Therapist, Psychiatrist or Coach: Which Do You Need?

A therapist treats mental health concerns through talk therapy, a psychiatrist is a medical doctor who diagnoses mental health conditions and can prescribe medication, and a coach helps you set and reach practical goals, such as a career direction, without diagnosing or treating mental health conditions. Many people need one of the three; some do best with two working together. Blackburn Clinical Services in Los Angeles offers therapy in our Mar Vista office or by secure video for clients located in California, career coaching by video or in the office, and psychiatric care can be arranged and coordinated with your therapist. Call (888) 870 7405.

Call (888) 870 7405

Monday to Friday, 9 AM to 5 PM. No diagnosis or referral is needed to start therapy.

The short answer

Start with a therapist if you feel anxious, low, stuck in the same patterns, or are dealing with trauma, grief, relationships or substance use.
Ask about a psychiatric evaluation if symptoms are severe, are not improving with therapy, affect sleep, work or school, or you think medication may help.
Choose a coach if the main need is practical, such as direction, routines, a job search or follow-through, and mental health symptoms are not driving the problem.
Not sure? A therapy assessment is a reasonable first step. A good therapist will tell you if psychiatric care or coaching would help too.

What is the difference between a therapist, a psychiatrist and a coach?

The three roles overlap in what people talk about, but they differ in training, in what they are allowed to do, and in what they are for. The simplest way to see it is side by side.

Therapist, psychiatrist and coach compared
	Therapist	Psychiatrist	Coach
Main focus	Changing patterns of thought, emotion and behavior through talk therapy	Diagnosis, medication and the medical side of mental health	Practical goals: direction, routines, follow-through
Training in California	Licensed clinicians such as LMFT, LCSW, LPCC or licensed psychologist	Medical doctor (MD or DO) with residency training in psychiatry	No state license is required; training and certifications vary
Diagnoses mental health conditions	Yes, within the scope of their license	Yes	No
Prescribes medication	No	Yes (psychiatric nurse practitioners can too)	No
Typical visits	Weekly sessions, often 45 to 60 minutes	An evaluation, then follow-up visits focused on symptoms and medication	Scheduled sessions around goals and a plan between them
A good fit when	Anxiety, depression, trauma, relationships, substance use, life transitions	Severe or persistent symptoms, or questions about medication	Feeling stuck on work or school without significant symptoms
At Blackburn	In our Mar Vista office or by secure video for clients located in California	Psychiatric care can be arranged and coordinated with your therapist	Career coaching by video or at our Mar Vista office

In California, therapists are licensed by the Board of Behavioral Sciences (marriage and family therapists, clinical social workers and professional clinical counselors) or the Board of Psychology (psychologists), and physicians by the Medical Board of California. You can check any license on the state Department of Consumer Affairs license search. Coaching is not a licensed profession in the state, which is one reason a coach should not be treating a mental health condition.

Which one should you see first?

Start with what is getting in the way. If the honest answer is mood, worry, panic, sleep, drinking or a pattern you keep repeating, start with a therapist. If you already know a diagnosis and want to talk about medication, or symptoms are severe enough that daily life is slipping, ask about a psychiatric evaluation. If you feel steady but directionless about work or school, a coach may be enough.

Weeks of low mood, worry or poor sleep: a therapist first; psychiatric care if it is not improving.
Panic attacks, intrusive thoughts or trauma symptoms: a therapist, with psychiatric care if needed.
Drinking or drug use you want to change: a therapist experienced in substance use; see dual diagnosis treatment.
A recent diagnosis of ADHD, bipolar disorder or depression and questions about medication: a psychiatric evaluation.
No idea what career fits, repeated false starts, trouble following through: a coach, or coaching plus therapy if anxiety or attention problems are part of it.

Can you see a therapist and a psychiatrist at the same time?

Yes, and for many conditions the two are commonly combined. The National Institute of Mental Health notes that psychotherapy is often used together with medication. The important part is coordination: the therapist and the prescriber should share what they see, with your permission, so the plan stays consistent. At Blackburn, psychiatric care can be arranged and coordinated with your therapist. For more detail, read therapist or psychiatrist: which do you need.

When is a coach the right choice, and when is it not?

Coaching works best when the problem is mostly practical and you have the stability to act on a plan. It is not the right tool when symptoms such as depression, anxiety, trauma or substance use are what keep you stuck, because a coach is not trained or licensed to treat them. Many people do both: therapy for what is underneath, coaching for the next concrete step.

Career coaching or therapy for work and school problems
What you notice	Usually start with
You do not know what direction fits your strengths and values	Career coaching
You know what to do but cannot build the routine to do it	Coaching, plus an ADHD evaluation if attention has always been a struggle
Dread, panic or low mood every time you think about work	Therapy
Burnout that a weekend or vacation does not fix	Therapy first, then coaching for the return
Rebuilding work and routines in recovery from substance use	Therapy and coaching together

How does this work at Blackburn Clinical Services?

Blackburn Clinical Services is an outpatient practice at 12326 Venice Blvd in Mar Vista, West Los Angeles. All services are available individually or can be combined into a customized package:

Therapy for adults, young adults and teens 13 to 17, in our office or by secure video for clients located in California. Some Saturday therapy appointments are available.
Psychiatric care and medication management can be arranged and coordinated with your therapist.
Career coaching, strengths-based and values-driven, by video or at our Mar Vista office. See career coaching by video in California.
The Concierge Outpatient Program, a one-on-one alternative to IOP, typically 3 to 5 hours a week with no groups, when weekly sessions are not enough.

Choosing for a teen? Read psychiatrist, psychologist or therapist for teens and how to choose a therapist for your teen.

Frequently asked questions

Do I need a referral to start therapy at Blackburn?

No. No diagnosis or referral is needed to start therapy. Call (888) 870 7405, Monday to Friday, 9 AM to 5 PM.

Can a therapist prescribe medication?

No. In California, therapists and psychologists do not prescribe medication; psychiatrists and psychiatric nurse practitioners can. At Blackburn, psychiatric care can be arranged and coordinated with your therapist.

Is a coach a substitute for therapy?

No. A coach does not diagnose or treat mental health conditions. If anxiety, depression, trauma or substance use are part of what holds you back, therapy is the better place to start, and coaching can be added alongside it.

Can I do career coaching and therapy at the same time?

Yes. At Blackburn, career coaching can stand on its own or be combined with individual therapy, psychiatric care, neuropsychological testing or the Concierge Outpatient Program.

Can I do this by video?

Therapy and career coaching are available by secure video for clients located in California, or in our Mar Vista office. Psychiatric care can be arranged; we explain how when you call.

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