A college education, medical school, an M.D., and a residency in psychiatry produce a psychiatrist, but in recent years many psychiatrists have given up on talk therapy. They are likely to see four or more patients per hour. Prescriptions for medications are the common result of a visit to a psychiatrist, and you may not be seen again for follow-up for some time. If the psychiatrist is in a group practice, you may be seen for talk therapy on a regular basis by a social worker, psychologist, or other counselor in that same practice. Of course, some psychiatrists still do talk therapy such as Freudian psychoanalysis. This can be very intense and may go on for years, but such a practice is confined to the economically advantaged in our society. In spite of its cost, this kind of treatment has no documented effectiveness for addiction treatment to prove that it is superior to cheaper and shorter treatments.

People often confuse psychiatry and psychology since members of both professions are properly referred to as Doctor. The use of the title Doctor is quite proper in addressing someone with any kind of doctoral degree be it an M.D. or Ph.D.

Doctoral degrees are awarded in all fields of learning. Medicine, over the years, evolved from a lowly occupation with little effectiveness to it present status of great respect as its methods improved. At first, one became a physician merely through an apprenticeship. Then, at one point not very long ago, people right out of high school entered a medical college. Then, a two-year pre-medical course was added; finally, the four-year college degree became necessary to enter medical school even as post-doctorial work was being added at the other end after the internship.

A psychologist usually holds a Ph.D. or a Psy.D. (Doctor of Psychology) degree. These are degrees awarded after four or more years beyond the four-year college. The training of a clinical psychologist usually includes training in research as well as training in psychological assessment, therapy methods, personality theory, a practical clinical internship, and much more. In almost every state, in order to represent oneself as a physician, social worker or psychologist, one must also hold the appropriate license, and this is true in dentistry, law and so forth. The standards for state licensing are often quite high and require passing an examination and interview screening.

We cannot, of course, be lulled into confidence just because our prospective helper holds an advanced degree. We still have to ask, "Is the degree in a field relevant to the problems with which I need help?" Doctoral degrees are awarded in many fields such as religious studies, law, sociology, music, political science, etc. Be sure to check the field in which prospective therapist earned the degree(s). If the earned degree is not in a mental health related area, you have questions to ask, and the clinician has explanations to make. Training in law or theology, as examples, is no guarantee that the person has any knowledge or skill for work in an unrelated field such as psychotherapy.

Remember our battle cry—caveat emptor! I have a friend who earned his Ph.D. in sociology and did wonderful work on the sociology of problem gambling. Over time, however, he became increasingly interested in working individually with pathological gamblers. At considerable expense and sacrifice to himself and his family, he went back to school and earned a second doctoral degree in clinical psychology, and I have no doubt he will be an outstanding therapist.

On the other hand, I remember a gentleman who had earned three Ph.D. degrees, but none of them were in a clinical field. Although he was a fine mathematician, I wouldn’t let him groom my cat let alone ask him for psychological advice; but there he was being an expert on addictions.

Another person of my acquaintance has a Ph.D. in economics and, when the opportunity arose, he went to work counseling addicts without getting any additional training or experience. While learning how to handle money is important—that’s what economists do—I hardly think economics should be the primary topic in psychotherapy. It is vital to know the field in which a clinician earned an advanced degree, and to know what practical experience, such as a supervised clinical internship, the person had. One horrible example most of us would recognize is a radio talk show host who specializes in emotional and relationship problems. She is often referred to as a psychologist or psychotherapist, but her Ph.D. is in biology with a specialty totally unrelated to psychology or mental health.

In 1971, nine years after I got my own Ph.D. at the University of Pittsburgh, I took two days of written examinations and earned a psychology license in the State of California. I could have then advertised myself as a Californian Licensed Psychologist, but it would have been very misleading. My Ph.D. was in experimental psychology, not clinical psychology. California, at the time, licensed psychologists in specialized fields. By training and employment, my license was in experimental psychology, and I was then engaged in full time behavioral research for the state itself. I did not counsel patients and came into contact with them only when they served as subjects in my research.