Therapist, Psychologist, or Psychiatrist? A Tennessee Parent's Guide

By Sukhmani Kaur Sadana, MD · Double board-certified in general psychiatry and child & adolescent psychiatry · Last reviewed October 22, 2026

When a child is struggling emotionally or behaviorally, one of the first questions parents ask is:

"Who should we see: a therapist, a psychologist, or a psychiatrist?"

The titles sound similar, but the training and the kind of help each one provides are different. Knowing the differences helps you choose a sensible first step, especially when appointments can take time to get.

The short answer: these professionals work best together. Here is what each one does.

Therapists

"Therapist" is a broad term rather than a single degree. In Tennessee, licensed therapists include:

• Licensed Clinical Social Workers (LCSW)

• Licensed Professional Counselors with the Mental Health Service Provider designation (LPC-MHSP)

• Licensed Marriage and Family Therapists (LMFT)

What therapists do: They provide talk therapy, such as cognitive behavioral therapy (CBT), play therapy, and family therapy. They help children build coping skills, support parents with behavioral strategies, and work through stress, anxiety, grief, and adjustment difficulties. For many mild to moderate concerns, therapy is the right place to start, and for many conditions it is a core part of treatment.

Therapists do not prescribe medication.

Psychologists

A psychologist holds a doctoral degree (PhD or PsyD) in psychology.

What psychologists do: Psychologists are specialists in psychological assessment and therapy. They perform detailed testing, such as evaluations for ADHD, autism, and learning disabilities, cognitive and academic testing, and diagnostic clarification, and many also provide therapy.

Psychologists in Tennessee do not prescribe medication. (A small number of other states allow specially trained psychologists to prescribe.)

Psychiatrists

A psychiatrist is a medical doctor (MD or DO) who specializes in mental health. A child and adolescent psychiatrist completes medical school, residency training in general psychiatry, and then two additional years of specialized training focused on children, adolescents, and families.

What psychiatrists do:

• Diagnose psychiatric conditions within a full medical and developmental context

• Look for medical causes or contributors, such as thyroid problems, anemia, sleep disorders, or seizures

• Order and interpret laboratory tests when needed

• Prescribe and monitor psychiatric medication, including side effects and interactions

• Care for complex situations, such as several conditions at once or symptoms that haven't improved with treatment so far

In children, this medical lens is especially useful. Developing bodies and brains respond to medication differently than adults do, and some medical conditions can look like psychiatric symptoms.

Psychiatric nurse practitioners and pediatricians can also diagnose and prescribe for many common conditions, and many families start with their pediatrician.

Working together

Many children do best with a combination: a therapist for skills and support, and a psychiatrist to clarify the diagnosis and consider whether medication would help. My practice focuses on psychiatric evaluation and medication management, and with your permission I coordinate with your child's therapist, pediatrician, and school.

It is not a competition. It is a team.

When might a psychiatrist be a good first step?

Consider starting with a child psychiatrist if:

• Symptoms are moderate to severe, or clearly getting in the way of school, friendships, or family life

• There are safety concerns, such as self-harm or talk of not wanting to be alive

• Therapy has helped but symptoms remain

• The diagnosis is unclear, or there may be more than one thing going on

• Your pediatrician has suggested a psychiatric evaluation

• You have questions about medication

A quick guide

• Stress, adjustment, or mild anxiety: Therapist

• Need formal testing (learning, autism, ADHD testing): Psychologist

• Moderate or severe symptoms, or several concerns at once: Child psychiatrist

• Questions about medication: Child psychiatrist (or your pediatrician)

• Ongoing support plus medical care: Therapist and psychiatrist together

There is no wrong door. Any of these professionals can help you find the right next step. Choosing with some understanding, rather than guessing, can shorten the path to effective care.

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Frequently asked questions

Do I need a referral to see a child psychiatrist in Tennessee?

Not for a self-pay practice like ours. If you plan to seek out-of-network reimbursement from insurance, check whether your plan has requirements.

Can psychologists in Tennessee prescribe medication?

No. In Tennessee, medication is prescribed by physicians, including psychiatrists and pediatricians, and by certain other licensed prescribers such as nurse practitioners.

Does a psychiatrist provide therapy?

Some psychiatrists do. My practice focuses on evaluation and medication management, and I work alongside your child's therapist.

Can my child see a therapist and a psychiatrist at the same time?

Yes. This is common and often works well.

If your child is in crisis, call or text 988 (Suicide & Crisis Lifeline), call 911, or go to the nearest emergency room.

If you are in Tennessee

If you are unsure what level of care your child needs, a psychiatric evaluation can help clarify the next step. You can reach us through our secure contact form.

This is general education, not medical advice. Talk to your own clinician about your child.

Sources

• American Academy of Child & Adolescent Psychiatry, Facts for Families: Child and Adolescent Psychiatrists: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/The-Child-And-Adolescent-Psychiatrist-000.aspx

• Pharmacy Times, States grant prescribing authority to psychologists (2025): https://www.pharmacytimes.com/view/states-grant-prescribing-authority-to-psychologists

• 988 Suicide & Crisis Lifeline: https://988lifeline.org/