Psychiatrist or Psychotherapist: Who Treats, Who Counsels

A psychiatrist is a specialist physician in psychiatry and psychotherapy. He or she makes diagnoses, assesses whether there are physical causes behind the symptoms, and is authorized to prescribe medication.

How do I find a psychiatrist?

For those with statutory health insurance, the appointment service center at 116117 also arranges appointments with specialist physicians, including psychiatrists. To do so, you must have a referral, for example from a primary care practice; exceptions apply, among others, to acute cases. For the psychotherapy consultation, however, you do not need a referral.

Psychological Psychotherapist and Psychological Counselor

A psychological psychotherapist, on the other hand, is not authorized to prescribe medication: He or she is licensed and treats clinically significant disorders using scientifically recognized approaches. Depending on the condition and its severity, a combination of both may be appropriate, medication and therapy at the same time; in such cases, a psychiatrist and a psychotherapist work together. The situation is quite different for a psychological counselor: The title is unprotected, there is no required training and no connection to illness. Anyone who actually wants to treat illnesses needs a license to practice or a license to practice as an alternative practitioner; for the latter, no specialized training is required, only a knowledge check.

A Rule of Thumb

My own case: I am licensed and offer counseling by a licensed practitioner, without any connection to illness. As a rule of thumb: The medication question belongs with the psychiatrist; unclear physical involvement is assessed first by the primary care practice or the psychiatrist; what has clinical significance belongs in psychotherapy; and a concern unrelated to illness that calls for understanding and clarification belongs in counseling. Counseling does not replace necessary treatment.