LMHC, psychologist, or psychiatrist: who should you see?

It is easy to feel confused

Therapist, counselor, psychologist, psychiatrist. The titles sound alike, and many people put off reaching out because they are not sure which one they need. The good news is that you do not have to get it exactly right on the first try. A licensed professional can tell you if another kind of care would fit better and help you find it.

Psychiatrist: a medical doctor

A psychiatrist is a medical doctor (an M.D. or D.O.) who specializes in mental health, including substance use^{Source [1]}. After medical school, psychiatrists complete four years of psychiatry residency^{Source [1]}.

Because they are physicians, psychiatrists can prescribe medication, and they can also provide psychotherapy^{Source [1]}. In practice, many people see a psychiatrist for medication and a therapist for regular talk therapy. Medications are often used together with other treatments, such as psychotherapy^{Source [2]}.

Psychologist: a doctorate in psychology

In New York, a licensed psychologist holds a doctoral degree in psychology and completes two years of full-time supervised experience^{Source [3]}. Many psychologists provide therapy, and they often have extensive training in research or clinical practice^{Source [1]}.

Licensed mental health counselor (LMHC): a master's in counseling

In New York, an LMHC holds a master's or doctoral degree in counseling, completes at least 3,000 hours of supervised counseling experience after the degree, and passes a national clinical exam^{Source [4]}.

New York law describes the practice of mental health counseling as the evaluation, assessment, and treatment of problems with behavior, emotion, personality, or relationships, using counseling and psychotherapy with individuals, couples, families, or groups^{Source [5]}. In everyday terms, LMHCs are therapists. The same law does not allow counselors to prescribe medication^{Source [5]}.

The differences at a glance

Here is a short summary of how the three compare in New York:

• Psychiatrist: medical degree and psychiatry residency. Can prescribe medication and can provide therapy^{Source [1]}.
• Psychologist: doctoral degree in psychology and two years of supervised experience^{Source [3]}. Often has extensive training in research or clinical practice^{Source [1]}.
• LMHC: master's or doctoral degree in counseling and 3,000 supervised hours. Provides counseling and psychotherapy, and does not prescribe^{Source [4]}.

Is it better to see a psychologist or a therapist?

Not necessarily. For talk therapy, the title matters less than finding a licensed professional you trust. A review that combined 295 studies found that a stronger working relationship between client and therapist is linked to better outcomes^{Source [6]}. Feeling heard and respected is a better sign of a good fit than a particular degree.

How to choose where to start

A few questions can point you in the right direction:

• Do you want someone to talk with regularly about what you are going through? A therapist, such as an LMHC or a psychologist, is a good fit.
• Do you think you may need medication, or have you taken it before? A psychiatrist or your primary care provider can talk with you about it.
• Has someone, such as a school, an employer, or an attorney, asked for formal psychological testing or an evaluation? Ask what kind of professional they require.
• Not sure at all? A primary care provider can do a first mental health screening and refer you to a mental health professional^{Source [7]}.

If you are looking for a "psicólogo" in Spanish

Many Spanish speakers search for a psicólogo when they mean any therapist. We want to be clear: our licensed mental health counselor is not a psychologist. She is an LMHC who provides psychotherapy in English and in Spanish, without an interpreter. If what you are looking for is someone to talk with in your own language, our page on therapy in Spanish explains how it works.

When to reach out

It may be time to talk with a professional if worry, sadness, or stress has lasted for weeks, if it is getting in the way of your sleep, work, school, or relationships, or if the things that used to help are not helping anymore. You do not need to wait until things feel unbearable.

If you are thinking about suicide or are in emotional distress, call or text 988 to reach a trained crisis counselor, any time of day^{Source [7]}. In a life-threatening emergency, call 911.

How we can help

At Choosing Hope, our licensed mental health counselor provides individual therapy for adults and couples and family therapy, in English or in Spanish. We work with concerns such as anxiety, depression, trauma, and grief. We do not prescribe medication. If you need it, we can work alongside your psychiatrist or primary care provider.

Every session is online on a secure video platform, so you can join from anywhere in New York State. You need to be physically located in New York State during each session. Our pricing page lists every rate, including our sliding scale spots. If you are still not sure what kind of support fits, call us or fill out our short contact form, and we will help you figure out where to start.

Common questions

References

1. American Psychiatric Association (2026). What is Psychiatry?
2. National Institute of Mental Health (2023). Mental Health Medications
3. New York State Education Department, Office of the Professions (2026). NYS Psychology: License Requirements
4. New York State Education Department, Office of the Professions (2026). License Requirements for Mental Health Counselors
5. New York State Education Department, Office of the Professions (2026). Education Law, Article 163: Mental Health Practitioners
6. Flückiger C, Del Re AC, Wampold BE, Horvath AO. Psychotherapy (2018). The alliance in adult psychotherapy: A meta-analytic synthesis
7. National Institute of Mental Health (2026). Help for Mental Illnesses