Psychology and Psychiatry
What is the difference between a psychologist and a psychiatrist?
Psychology and psychiatry can both participate in mental health care, with their own training and roles. You may consult one or both, depending on your situation.
For those living outside Brazil, doubts may arise while trying to arrange care in different countries and languages: does it make sense to continue with a psychiatrist and start Portuguese-language psychotherapy? The answer depends on your assessment and your goals. This page explains what each professional can offer and how to discuss treatment options.
The main difference
What each professional does
Psychologist
A psychologist is a professional with training in Psychology and registration with the Regional Psychology Council. In clinical practice, they may conduct psychological assessments and psychotherapy, in accordance with their training, competence, and the profession’s standards.
In psychotherapy, we explore with the person their experiences, emotions, interpretations, behaviors, and relationships. The process takes into account individual history and the context in which difficulties arise. There are different psychological approaches; in my practice, I work with Cognitive Behavioral Therapy.
As a psychologist, I do not prescribe medication. When a medical evaluation seems appropriate, I can discuss a referral.
Psychiatrist
He is a physician with training in Psychiatry. He can perform medical evaluations, formulate diagnostic hypotheses, investigate relevant clinical conditions, and prescribe treatments, which may include medication when appropriate. He also monitors treatment effects, response, and the need for adjustments to prescribed therapy.
Psychologists also assess psychological aspects and may formulate clinical hypotheses within the scope of their practice. The distinction should not be reduced to the idea that one professional only listens and the other only diagnoses or prescribes.
Psychological work
What psychotherapy can offer
Psychotherapy creates a regular space to examine experiences with attention to your history. Some issues become clear in concrete situations: a conversation you put off, a boundary that is difficult to set, a decision that keeps coming back to mind, or a move to another country that has changed your relationships. The process does not require you to arrive with a diagnosis or know how to explain everything in the first session.
Understanding patterns in the context in which they arise
In Cognitive Behavioral Therapy, we observe how you interpret a situation, what you feel, and how you respond to it. For example, a person who receives feedback about their job may perceive it as a specific suggestion or as proof of incompetence. Investigating these interpretations involves examining facts, past experiences, and the professional environment. This is not about automatically replacing a difficult idea with a positive one.
Explore choices, relationships, and patterns of behavior
The process can also explore how you ask for help, how you communicate, how you handle conflicts, how you set boundaries, and how you draw closer to—or distance yourself from—people who matter to you. When avoidance, perfectionism, or excessive self-expectations are present, we explore the role these behaviors have played and what is happening today. Possibilities for change are built together with the person, taking their actual circumstances into account.
Space for concerns that go beyond a diagnosis
Even during medical treatment, someone may wish to talk about family, work, adapting to another country, losses, relationships, and life plans. These issues can be relevant without needing to be treated as symptoms. Psychotherapy allows for accompanying them over time and reviewing, together, what makes sense to work on at each stage.
These are possibilities of the psychological process, not promised outcomes. The work depends on assessment, the therapeutic relationship, agreed-upon goals, and each person’s context.
Online psychotherapy
Want to talk about what you want to work on?
If any of the topics on this page resonate with you, an initial contact can clarify how psychotherapy works and check availability for sessions. There is no need to have a diagnosis or to share your entire history by message.
How can medication and psychotherapy participate in care?
These are different resources that can be indicated individually or together. Medication, when prescribed by a physician, is part of a treatment plan that considers the assessed condition, expected benefits, possible side effects, and the person's preferences. Psychotherapy is a psychological work process in which patterns of reaction, relationships, decisions, and life conditions can be examined.
Not everyone who undergoes psychotherapy needs psychiatric follow-up. The need for a medical evaluation is based on the clinical situation, not simply on the fact that the person is in psychotherapy. Similarly, being in psychiatric treatment does not make psychotherapy mandatory for everyone. She can integrate care when there is clinical indication and psychological objectives to work on, also considering the person's preferences and possibilities. The plan may include one of these resources, both, or other forms of care.
