Psychiatrist, psychologist, psychotherapist, psychoanalyst, psychopractitioner, therapist, coach… Today, faced with growing demand, the “psy” offer has exploded. It’s becoming increasingly complicated not to drown in this ocean of professionals with similar names.
Yet understanding these differences is essential: it’s hard enough to ask for help when you’re not doing well, there’s no point in prolonging the process by seeing the wrong professional.
This article aims to clarify all of this, explain the differences between them, and give you a complete explanation of what they do… and what they don’t do.
Table of Contents
The Psychiatrist
The psychiatrist is a doctor, so they have 6 years of general medicine + 4 years of specialization in psychiatry. They’re trained to make diagnoses and prescribe medications like antidepressants, anxiolytics, antipsychotics, sleeping pills, and can treat severe psychiatric conditions, even hospitalize you against your will if you’re a danger to yourself or others. Additionally, their diagnosis will be part of your medical record and will be visible to other doctors, and psychiatric diagnoses can potentially create biases that will negatively affect your future medical care.
If they haven’t done other training like psychotherapy or psychoanalysis, they’re not trained to treat you using specific therapeutic techniques. Their approach is therefore exclusively medication-based.
Reimbursement:
- Sector 1: 70% by Social Security (with referring physician), 30% outside care pathway
- Sector 2: partial reimbursement based on €39, excess charges at your expense
- You can consult directly, without referring physician approval
Average price:
- Sector 1: €55 (since December 2024), then €57 starting July 2025
- Sector 2: €60-120+ (free excess charges)
Session duration:
Between 10 and 30 minutes. They’re in high demand, often with very long waiting lists.
My opinion:
For me, the psychiatrist is a healthcare professional you should only consult if you need medical treatment: from experience, it’s better to leave diagnosis to psychologists whose sessions are longer and who are specially trained to do very comprehensive psychological assessments. In fact, they often work in tandem with psychiatrists for this reason.
Note: a psychological assessment is not a medical diagnosis that only a doctor can make.
Taking psychotropic drugs isn’t something to take lightly, and your diagnosis will be noted in your medical files that any doctor can consult, which can be very stigmatizing and potentially complicate your care for other issues.
That said, there are circumstances where certain psychotropic drugs can be necessary, even life-saving, like antipsychotics in cases of psychosis, mood stabilizers for severe bipolar disorders, antidepressants for very severe depression, or anxiolytics for acute anxiety attacks over very short periods.
If you think you need them, don’t hesitate to ask.
⚠️ Warning: If you tell a psychiatrist you feel suicidal, there’s a good chance they’ll hospitalize you against your will – with or without your consent. They have this power, and it’s perfectly legal. Medical trauma and psychiatric abuse are unfortunately studied phenomena that can severely worsen your condition.
The Psychologist
The psychologist holds a level 2 master’s degree in psychology, obtained after 5 years of university studies. This university training focuses on research, statistics, diagnostic evaluation, and psychological theories, but doesn’t include specific therapeutic training. Specializations are rather based on patient age (child, elderly) or on a particular field of activity (occupational psychologist, school psychologist).
This university training is excellent for understanding human functioning and making precise psychological assessments (which are not medical diagnoses), and that’s why these professionals often work in tandem with psychiatrists.
Reimbursement:
- “Mon soutien psy” contracted psychologist: 12 sessions per year reimbursed at 60% by Social Security (€30 reimbursed out of €50), plus 40% by your insurance. Since 2025, no prior approval from a referring physician is needed.
- Non-contracted psychologist: no Social Security reimbursement
- Psychologist at CMP (Medical-Psychological Center): 100% covered
Average price:
- “Mon soutien psy” contracted psychologist: €50 per session (€0 out-of-pocket with good insurance)
- Non-contracted private psychologist: €60-100+
- CMP: free (but very long waiting lists)
Session duration:
45-60 minutes generally
My Opinion
The psychologist, spending more than 10 minutes with their patient, is much better at making diagnoses than the psychiatrist. From experience, if they’re up to date on evidence-based care, they’re quite effective when it comes to understanding what’s wrong, and that’s why if you’re looking for medical care, I advise you to find a psychologist who works with a psychiatrist, and combine these two professionals. This will avoid wasting months, even years with a psychiatrist who only has 10 minutes to spare and basically plays darts with the DSM-5.
