Mental health disorders, such as anxiety, depression, and post-traumatic stress disorder, are extremely common around the world and here in Michigan. Millions of people seek treatment, visiting support groups, therapists, and psychiatrists for their treatment.

A lot of treatment for these disorders involves talk therapy, where a trained specialist uses verified and scientifically proven techniques to help you talk through, work through, and cope with your specific issues. Different forms of talk therapy, from cognitive behavioral therapy and dialectical behavioral therapy, and therapies with different frameworks like EMDR and PIT, are all available.

While talk therapies work for many people, many others have resistant disorders, where words alone aren’t enough to help. That’s where medication comes into play.

Medication is often stigmatized for mental health disorders, but it’s actually quite effective when handled properly. Being able to prescribe medications, as well as adjust dosages for cases where the balance of beneficial effects and detrimental side effects is off, is a key part of this style of treatment.

Prescription medications that alter brain chemistry are serious business, and that means they need to be regulated carefully. As such, only specific groups of people are allowed to prescribe these medications.

There’s a divide in mental health treatment between the groups that can and the groups that cannot prescribe medication. Seeking the right kind of treatment from the right professionals is key to successful treatment, so it’s important to know the differences.

DISCLAIMER: This article is for informational and educational purposes only and should not be considered medical or psychological advice. The information presented here is not intended to diagnose, treat, cure, or prevent any mental health condition or replace professional therapeutic care. Every individual’s experience with trauma and mental health is unique. Please consult with a qualified mental health professional, therapist, or healthcare provider to determine the most appropriate treatment approach for your specific situation. If you are experiencing a mental health crisis or emergency, please contact your local emergency services or crisis hotline immediately.

Before We Begin

In addition to our normal disclaimer, there’s one more thing to mention here: a lot of this terminology is muddled. Common parlance isn’t always a match for the legal definitions of the people involved in your mental health treatment. The legal definitions in Michigan are set by the state code, and generally reflect national standards, but specifics of licensure and other details can vary from state to state.

This can also be a challenge if you’re seeking therapy remotely through a national service, such as through Talkspace or BetterHelp. Since medical professionals need to be licensed in the state where they’re practicing, getting medications managed by national platforms requires some specific hoops to be jumped through, which in-person therapists don’t need to worry about.

All of this is to say, while we’re trying to bring clarity to the terminology and legal restrictions on different kinds of mental health treatment, most of it isn’t actually information you’ll need to know. That’s because even the therapists who can’t prescribe medications have avenues they can take to help you regardless, which we’ll discuss later on in the post.

So, don’t worry about whether or not you should seek the right kind of professional to give you your medication; just about any trained professional can get you the help you need, either directly or through a partnership. Seeking treatment at all is more important than trying to find the right specific provider on your first try.

Can a Therapist Prescribe Medication in Michigan?

Generally speaking, no, a therapist cannot prescribe or manage medication in the state of Michigan.

It’s important to recognize, though, the difference between the casual definition of “therapist” and the legal definition.

Many people use the term “therapist” to refer to any professional who gives them therapy for their mental health issues. But using it as an umbrella term makes it harder to know specifically what you’re talking about. There are many groups of people who can provide therapy, but they aren’t all considered therapists.

The legal definition of a therapist is someone who provides therapy but who is not licensed to practice medicine. More often, to differentiate them, these people are known as psychotherapists instead of just therapists.

What it all comes down to is whether or not the individual provider of therapy is licensed to practice medicine or not.

What Kinds of Therapists Cannot Prescribe Medication?

Broadly, there’s a bar of study that needs to be cleared to be able to prescribe medication. This is a level of higher learning that many practitioners do not achieve. Critically, it’s also not required to treat people through talk therapy and similar means.

What kinds of job titles can provide therapy but not prescribe medication?

• Counselors. Counselors can be certified in specific programs, like peer-led support groups, or they can be licensed at a higher level as professional counselors. Professional counselors may have Bachelor’s degrees, or they may have a Master’s degree in a field like social work.
• Social Workers. Social workers are similar to counselors, without the lower-end casual terminology. To be a social worker, you must have at least a Bachelor’s of Social Work, or more commonly a Master’s degree, and pass the licensing requirements.
• Therapists. Psychotherapists, as well as other specific kinds of therapists like group therapists and family therapists, generally need at least some schooling in their field. A Bachelor’s or Master’s degree in counseling, psychology, or social work is common. And, again, they’ll need a license to practice in the state.
• Psychologists. Psychologists are specialized practitioners with advanced degrees in psychology, often a Master’s degree, but sometimes even a PhD. They tend to specialize in a particular kind of therapy and go deep into it, whether it’s CBT, DBT, EMDR, or another practice.

There’s a lot of overlap around the edges of these definitions. If you’re ever curious, you can ask what kind of professional your therapy provider is. In order to practice therapy, a provider needs to have some kind of license or certification with the state, with the exception of peer-led support groups and similar informal practices.

What Kinds of Providers Can Prescribe Medication?

Psychiatrists.

Psychiatry is the branch of medicine specifically focusing on mental, emotional, and behavioral health. Unlike psychologists, though, psychiatrists are medical professionals first, and mental health professionals second.

