Behavioral health has more provider categories than almost any other specialty. Here is who's who, what they can do, and what each is trained in.
Prescribers (can write prescriptions)
- Psychiatrist (MD or DO) — physician with a 4-year psychiatry residency. Diagnoses and treats the full range of mental health conditions, prescribes medications, and (depending on training) provides psychotherapy.
- Child & Adolescent Psychiatrist (MD/DO) — psychiatrist with additional fellowship in working with patients under 18.
- Addiction Psychiatrist (MD/DO) — psychiatrist with subspecialty training in substance use disorders. May provide MAT (medication for opioid or alcohol use).
- Geriatric Psychiatrist (MD/DO) — psychiatrist with fellowship in older-adult mental health (dementia, late-life depression).
- Psychiatric/Mental Health Nurse Practitioner (PMHNP) — advanced practice nurse with prescriptive authority for mental health conditions. Scope of practice varies by state.
- Family Medicine / Internal Medicine MD — many primary care physicians manage routine antidepressants and anti-anxiety medications.
- Prescribing Psychologist (PsyD/PhD with prescriptive authority) — exists in a handful of states (e.g., LA, NM, IA, IL, ID, CO, IN, UT) with additional training.
Non-prescribers (therapy only)
- Clinical Psychologist (PhD or PsyD) — doctoral-level. Performs psychological testing (IQ, ADHD, neuropsychological evaluations) and evidence-based therapies. Does not prescribe in most states.
- LCSW (Licensed Clinical Social Worker) — master's level. Therapy, often with a community and case-management emphasis.
- LMFT (Licensed Marriage & Family Therapist) — master's level, trained specifically in couples and family systems work.
- LPC / LMHC (Licensed Professional Counselor / Licensed Mental Health Counselor) — master's level. General therapy training; titles vary by state.
Quick matrix — what can each do?
| Provider | Diagnoses | Prescribes | Therapy | Testing |
|---|
| Psychiatrist (MD/DO) | ✓ | ✓ | Sometimes | — |
| PMHNP | ✓ | ✓* | Sometimes | — |
| Psychologist (PhD/PsyD) | ✓ | —* | ✓ | ✓ |
| LCSW / LMFT / LPC / LMHC | ✓ | — | ✓ | — |
* State-dependent. PMHNP prescriptive authority and psychologist prescribing rules vary by state.
How to choose a therapist
- Modality — therapy is not one thing. Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) have strong evidence for anxiety, depression, and emotion regulation. Eye Movement Desensitization and Reprocessing (EMDR) and Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) have strong evidence for PTSD. Acceptance and Commitment Therapy (ACT) for many conditions. Psychodynamic therapy for relational and chronic concerns.
- Evidence base — ask the therapist what training they have in evidence-based approaches for your concern. A good therapist will not be defensive about this question.
- Fit — the strongest predictor of therapy outcomes across studies is the therapeutic alliance. If the first few sessions don't feel right, it is reasonable to try someone else.
- Logistics — fees, insurance, in-person vs. telehealth, frequency, after-hours availability. Confirm before the first appointment.