Additionally, many psychologists (but not all!) have completed their training with other specializations like CBT, EMDR, etc., so they’ll have real treatment skills that can help you, although it’s important to have care adapted to your unique case. A practitioner can be perfectly competent in their specialty but ineffective if that specialty isn’t suited to you: it’s like seeing a podiatrist for a toothache. Make sure your psychologist has the therapeutic training you need, because not all of them do.
⚠️ Warning: even though a psychologist can’t hospitalize you against your will, they can alert a psychiatrist or authorities if they believe you’re a danger to yourself or others.
The Psychotherapist
The title of psychotherapist is “protected” in France since 2010. To get it, you need a master’s in psychology (bac+5), plus 400 hours of training in clinical psychopathology, plus a 5-month internship.
Basically, it’s a psychologist with 400 additional hours of… psychology. The same thing they already studied for 5 years, but with even more theoretical psychopathology, diagnosis, clinical cases, and supervision. It’s a premium psychologist, basically. Just like the psychologist, they don’t learn specific therapeutic techniques unless they do additional training. They have knowledge about these different methods but aren’t trained to use them.
Reimbursement:
Same as psychologists
Average price:
€60-100
Session duration:
45-60 minutes
My opinion:
The psychotherapist is a psychologist who did one more year to… be a psychologist with an additional title. It’s French bureaucracy in all its glory: creating an extra degree to try to control people that changes nothing in practice but gives the illusion of specialization. In reality, you’ll get exactly the same thing as with a psychologist, just with a nice extra title. Of course, some then train in specific techniques, but that’s not guaranteed.
Note: You’ll also find “Psychotherapy Practitioners” (unprotected title) out there who do similar training but without the 5 years of university studies. The goal is to be able to circumvent the rules to use the word psychotherapy (because people know it and it sounds serious) without going through university.
The Psychoanalyst
Psychoanalysis is an old but very controversial discipline that requires several years of training (between 3 and 5 years), and having undergone your own psychoanalysis. It’s the only discipline that requires the practitioner to have done some self-reflection (which doesn’t guarantee quality but at least they made the effort). Additionally, a serious psychoanalyst has the obligation to be under continuous supervision: they must consult a training analyst (a shrink’s shrink) several times a year to discuss clinical cases, continue their personal work, etc.
A psychoanalyst can also be a psychologist or psychiatrist, but they’re not necessarily so. Several schools offer this training, and it’s not particularly regulated outside the requirements specific to each organization.
Why is it controversial? Because of its androcentric (even misogynistic) theories, its position on autism which is outdated and very harmful to concerned patients (autism is not psychosis!), and its omnipresence in medico-legal settings which has no place given that the approach is absolutely not scientific nor based on evidence-based care.
There are two main psychoanalytic schools in France: Freudians and Lacanians. The approach differs in theory but especially in session duration: a Freudian psychoanalyst does 45 to 50-minute sessions, while Lacanians don’t set session duration in advance, leaving it up to the analyst to end the session at any moment for greater impact. Thus, the duration is totally random, possibly even just 10 minutes, while the price, however, is not random at all, which obviously opens the door to all kinds of abuse.
Psychoanalytic therapy is known for its length: you need to count on 2 years minimum. It can happen face-to-face, and we talk about analysis when the patient is lying on a couch. This technique isn’t suitable for all profiles, notably for those with post-traumatic stress disorder, but normally the psychoanalyst will know if you’re a candidate for this and doesn’t impose anything anyway.
Reimbursement:
None
Average price:
€40-80
Session duration:
5-30 minutes (Lacanians); 50 minutes (Freudians)
My opinion
I became a psychoanalyst after training in many different approaches because, in my personal and clinical experience, psychoanalysts listen better than any other specialist. We’re specifically trained for this – to consider the patient as a whole person, beyond pathologizing diagnoses. That said, this doesn’t erase the damage that’s been done to the autistic community and continues to be done, since there hasn’t been any official position change yet.
Psychoanalysts aren’t necessarily trauma-informed and don’t have knowledge about neurodiversity unless they’ve specifically studied it or made it their specialty. They also lack specific training or protocols for domestic violence, psychological manipulation, eating disorders, addiction, and similar issues. If you’re seeking help for any of these problems, you absolutely need to ask about your psychoanalyst’s competence in these areas during your initial consultation. Don’t hesitate to find someone else if their experience doesn’t match your needs.
