Psychiatrist, Psychologist, or Psychotherapist? Why Talking is Often the Best First Step.

If you’ve decided to explore options to improve your mental health, congratulations. That is always the hardest step. But the second hardest step is often figuring out who to call.

Between "Psychiatrist," "Psychologist," and "Psychotherapist," the terminology can be confusing. It’s not uncommon for us to receive messages from clients asking, "Do I need a doctor? Do I need pills? Or do I just need to talk to someone?"

At our practice, we believe that for the vast majority of people, psychotherapy (talk therapy) is the most effective first line of defense.

Here is a simple breakdown of the differences, and why we recommend starting your journey with a psychotherapist and counsellor before considering medication.

The "Big Three" Explained

To make the right choice, you first need to know the players.

1. The Psychiatrist ( The Medical Doctor) A psychiatrist is a medical doctor (MD) who specializes in mental health. Because they have a medical background, their primary focus is often on the biology of the brain.

• Primary Tool: Medication (antidepressants, mood stabilizers, etc.).

• Typical Session: Shorter sessions (15–30 mins) focused on symptoms and medication management.

• Best for: Severe, complex mental illness (like Schizophrenia or Bipolar Disorder) where chemical intervention is necessary to stabilize the brain. We have many psychiatrist partners in our practice and refer clients there when necessary.

2. The Psychologist (The Scientist-Practitioner) A Clinical Psychologist holds a Doctorate degree (PhD or PsyD). They are experts in the science of human behavior.

• Primary Tool: Psychological testing, diagnosis, and evidence-based psychotherapy (like CBT).

• Typical Session: 50–60 minutes of talk therapy.

• Best for: diagnosing complex conditions (ADHD, Autism) and providing high-level therapy. Vincent Ng in our practice provides these services with many years of experience in Singapore.

3. The Psychotherapist / Counsellor (The Change Agent). These are the specialists you likely picture when you think of "therapy."

• Primary Tool: Talk therapy, connection, and relationship building. They are professionally trained with multiple degrees and diplomas. In our practice, Geetika is the lead psychotherapist and has lived/worked in both Asia and Europe (4 countries) with three Masters degrees and other qualifications from a range of Singapore and international universities.

• Typical Session: 50–60 minutes of deep conversation and skill-building.

• Best for: Stress, anxiety, depression, relationship issues, teenage angst, trauma, and life transitions among others.

Why Psychotherapy Should Be Your "First Choice"

In a world that loves quick fixes, it is tempting to go straight for a pill that makes the bad feelings go away. Medication has a vital place in mental health, but for most people, therapy should come first. Here is why.

1. Treat the Root, Not Just the Symptom

Medication is excellent at turning down the volume of your symptoms. If your anxiety is a 10/10, a pill might bring it down to a 6/10. However, medication rarely teaches you why you are anxious or how to handle that anxiety when it spikes again. Psychotherapy digs into the root cause. We look at your history, your thought patterns, and your relationships to understand the "why" behind your struggle.

2. Skills You Keep Forever

When you stop taking medication, the chemical support ends. When you stop therapy, the skills you learned stay with you. Psychotherapy is about education. We teach you coping mechanisms, communication skills, and emotional regulation techniques. These are tools you put in your pocket and carry for the rest of your life. You are not just getting treated; you are getting trained.

3. No Side Effects

Psychiatric medications can be life-saving, but they often come with a "cost" in the form of side effects—weight gain, sleep issues, or emotional numbing. Talk therapy has zero physical side effects. It is the "least invasive" treatment. Just as you would likely try physical therapy for back pain before jumping straight to surgery, it makes sense to try psychotherapy for emotional pain before jumping to pharmaceutical intervention.

4. The "Stepped Care" Approach

The gold standard in modern healthcare is "Stepped Care." This means starting with the most effective, least intrusive treatment. For mild to moderate depression and anxiety, clinical guidelines overwhelmingly recommend psychotherapy as the first step. If—and only if—therapy alone isn’t providing enough relief, we then "step up" and bring in a psychiatrist to add medication to the treatment plan.

When Should You Call a Psychiatrist?

We are not anti-medication; we are pro-appropriate treatment. You should consider a psychiatrist if:

• You are experiencing hallucinations or delusions (psychosis).

• Your symptoms are so severe that you cannot get out of bed, function at work, or engage in therapy sessions.

• You have been in therapy for some time and have hit a "plateau" where you aren't making further progress.

The Bottom Line

You don’t have to figure this out alone. If you start with a psychotherapist, you are starting in a safe, holistic place. A good therapist will be the first to tell you, "I think medication could really help support our work," and can refer you to a trusted psychiatrist if needed.

Frequently Asked Questions

Q: Can a psychotherapist prescribe medication if I decide I need it later? A: No, psychotherapists and psychologists cannot prescribe medication (in most jurisdictions). However, we are trained to recognize when medication might be necessary. If we believe a biological intervention would help you, we can write a referral letter to your GP or a trusted psychiatrist to get you that help while continuing our therapy sessions.

Q: Can I see a psychiatrist and a psychotherapist at the same time? A: Absolutely. In fact, for conditions like severe clinical depression or bipolar disorder, this is often the "Gold Standard" of care. The psychiatrist manages your chemical balance, while the therapist helps you navigate your thoughts and behaviors. We regularly collaborate with psychiatrists to ensure you get holistic care.

Q: Do I need a referral from my doctor to see a psychotherapist? A: Generally, no. One of the biggest advantages of private practice psychotherapy is accessibility. You can usually self-refer and book an appointment immediately. Psychiatrists, on the other hand, often require a referral from a General Practitioner or a Psychotherapist.

Q: Is a Psychologist "better" than a Psychotherapist? A: They are just different. If you require formal diagnostic testing (for example, for court cases, school accommodations, or official disability diagnoses), a Psychologist is required. However, if your goal is to talk through trauma, relationship issues, or anxiety, a Psychotherapist or Counsellor is highly trained in these specific areas and is often more affordable and accessible.

Q: How do I know if therapy is working? A: Unlike taking a pill where the chemical effect might be felt quickly, therapy is a process. You generally know it is working when you start having "Aha!" moments outside of the session, when you feel better equipped to handle stress, and when your symptoms (like panic attacks or low moods) become less frequent or less intense.

Contact us if you want to have an introductory session with our lead therapist.