Psychiatric providers can be full doctors, with M.D. or D.O. titles, PhDs in their fields, and professional capabilities. They are fully capable of providing prescriptions for medications for their patients.

There’s also a mid-level degree called the PMHNP, or Psychiatric Mental Health Nurse Practitioner. This is a nursing degree rather than a full medical doctorate, and is considered a specialization within nursing. PMHNPs are also allowed to prescribe mental health medications.

The flip side of the coin here is that psychiatrists tend to be much less common than various kinds of psychologists and therapists. This is because the level of schooling necessary is higher, so it takes more time and more investment in medical school to achieve that level of practice.

Because of this, many psychiatric nurse practitioners and psychiatrists, while they can provide therapy services, may not actually do so. While it’s much more common for psychiatric nurse practitioners to provide therapy services, psychiatrists often do not, with around half of psychiatrists providing no therapy services at all.

Getting Medication Management from Therapy

If therapists and psychologists can’t prescribe medication, but psychiatrists don’t provide therapy, and you need both, what can you do?

Fortunately, this isn’t as much of a problem as it may sound.

The vast majority of therapists, social workers, and psychologists have partnerships with either medical doctors or psychiatrists who have prescription capabilities. If the therapist feels you may need a medication or that you may need your meds adjusted, they can reach out to a prescriber in the office to ask for an evaluation. The prescriber will then assess what is best for the patient related to medications.

Here at BMC-Troy, our staff of physicians and psychiatric nurse practitioners work collaboratively to manage medication alongside therapy and other treatment options.

What this means is that you don’t need to seek out and find a specific psychiatrist or doctor to manage medications, or even run messages between your therapist and your doctor. Your therapist will have their own connections and can communicate your concerns with your prescriber for you if needed. From there, an appointment would be scheduled with your prescriber.

Therapist or Psychiatrist: Which Professional Should You Seek Out?

The kind of professional you seek out depends on your specific needs.

People with anxiety, PTSD, depression, and substance use disorder frequently center treatment around talk therapy in its various forms. Psychological treatment options can target and address the underlying causes of harmful behaviors and thought patterns, and can help arm you with coping mechanisms to break out of negative thought patterns and move towards healthier thoughts.

At this level, you may not need medication. While you could still potentially benefit from low-dose medications, many people choose to put medication as a “last resort” and try to work through their issues with talk therapy first.

Unfortunately, medication tends to be stigmatized, and it does have potential side effects. For individuals who have concerns about potential side effects, their prescriber can further discuss and explain the most common ones to expect. Often times side effects are brief and not long lasting.

Seeking treatment from a therapist, counselor or psychologist can be a good first step to get you started on the path to recovery – they can work with you to help identify your specific issues and the coping strategies and treatment options that work best for you.

For cases where anxiety, depression, PTSD, or substance use disorder are more severe, or when they’re considered treatment-resistant, talk therapy alone might not be enough. Sometimes it’s a matter of brain chemistry, and no amount of coping strategies can alter your neurotransmitters on such a fundamental level. Other times, coping mechanisms alone aren’t enough, or there are physiological symptoms of addiction (in substance use disorder) that talk therapy alone can’t address.

In these cases, you have a choice. You can seek out a therapist, counselor, or psychologist, and they can work with you and your primary care physician or nurse practitioner, who can manage medications for you.

You can also seek out a psychiatric nurse practitioner or a full psychiatrist. PHMNPs in particular are the sweet spot for providing both talk therapy avenues of treatment and medication management, all from one individual.

Finally, there are other mental health disorders that may need a medication-first approach. In particular, disorders like schizophrenia and bipolar disorder, severe depression and anxiety, and physiological addiction all generally require medication to manage before talk therapy has a chance of working. In these cases, getting started with a psychiatrist or psychiatric nurse practitioner can be the right place to start.

The fact is, though, everyone in any mental health field wants the best for you. You can get an appointment to seek treatment with anyone, and they will help you if they can. If they feel that they aren’t equipped to handle your specific issues, they can refer you to someone who can.

Seeking Treatment at BMC-Troy

Here in the Detroit area, we’re proud to provide a wide range of mental health treatment in our office.

Our clinical services include:

• Individual therapy for everything from anxiety, depression, and substance abuse to ADHD, life transitions, grief, and more. Standard talk therapy methods like CBT, DBT, and psychodynamic and interpersonal therapy are all available, so we can offer you the method that works best for you.
• Augmented therapies that include alternative mechanisms, such as the eye movement in EMDR or the movements in Trauma Release Exercises, are also available through our office.
• Marriage, family, and group therapy options are also available for cases where your mental health challenges involve your relationships as well.
• Our physicians and psychiatric nurse practitioners, provide medication management right here in our office. We can review your existing medications or prescribe new medications as necessary to get you the help you deserve.

For an initial assessment and to get you on the path to treatment, or if you have any questions you’d like to ask, simply call our office at 248.528.9000 during business hours, and we’ll be happy to assist you. If you are interested in making an appointment for therapy or medication management, go to bmctroy.com under the electronic forms tab to complete the new patient paperwork. We will call within 1-2 business days to schedule an appointment.