There are three professional groups when it comes to mental health: Psychiatrist, Psychologist and Psychotherapist. What’s their difference?

Psychiatrist, psychologist and psychotherapist: differences and similarities in Austria and Germany

There are three main professional groups in the world of mental health: Psychiatrist, Psychologist and Psychotherapist. Although they all pursue the goal of helping people with mental health problems, they differ in terms of training, competences and fields of activity. This article sheds light on the differences and similarities between these professions in Austria and Germany.

Psychiatrist

Training and qualifications

Psychiatrists are licenced doctors who complete specialist training in psychiatry and psychotherapy after studying medicine. This training usually lasts five years and includes both psychiatric and psychotherapeutic content.

Fields

Psychiatrists diagnose and treat mental illnesses. They are the only one of the three professional groups authorised to prescribe medication. They can also carry out physical examinations and admit patients to clinics.

Here is a detailed overview of what a psychiatrist does:

✅ Diagnosis

• Psychiatrists conduct detailed anamnesis interviews with patients in order to understand their symptoms, life history and course of illness.
• They use standardised tests, questionnaires, physical examinations and, if necessary, laboratory tests or imaging (e.g. MRI) to rule out organic causes.
• The aim is to categorise the symptoms in a diagnostic system such as ICD-10 or ICD-11.

✅ Medical Treatment

• Psychiatrists are the only therapeutic professional group authorised to prescribe psychotropic drugs, e.g:
  • Antidepressants
  • Neuroleptics
  • Anxiolytics
  • Mood Stabilisers
  • Sleeping pills
• They monitor the effects and side effects, adjust dosages and discuss alternatives.

✅ Psychotherapeutic Treatment

• Many psychiatrists are also trained as psychotherapists, e.g. in:
  • Behavioural Therapy
  • Depth psychology-based Therapy
  • Systemic Therapy
• They then carry out talking therapies and often combine these with drug treatment.

✅ Emergency Care

• Psychiatrists often work in clinics or outpatient clinics and provide care in acute crises:
  • Suicide risk
  • Acute psychoses
  • Severe depression or mania
• In such cases, they can arrange compulsory hospitalisation or inpatient admissions in accordance with legal requirements.

✅ Long-term Rehabilitation

• Psychiatrists often accompany patients on a long-term basis, for example in cases of
  • Schizophrenia
  • Bipolar disorders
  • Chronic depression
• They often work on an interdisciplinary basis with psychologists, social workers, nursing staff and therapists.

Psychologist

Training and qualifications

Psychologists have completed a degree in psychology, which deals with human behaviour, thinking and feeling. In Austria, a degree in psychology is a prerequisite for the professional title. In addition, there are postgraduate training courses in ‘clinical psychology’, which authorises you to work with clinically ill people, and ‘health psychology’, which is primarily about disease prevention. These professional titles are protected and require registration in special lists of the Federal Ministry of Health.

In Germany, the job title ‘Psychologist’ is also protected and requires a university degree in psychology. However, the specifications ‘clinical psychology’ and ‘health psychology’ are not protected, which is why there is no state registration list.

Fields

Psychologists work in various fields, including research, human resources, education, clinical psychology and health psychology. In clinical practice, they carry out psychological assessments and provide psychological counselling and treatment. They are not allowed to prescribe medication, but work closely with physicians when medication is necessary.

Here is a detailed overview of what a psychologist does:

✅ Diagnostics

One of the most important areas of responsibility is psychological diagnostics:

• Carrying out and analysing tests and questionnaires
• Assessing intelligence, performance, personality, emotional experience, stress, etc.
• Diagnostics can take place in the following contexts, for example:
• Clinics (mental illnesses, course of therapy)
• Schools (learning difficulties, ADHD)
• Courts (expert reports)
• Companies (Aptitude Tests)

✅ Counselling & Prevention

• Many psychologists offer psychological counselling – i.e. discussions on crisis management, life counselling or prevention, e.g. in the case of
  • Stress
  • Relationship Conflicts
  • Insecurities at work
• These counselling sessions are not psychological treatment or therapy, but can be the first steps towards relief or accompany the path to therapy.