A specific example comes from the British NICE institute's guideline on depression in adults. For more severe depression, it presents the combination of individual cognitive behavioral therapy and an antidepressant as one of the options. This does not mean that every person taking psychiatric medication should undergo psychotherapy, nor that the same combination is indicated for other conditions. The decision requires individual assessment. Read the clinical guideline.
Why have psychotherapy during psychiatric care?
Medical consultations and psychotherapy sessions may have different objectives within the same care plan. In psychotherapy, you can dedicate time to everyday situations and observe how they relate to what you want to understand or change in your life. The use of prescribed medication does not interfere with this work.
Questions related to habits, relationships, work, and choices can remain relevant throughout medical care. Psychotherapy offers a space to explore them regularly and collaboratively. It is worthwhile to discuss this possibility with the involved professionals, without interrupting or modifying your medical treatment on your own.
What if I'm already in psychotherapy?
At certain points, the psychologist may discuss with you the appropriateness of a medical evaluation. This possibility depends on what appears in the clinical assessment and the individual's context; it cannot be determined by a list of experiences presented on this page.
Seeking medical evaluation does not diminish the value of psychotherapy. Similarly, using prescribed medication is not a personal failure. Every decision should take into account the specific situation, the objectives of care, and the individual's preferences.
How can interprofessional care work?
When a psychologist and psychiatrist are treating the same person, it can be useful to align strictly relevant information for care. Before any contact between professionals, this proposal must be discussed with you, respecting confidentiality and applicable regulations. The existence of two treatments does not authorize an automatic exchange of information or access to the entirety of sessions.
You may also bring to appointments questions about what you have noticed, concerns about your treatment, and situations that are interfering with your daily routine. If a medication has been prescribed and you notice unwanted effects or are considering stopping it, talk with the professional who prescribed it. This page does not provide guidance on starting, adjusting, or stopping medications.
An example close to the life of someone working abroad
Imagine a Brazilian person working in an international team who has started avoiding meetings. There are many questions before concluding what is happening: how are the hours and real work demands? What happens in those meetings? Are there other life changes underway?
In psychotherapy, these situations can be explored with attention to interpretations, emotions, behaviors, and relationships. A medical evaluation, when indicated, may consider clinical aspects and treatment options within that professional's scope of competence. This example illustrates how different questions can complement one another; it is not intended to assign a diagnosis or prescribe a combination of treatments.
For those living outside Brazil, the country of residence also matters when verifying online service conditions with a Brazilian professional. This analysis is conducted during the initial contact.
Frequently asked questions
What can I bring to psychotherapy?
You can talk about relationships, decisions, work, life changes, and situations you wish to understand. The first session helps to get to know your concerns and build the goals of therapy.
Can I seek psychotherapy without a psychiatric diagnosis?
Yes. You do not need a diagnosis to discuss relationships, life changes, or issues you wish to understand.
Should I inform my psychiatrist that I have started psychotherapy?
You can bring this information to the session and discuss how the forms of care relate to one another. If direct contact between professionals is needed, this must be discussed with you and managed in accordance with confidentiality rules.
Who answers questions about my medications?
The prescribing professional is the reference for questions regarding use, side effects, dosage, and discontinuation. Do not change a prescription based on guidance from this page.
Do you provide services to people living outside Brazil?
Please indicate your country and, where applicable, your region of residence at first contact. The possibility of service is verified based on applicable regulations.
To check
Sources of this page
Information regarding medical practice in Psychiatry was verified in American Psychiatric AssociationThe explanation for combined treatments uses the NICE guideline for adult depressionOnly in the specific context indicated. Sources help understand care options and do not replace individual assessment.
Online psychotherapy
Shall we talk about the possibility of psychotherapy?
If you are already in psychiatric care and want to explore personal, professional, or relational issues, you can reach out to learn more about my psychological services. Psychotherapy can also begin without a prior psychiatric consultation. The first contact is meant to review service availability and terms, with no obligation to begin therapy.
I provide exclusively online services in Brazilian Portuguese, with 50-minute sessions. For your initial contact, please indicate your country of residence, time zone, and availability. Services are private; the fee is communicated directly upon contact.
Alexandre Bartoli
Psychologist · CRP 04/86889
Português do Brasil
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