for special needs. She originally wanted to vent her bitterness about work and the forced marriage at home. However, within 10 minutes of going in, the doctor asked about her symptoms, took a scale, and directly prescribed antidepressants. She felt that she was not understood, took the medicine and left, and turned to me for consultation. After two conversations, I discovered that she already had obvious morning and night stress, and occasionally had suicidal thoughts. I quickly advised her to go back and take medicine as prescribed by the doctor, and wait until her mood stabilized before cooperating with the consultation. It took about half a year for her to slowly get better. You see, it's not that anyone is unprofessional, it's that everyone has a deep misunderstanding of the work content of the two.

Let me first clarify for everyone some of the identities that are often confused: What we usually call "psychiatrists" are officially called psychiatric practitioners. They must pass the national medical practitioner qualification certificate and be registered in a relevant department of psychiatry. Only then can they have the legal right to prescribe and make medical diagnoses. Many people think that psychiatrists can only prescribe medication. In fact, this is not the case. Many psychiatrists will also systematically learn psychological techniques such as cognitive behavior and family therapy. If you sign up for their psychotherapy account, they can also provide long-term conversational intervention. However, public medical resources are too tight. Doctors in general outpatient clinics may have to answer 70 or 80 calls a day. The first priority during the first consultation is to quickly detect the risk of severe mental illness. They do not have that much time to listen to you about the details of your quarrel with your partner.

Let’s talk about psychological counselors. After the country canceled the original second- and third-level psychological counselor professional qualification certificates in 2017, the most recognized ones in the industry are now registered psychologists and assistant psychologists in the registration system of the Chinese Psychological Society, as well as psychotherapist certificates issued by the health system. Here is an important distinction. Point, although psychotherapists can engage in psychological intervention work in medical institutions, they still do not have the right to prescribe, nor can they independently make medical diagnoses of mental illnesses. Any consultant who dares to say to you, "You are suffering from depression, I will recommend you a medicine and you will be fine." If you turn around and leave, you are definitely a liar.

The service populations of the two actually have a lot of overlap, but the core boundaries are very clear: If you have obvious psychotic symptoms, such as hallucinations and delusions, or you have been diagnosed with severe mental illness such as bipolar disorder, severe depression, or schizophrenia, you must see a psychiatrist for the first diagnosis, and drug intervention is the first choice. After the condition is stabilized, the effect will be better if you cooperate with psychological consultation.； If it is just a practical problem, such as being so consumed in the workplace that you don’t want to go to work every day, always quarreling about the same issue in your intimate relationship, your child being rebellious and refusing to go to school during adolescence, or you are suffering from mild anxiety or depression, and you can still eat and sleep normally to cope with your daily work, then it is absolutely fine to find a professional psychological counselor.

Of course, there are different voices in the industry now. Some psychiatrists feel that many consultants do not have medical backgrounds, which can easily miss the diagnosis of serious diseases and delay the treatment of clients.； Some counselors also feel that some psychiatrists rely too much on drugs and ignore the psychological motivations of clients. In fact, the two are not antagonistic at all. My current studio has a long-term cooperation with a nearby psychiatric clinic. When I encounter visitors who are suspected of being at risk of serious diseases, I will refer them to the doctor as soon as possible. The doctor will also refer patients with mild symptoms or stable conditions who need psychological intervention to me. For visitors, getting the most appropriate help is the most important. There is no need to worry about who is more powerful.

In fact, for the general public, there is no need to distinguish the two identities so clearly. When you are really not sure who to call, just judge based on the simplest criteria: as long as you feel that your condition has affected normal eating, sleeping, work and school, or even the idea of ​​harming yourself, don't hesitate to go to the psychiatric department to register for investigation first.； If you are just worried and want to figure out why you keep falling into the same pit, just find a reliable counselor to talk to. In the final analysis, whether it is a psychiatrist or a counselor, they are just people who help you get through emotional depression. The one that suits you is the best.