What psychoanalysis does exceptionally well is listening. A good psychoanalyst won’t judge you and will approach you with genuine respect and humanity. They should be open-minded and intellectually curious. If you want to talk things through, reflect on your life, and do some real introspection with skilled support, this is your person.
The Psychopractitioner/Therapist
These two terms are interchangeable, with psychopractitioner being used more and more because it’s classy and in France, the word therapist has been dragged through the mud by numerous criticisms of this unregulated field.
Because what defines the field is indeed this wild side: training and schools differ in seriousness and quality, and don’t have the appearance of seriousness of other titles.
And yet. Depending on the therapy in question and the therapist’s quality, they are by far the most effective. Technically, CBT and EMDR are therapies. They’re known and recognized worldwide for their efficiency. When this happens, the medical world does everything to appropriate them and monopolize access to them, thus, practicing EMDR in France is only possible for psychiatrists and psychologists, depriving many people of access to this care under the pretext of quality. Doctors tried to do the same for psychoanalysis, but Freud himself told them to get lost quite virulently in his book The Question of Lay Analysis (even though he was a doctor himself), explaining that doctors are the least qualified to practice psychoanalysis because they already think they know everything. Anyway, it’s always the same: when a therapy is truly effective and becomes famous, if access to its practice is restricted by doctors, it will be taught under other names, circumventing the problem.
Reimbursement:
None
Average price:
Generally between €50 and €100, but there’s a new trend of selling multi-session “programs” which can quickly reach thousands of euros in investment.
Session duration:
50 minutes to 1.5 hours for most practices, but impossible to generalize due to the multitude of approaches.
My opinion
I’m a psychopractitioner in NLP, Brainspotting, CBT, and I’ve done numerous trainings in various therapies. Personally, I don’t want to work in the medical world, but I think this war between different healers is ridiculous. We should be working together because we have the same goal: helping others.
The problem with non-regulation is non-regulation, meaning you have no quality guarantee. This doesn’t mean that quality isn’t there, nor that you’ll necessarily find it with psychiatrists or psychologists.
But the beauty of non-regulation is this freedom of exploration that’s responsible for all the therapeutic advances that exist today. All therapies without exception, including medicine and psychiatry, were once unregulated. Don’t forget that. And in regulation, there’s bureaucracy, protocol complications that are only there to give the illusion of authority. Regulation is not a guarantee of quality or effectiveness. It’s just an illusion to reassure you.
There are good and bad practitioners in all disciplines. The key is finding the method and therapist that suit you and help YOU.
Coach and personal development
Personal development is a field focused on self-improvement and life optimization, but it doesn’t treat clinical conditions or specific psychological problems. It’s meant to help with everyday challenges like productivity, goal-setting, or interpersonal skills – basically life coaching rather than therapy. Coaches are the main practitioners in this space.
Sessions aren’t reimbursed of course, and the price varies, from a hundred euros to thousands, even tens or hundreds of thousands for the most famous coaches. Just like the price, session duration depends on the coach and their particular method.
⚠️ Warning: Anyone can call themselves a coach – there’s no regulation. Some have followed serious and recognized training in specialized schools, others became self-proclaimed coaches after reading a few books. The best coaches have recognised degrees in the field and solid training, but this isn’t guaranteed by the title. There’s a wide variety of coaches: life coach, work coach, relationship coach, sports coach, nutrition coach, etc. It’s up to you to verify their training and experience before committing.
My opinion
Coaches can be really valuable if you want support in improving your life. It’s a modern approach that I think makes a lot of sense. They’re there to motivate you, encourage you, and help you become more effective and comfortable with yourself.
The only downside is when coaches try to play therapist without the proper training – there’s an important difference in approach. But if you don’t have specific issues to work through and just want to enhance your quality of life, a coach could be a great fit.
Conclusion
And there you have it! So we have the psychiatrist (maximum regulation, exclusively medication-based approach), the psychologist (regulated but with limited tools without additional training), the psychotherapist (a glorified psychologist), the psychoanalyst (controversial but humanistic), the psychopractitioner or therapist (unregulated but potentially excellent), and finally the coach (non-therapeutic approach).
I hope this article will help you find some clarity in this therapeutic swamp, and allow you to find the practitioner who’s right for you.