Help! Do I need a counselor, coach, therapist, psychologist or psychiatrist?

How do you decide between all the choices?

With so many choices (including counselors, therapists, psychologists, psychiatrists, life coaches, trainers and self-professed gurus), it can get downright confusing.

How do you pick one – and how do you know you’ve made the right choice? Let’s begin by looking at each of these professions by title (and function) so you better understand what your options are.

Counselors, therapists and psychologists

The terms counselor, therapist and psychologist are often used interchangeably. Each is a trained and licensed (by the state or jurisdiction in which they practice) mental health professional. It’s important to note that some therapists are general counselors addressing behaviors and relationships – while others specialize in specific areas such as family and marriage counseling, substance abuse/ addiction or anxieties and phobias.

Life coaches

Drawing from areas of sociology and psychology, life coaching is a relatively new area of therapy. It’s important to understand that life coaches (and their benefits) can vary tremendously in experience, training and expertise. What’s more, they don’t have the same licensure requirements as psychologists and psychiatrists. Life coaching may involve mentoring, accountability, teaching and direction – with some practitioners specializing in career, finances or health (and possibly combining various aspects for a more holistic approach).


Of the options we’re discussing here, a psychiatrist is the only physician. They are medical doctors who specialize in the diagnosis and treatment of mental disorders.

They evaluate patients to determine whether (or not) their symptoms are the result of a physical illness, a combination of physical and mental or are strictly psychiatric.

As part of the clinical assessment process, psychiatrists may perform blood tests, physical exams and various other scans and tests. They may also prescribe medication as part of a patient’s treatment plan. While some psychiatrists combine the medical and medication management with psychotherapy, most psychiatrists today (in general) do not provide therapy themselves but opt to work with psychologists as part of a patient’s overall treatment plan.

Advisors, trainers and consultants

These often fall into the business- or goal-oriented arenas. To name a few, there are spiritual advisors (such as priests, pastors and rabbis), fitness and/or personal trainers, nutritional consultants and business advisors. While this group often overlaps with what some life coaches do, they tend to be more specialized and narrower in scope.

So to improve your life, how do you choose?

Match the person and profession to your intended purpose.

Once you better understand the different types of help that are available, the next thing you should do is determine your goal and intended outcome. For example, if you tend to drink too much to deal with social anxiety, a therapist or psychiatrist who specializes in anxiety and addiction may be the best fit. On the other hand, if you don’t have a specific issue you’re trying to resolve but are simply looking for help to improve your life, a life coach or general counselor may be what you need.

However, if you’re looking to address any health-related issues such as depression, ADHD (attention deficit disorder), panic attacks, etc., you should see a medical doctor (in this case, a psychiatrist) to make sure your medical screening is addressed first. Your physician will then determine if you would benefit from medication and/or additional assistance from a psychologist or other trained professional.