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Mental Health Center

Psychology vs. Psychiatry: Which Is Better?

Confused by the difference between a psychiatrist and a psychologist? WebMD explains who does what and how that affects treatment.
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Prescribing Powers continued...

Psychiatrists who work at clinics and hospitals certainly see many hard cases. "The major patients they see are severely mentally ill, but there are others who are not," Goin tells WebMD. She says she practices a lot of psychotherapy in her private office and that most of her patients there are not on medication.

Increasingly, however, psychiatrists in private practice spend their time with medication management and not psychotherapy. Other mental health providers usually do therapy sessions, and when they see a patient who could benefit from medication, they send the patient to a psychiatrist for an evaluation and possibly a prescription.

Fees

"It usually is not the psychiatrists' choice to only prescribe medicine," Goin says. But if a psychiatrist participates in a health insurance plan, the plan's fee structure may discourage time spent on psychotherapy.

A study published in the journal Psychiatric Services in 2003 shows that psychiatrists earn less for doing therapy. On average, a psychiatrist who charges for 45-50 minutes of psychotherapy earns $74-$107 less than he or she would for three 15-minute sessions of medication management.

The reason may be that insurers figure that psychotherapy, which is time consuming and may go on for months, should be handled by providers who charge less. "The reality is that psychiatrists' fees are often higher than psychologists'," Goin says.

According to the Centers for Medicare and Medicaid Services, "reasonable" charges for a 45- to 50-minute therapy session are $70-$130 for a psychiatrist and $65-$114 for a psychologist.

These guidelines are based on data from 1988. The 2003 Psychiatric Services study shows psychiatrists charging an average of $107-$155 per session for therapy.

Psychological Testing

In addition to psychotherapy and research, psychologists use a variety of tools to examine a person's psychological underpinnings and personality (and how that could affect life experiences).

Psychologists tend to use these tests more than psychiatrists.

Personality tests include the questionnaires such as the Minnesota Multiphasic Personality Inventory (MMPI) and the Millon Clinical Multiaxial Inventory (MCMI), and the famed Rorschach test - where the person is shown a variety of inkblots and asked to tell the therapist what they see. These tests are meant to reveal how people see themselves and how they may behave.

Psychological testing also includes neuropsychological tests, which evaluate brain function to diagnose or assess the extent of damage from an injury or illness.

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