✅ Research & Teaching

In academic psychology, psychologists research how people learn, feel, behave or develop. They work in research institutes or universities, conduct studies, publish results and teach students. Areas of specialisation can be:

• Cognitive psychology
• Social psychology
• Developmental psychology
• Neuropsychology

✅ Occupational and organisational psychology

In companies, psychologists take care of e.g:

• Personnel selection and development
• Team development
• Management coaching
• Job satisfaction and health
• Psychologists also work in traffic psychology (e.g. MPU assessments) and sports psychology (e.g. mental training strategies).

✅ Clinical Psychology

• In clinical psychology, psychologists work with people who are mentally stressed or ill.
• They conduct diagnostic interviews, test stress and resources and help with treatment planning.
• In Austria and Germany, this requires an additional qualification as a ‘clinical psychologist’.

✅ Help in Crises

• Support for acute psychological stress: Breakups, cases of death, panic attacks, etc.
• Stabilisation, activation of resources, psychoeducation

✅ Long-term Therapy

• Treatment of chronic mental illnesses
• Work on underlying patterns and relationship experiences
• e.g. personality disorders, complex trauma disorders

✅ Cooperation with other professional groups

• Psychologists often work closely with other professionals, e.g:
  • Psychiatrists
  • Social workers
  • Occupational therapists
  • Educators
  • Carers

Psychotherapist

Training & qualification

In Austria, training to become a psychotherapist consists of a general part, the so-called propaedeutic, and a specialised part, in which a specific psychotherapy method is studied in depth. These training programmes are usually completed on a part-time basis. Frequent basic professions of psychotherapists are psychology, education, social work and medicine, especially in the case of psychiatrists with additional therapeutic qualifications. Since 2023, there has been an academic alternative, namely a university degree in psychotherapy.

In Germany, until 2019, training to become a psychological psychotherapist took place after studying psychology and included several years of further training with a state licence to practise. Since 2020, a specially implemented psychotherapy degree programme has been indicated, which is also followed by several years of further training with a licence to practise.

Fields

Psychotherapists treat psychological, psychosocial and psychosomatic disorders through counselling and therapeutic techniques. They are not allowed to prescribe medication, but work closely with doctors if medication is necessary.

Here is a detailed description of what a psychotherapist does:

✅ Psychotherapy

• Individual, couple, group or family therapy
• Discussions to clarify causes and develop solution strategies
• Promoting self-reflection, emotion regulation and new behaviours

✅ Diagnostics & Planning of Therapy

• Psychotherapists make psychological diagnoses as part of their training
• Planning and documentation of the course of therapy
• Clarification of indications: Is psychotherapy useful? Or is medical treatment necessary, for example?

✅ Help in Crises

• Support for acute psychological stress: Breakups, cases of death, panic attacks, etc.
• Stabilisation, activation of resources, psychoeducation

✅ Long-term Therapy

• Treatment of chronic mental illnesses
• Work on underlying patterns and relationship experiences
• e.g. personality disorders, complex trauma disorders

✅ Cooperation with other professional groups

• There is close co-operation with:
  • Psychiatrists (for diagnostics, medication)
  • General practitioners (for referrals, physical examinations)
  • Clinical psychologists (for test diagnostics)
  • Social workers, educators

Similarities and differences – psychiatrist, psychologist and psychotherapist

Topic	Psychiatrist	Psychologist	Psychotherapist
Training	Medical studies	Psychology studies	Various (f.e. Psychology, Pedagogy)
Qualification	Specialist training in psychiatry	F.e. Clinical Psychology	Therapy Training
Treatment	Medical, therapeutic	Psychological, diagnostic	Therapeutic
Medication	Yes	No	No
Insurance Refund	Yes	Partly (in clinical psychology)	Yes

Conclusion

While psychiatrists, psychologists and psychotherapists all work in the field of mental health, they differ in their training, competences and treatment methods. In Austria and Germany, the professional titles are protected by law to ensure quality and professionalism in the care of mentally ill people.

When seeking support, it is important to consider the specific qualifications and responsibilities of the professionals in order to receive the appropriate help.

Psychiatrist, psychologist and psychotherapist: not sure which of the three professional groups can offer you the best help? Would you like advice on making a decision and do you wand to get more detailed information? Let’s talk about it in a free initial session!

List of sources:

Berufslexikon AMS – Facharzt/-ärztin für Psychiatrie und psychotherapeutische Medizin

Berufslexikon – Psychologe/Psychologin

Berufsinformation BIC – Psychologe / Psychologin

Berufslexikon – PsychotherapeutIn

Psychotherapieausbildung