What's the Difference Between a Therapist, Psychiatrist, and Counselor?
The mental health provider landscape can be confusing. This guide explains who does what, psychiatrists, therapists, social workers, counselors, and what the right team looks like for someone with both addiction and a co-occurring mental health condition.
Medically Reviewed by:
Dr. Darrin Mangiacarne
Chief Medical Officer
At Banyan Treatment Centers, Chief Medical Officer Dr. Darrin Mangiacarne leads our nationwide clinical team with over a decade of addiction medicine experience, helping ensure evidence-based, compassionate care across every level of treatment.
Author / Written by: Banyan Editorial Staff
Medically reviewed by: Dr. Darrin Mangiacarne, CMO
Updated on: April 2026
Family Resources Hub › Mental Health Resources › Types of Mental Health Providers
Understanding the Mental Health Provider System
The mental health care system can be genuinely confusing, there are multiple types of providers with overlapping roles, different training backgrounds, different scopes of practice, and different billing arrangements. Families navigating dual diagnosis treatment often don't know who does what, who can prescribe, or who is the right fit for their loved one's specific situation. This guide clarifies the landscape.
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Who Does What: A Plain-Language Guide
Psychiatrist (MD or DO)
A medical doctor who specializes in mental health. Psychiatrists can diagnose mental health conditions, prescribe and manage psychiatric medications, and provide psychotherapy. In many settings, psychiatrists focus primarily on medication management and work alongside therapists who provide the counseling. For dual diagnosis, a psychiatrist who is familiar with addiction medicine is the gold standard for medication management.
Psychiatric Mental Health Nurse Practitioner (PMHNP)
An advanced practice nurse with specialized training in psychiatric care who can diagnose mental health conditions and prescribe medications in most states. PMHNPs function similarly to psychiatrists in outpatient settings and are increasingly common in addiction treatment programs as psychiatric staff. Scope of practice varies by state.
Licensed Clinical Social Worker (LCSW)
A master's-level clinician with specialized training in psychotherapy, case management, and systems navigation. LCSWs cannot prescribe medications but provide individual and group therapy, conduct assessments, and connect clients to community resources. They are among the most common therapy providers in addiction treatment settings.
Licensed Professional Counselor / Licensed Mental Health Counselor (LPC/LMHC)
Master's-level therapists licensed to provide psychotherapy for mental health and substance use disorders. Cannot prescribe medications. Names vary by state (LPC, LMHC, LCPC, LMFT). In dual diagnosis treatment, LPCs and LMHCs often provide the therapy component while a psychiatrist manages medications.
Licensed Marriage and Family Therapist (LMFT)
A master's-level therapist with specialized training in family systems therapy. LMFTs are particularly valuable when the addiction and mental health issues are affecting the family system as a whole, not just the individual. Family therapy is a component of evidence-based dual diagnosis treatment.
Addiction Counselor (CADC, LADC, CAC)
A counselor with specialized credentials in addiction treatment. Level of education and scope of practice varies significantly by credential, from bachelor's-level CADCs to master's-level LCADCs. In dual diagnosis treatment, addiction counselors typically work alongside clinical staff with broader mental health training.
What the Right Team Looks Like
Medication Management
For a loved one with a co-occurring psychiatric condition, depression, anxiety, bipolar disorder, PTSD, ongoing psychiatric medication management by a psychiatrist or PMHNP is often an essential component of sustained recovery. Ensure that any continuing care plan includes this.
Regular Individual Therapy
Weekly or biweekly individual therapy with a licensed clinician trained in both addiction and mental health, ideally using evidence-based approaches like CBT, DBT, or trauma-focused therapy. Group therapy is valuable but not a substitute for individual therapy in dual diagnosis treatment.
Communication Between Providers
If medication management and therapy are provided by different people, which is common, ensure they are communicating with each other and coordinating the treatment plan. A signed release of information allowing communication between providers is a basic but essential step.
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Related Guides
What Is Dual Diagnosis?
Why co-occurring mental health and addiction require integrated treatment.
Read the guide →Depression & Addiction
How depression interacts with addiction and what treatment looks like.
Read the guide →Anxiety & Addiction
How anxiety disorders drive substance use and complicate recovery.
Read the guide →Trauma & Addiction
How trauma history shapes addiction — and what trauma-informed treatment addresses.
Read the guide →Warning Signs of Relapse
Recognizing the behavioral and emotional signals that recovery needs more support.
Read the guide →What Does Long-Term Recovery Look Like?
Realistic expectations for supporting a loved one's recovery over time.
Read the guide →Additional Resources
Tools, community, and organizations to support your family's journey.
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Immediate help — national helplines and crisis resources for addiction and mental health emergencies.
View all crisis resources →Support Groups
Al-Anon, Nar-Anon, SMART Recovery Family & Friends, and peer groups for families.
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Clinician-authored articles, personal stories, and recovery news to keep families informed.
Read the Banyan blog →Insurance & Financing
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