Can a therapist prescribe medication?

In most states, no. Only psychiatrists, psychiatric nurse practitioners, and some primary care physicians can prescribe psychiatric medications. If your therapist believes medication may help, they will refer you to a prescriber.

Do I need to see a psychiatrist before starting therapy?

Not necessarily. You can start with either. However, if your symptoms are severe, if you suspect you may need medication, or if you want a diagnostic evaluation first, starting with a psychiatrist can help guide the therapy referral.

How do I know if I need medication or just therapy?

A psychiatric evaluation can help answer this question. In general, mild symptoms may respond well to therapy alone, while moderate-to-severe symptoms often benefit from medication alongside therapy. The decision is individualized.

Does SLS Psychiatry provide therapy?

SLS Psychiatry focuses on psychiatric evaluation and medication management. For ongoing psychotherapy, we coordinate with and refer to therapists who specialize in the approaches most relevant to your condition.

Psychiatrist vs Therapist: Which Do You Need?

Quick answer: A psychiatrist is a medical doctor who diagnoses mental health conditions and prescribes medication. A therapist (psychologist, licensed counselor, or social worker) provides talk therapy. Many patients benefit from seeing both — a psychiatrist for medication management and a therapist for ongoing psychotherapy.

When you decide to seek mental health support, one of the first questions is whether to see a psychiatrist or a therapist. They serve different roles, and understanding those differences helps you find the right starting point for your care.

What a Psychiatrist Does

A psychiatrist is a medical doctor (MD or DO) who has completed medical school and a psychiatry residency. Their training equips them to:

Conduct comprehensive diagnostic evaluations
Prescribe and manage psychiatric medications
Differentiate between psychiatric and medical causes of symptoms
Order lab work or imaging when clinically indicated
Coordinate with other healthcare providers
Monitor medication effectiveness and side effects over time

Most psychiatrists focus primarily on evaluation and medication management rather than providing weekly talk therapy. Their medical training allows them to understand how physical health, medications, hormones, and substance use interact with mental health.

What a Therapist Does

"Therapist" is an umbrella term that includes several types of licensed mental health professionals:

Psychologists (PhD or PsyD): Doctoral-level providers trained in psychotherapy and psychological testing
Licensed Professional Counselors (LPCs): Master's-level therapists providing counseling and psychotherapy
Licensed Clinical Social Workers (LCSWs): Master's-level providers offering therapy and community resource connections
Marriage and Family Therapists (LMFTs): Specialists in relationship and family dynamics

Therapists provide structured talk therapy using evidence-based approaches such as:

Cognitive Behavioral Therapy (CBT): Targets negative thought patterns and behaviors
Dialectical Behavior Therapy (DBT): Focuses on emotion regulation and distress tolerance
EMDR and trauma-focused therapies: Specific approaches for processing traumatic experiences
Psychodynamic therapy: Explores patterns from past experiences
Interpersonal therapy: Addresses relationship patterns affecting mood

Therapists typically see patients weekly or biweekly for 45–60 minute sessions.

When to See a Psychiatrist

You likely need a psychiatrist if:

You think medication might help your symptoms
Therapy alone has not been sufficient
You need a diagnostic evaluation for a complex or unclear condition
You are experiencing severe symptoms that impair daily functioning
You have co-occurring medical and psychiatric conditions
You need someone to rule out medical causes of your symptoms
You are already on psychiatric medication and need ongoing management

When to See a Therapist

You likely need a therapist if:

You want to develop coping strategies and behavioral changes
You are working through grief, relationship issues, or life transitions
You want to process trauma with evidence-based therapy
You need regular, structured support for managing anxiety or depression
You prefer a talk-based approach to treatment

Can You See Both?

Yes — and this is often the most effective approach. Research consistently shows that for conditions like moderate-to-severe depression, anxiety disorders, and PTSD, the combination of medication and therapy produces better outcomes than either alone.

A common arrangement:

Psychiatrist: Initial evaluation, diagnosis, medication management (visits every 1–3 months once stable)
Therapist: Weekly or biweekly therapy sessions for coping skills, behavioral change, and emotional processing

When both providers communicate (with your consent), they can coordinate a more comprehensive treatment plan.

The Key Distinction

The simplest way to think about it: a psychiatrist evaluates, diagnoses, and manages medication. A therapist provides structured psychotherapy. Both are valuable, and many patients benefit from having both on their care team.

Getting Started

If you are unsure where to start, a psychiatric evaluation can help clarify your diagnosis and determine whether medication, therapy, or both are appropriate. At SLS Psychiatry, initial evaluations include recommendations for therapy referrals when psychotherapy would benefit your treatment plan.