Our bodies are the primary way we experience our life. Since a psychiatrist is a physician, they understand the human body in a way that no other mental health professional can. In therapy with people without medical degrees, the physical body is an abstract concept rather than a tangible reality, which can lead to a psychotherapy that feels disconnected with the physical experience of our emotions. It is also helpful to have your medication be in line with the psychotherapeutic work, so we are not inadvertently going in two different directions with these two treatment modalities.

This is a common misconception; psychiatrists actually have the longest training of all mental health professionals. The minimum requirement for a psychiatrist is four years of medical school (including two years of classwork and two years of patient facing clinical training) and four years of residency (four full years of patient facing clinical training). It is also a requirement for training that all psychiatrists know how to do at least three types of psychotherapeutic modalities (supportive psychotherapy, psychodynamic psychotherapy, and cognitive behavioral therapy, although many psychiatrists train in much more). In contrast, doctoral level psychologists generally complete four years of school (two of classwork or research, followed by two years of patient facing clinical training) and one year of internship (one year of patient facing clinical training). Doctoral psychologists are often trained in at least one form of psychotherapy (either psychodynamic psychotherapy or cognitive behavioral therapy). Master’s level therapists (including LMFT, LCSW, MSW, LPCC) generally complete two year programs, which includes one year of schoolwork followed by one year of patient facing clinical work. Virtually all masters level therapists train only in cognitive behavioral therapy. Please note that it is common for many mental health professionals, regardless of degree, to pursue additional training beyond the minimum required years.

The unfortunate reality of our insurance based system heavily influences the way psychiatrists practice. Medication management is paid much more than psychotherapy, meaning that any psychiatrist working in an insurance based practice will either need to take a big pay cut to offer psychotherapy or will be heavily discouraged or penalized by leadership from offering it. It is much more financially efficient for the system to have psychiatrists mostly manage medication and for masters level or doctoral level psychologists to do psychotherapy. While I think this is "good enough" for patients with mild psychopathology, it may not serve the needs of patients with complex or severe symptoms. 

 While I will always hold that doing psychotherapy with your psychiatrist is the gold standard treatment, that does not mean that a patient cannot choose to work with a psychologist as well as a psychiatrist. Sometimes, patients also have financial constraints and have to pursue the treatment that makes the most sense for them. Psychotherapy can be deeply personal, and patients may often find they have a very good personality fit with a specific therapist that would be important to keep. Some patients may be in search of a very specific psychotherapeutic modality that the psychiatrist they have access to does not offer. There are many very talented psychologists who offer high quality care who I am happy to support by providing medication management that is always in line with their psychotherapeutic work.