What does a psychologist do, what happens in the first session and how do they differ from a psychiatrist? Learn their roles, methods and what they do not do.
You open the booking page on your phone for the third time and close it again. For months you have felt a heaviness inside; your sleep is broken, and the things you used to enjoy no longer draw you in. A friend told you, "Go and see a psychologist," but your head is full of questions: What will happen when I go? Will they make me lie on a couch, give me tests, prescribe pills? Will they just listen and nod? The answer to the question "What does a psychologist do?" is quite different from the impressions we pick up from films and TV series. In this article I look at what a psychologist actually does, how they differ from psychiatrists and other professionals, what you will encounter when you go to see one and in which situations it may be helpful to get in touch.
What Does a Psychologist Do? A Short Definition
A psychologist is a professional who studies human behaviour, emotions and thought processes using scientific methods and uses this knowledge to improve people's quality of life. In Turkey, becoming a psychologist requires completing a four-year undergraduate psychology programme at university. A psychologist's training is grounded not in medicine but in the behavioural sciences.
Psychology is a broad field. It has many branches, from developmental psychology to social psychology, and from industrial and organisational psychology to cognitive psychology. In this article I focus on the area people are most curious about: psychologists who work directly with clients in mental health.
In this area, a psychologist's core job is to understand and assess the psychological difficulties a person is experiencing and to help them cope with these difficulties. To do this, they draw on conversation, scientifically researched therapy methods and, where needed, psychological assessment tools.
Psychologist, Clinical Psychologist and Psychiatrist: Who's Who?
These terms are often confused. Knowing the differences between them makes it easier to approach the right person.
Psychologist: Someone who has completed an undergraduate degree in psychology. The undergraduate degree provides a basic foundation; additional training and supervision are needed on top of it to practise psychotherapy.
Clinical psychologist: A psychologist who, after a psychology degree, has completed a master's degree in clinical psychology. They have received more comprehensive training in assessing mental health difficulties, administering psychological tests and psychotherapy. Most clinical psychologists also undertake long-term training in a particular approach, such as cognitive behavioural therapy, schema therapy or play therapy.
Psychiatrist: A doctor who, after graduating from medical school, has completed specialist training in psychiatry. They diagnose mental illnesses and arrange medication when needed. A psychologist does not prescribe medication; in situations where medication may be needed, they refer to a psychiatrist.
Psychological counsellor: A graduate of a Psychological Counselling and Guidance (PDR) degree. They work as school counsellors or in counselling centres.
Psychologists and psychiatrists are usually not alternatives to each other but complementary. For example, someone experiencing severe depression can benefit both from psychiatric assessment and medication and from psychotherapy. We looked at this in detail in the article on the difference between a psychologist and a psychiatrist.
What Does a Psychologist Do? Core Roles
The work of a psychologist in mental health can be grouped under a few main headings.
Assessment and clinical interview
A psychologist's first task is to understand you and the difficulty you are facing. To do this, they hold structured or semi-structured interviews: When did the problem start, how has it developed, how does it affect your daily life, have you experienced anything similar in the past, how are your family, relationships, work or school? This information helps to build a picture of the problem and set the direction of the work.
Psychological tests
When needed, a psychologist administers standardised tests that measure intelligence, attention, personality, mood or level of development. These tests are not an "exam" but scientific tools that complement observation and interviews. Each test has undergone validity and reliability studies and should only be administered by people trained in their use. They should not be confused with the entertainment quizzes found online.
Psychotherapy
The best-known part of a psychologist's work is psychotherapy. Psychotherapy is a process carried out in regular sessions within a particular framework, aiming to bring about change in a person's emotional, cognitive or behavioural difficulties. Although it may look like "just talking", behind it lies a structured theory, defined goals and techniques supported by research.
Psychoeducation
A psychologist gives you information to help you understand how your problem works. For example, explaining to someone with panic attacks how the body's alarm system works and why palpitations are not dangerous is an important part of reducing anxiety. Giving parents information about child development also falls under this heading.
Referral and collaboration
When needed, a psychologist collaborates with psychiatrists, neurologists, paediatricians, schools or social services. They do not try to solve everything on their own; they act as a bridge to help you reach the support that best fits your needs.
Preventive work
In schools, organisations or after disasters, psychologists also carry out work aimed at raising awareness, building resilience and identifying at-risk groups before problems emerge. The psychosocial support work carried out in the region after the 6 February 2023 earthquakes is a well-known example.
Where Do Psychologists Work?
The answer to the question "What does a psychologist do?" also depends partly on where they work. Places where psychologists in mental health are commonly found include:
- State and university hospitals: They carry out assessments, testing and psychotherapy in psychiatry clinics, and work with families in child and adolescent mental health units.
- Private practices and counselling centres: Appointment-based centres offering individual, couples, family, child and adolescent therapy.
- Rehabilitation and special education institutions: They work with children with developmental differences and their families.
- The forensic field: They may prepare expert reports for courts and work in prisons and in child protection.
- Organisations: In some companies they provide counselling and training as part of employee assistance programmes.
- Disaster and crisis settings: They join psychosocial support teams after disasters such as earthquakes and floods.
- Online platforms: They work by video call with clients living in other cities and abroad.
This variety also shows why it is important to ask which area a psychologist is experienced in when you approach them. The needs of a parent seeking support for their child differ from those of an adult client.
What Really Happens When You See a Psychologist?
The image we see in films and series of leather couches and a therapist who silently takes notes and asks, "How does that make you feel?" does not reflect reality very well.
The setting: Most psychologists' consulting rooms are calm spaces with two armchairs, or an armchair and a sofa. You sit opposite each other and talk. The rooms of psychologists who work with children contain toys, a sand tray and art materials, because children express themselves through play.
The first meeting: In the first session, the psychologist tries to get to know you. They ask why you have come, about the history of the problem and about your life in general. Practical matters such as the principles and limits of confidentiality, the length and frequency of sessions, fees and cancellation terms are also discussed. You can also ask the psychologist about their approach, their experience and how the process will unfold; these questions both reassure you and help you see whether it is the right fit. You can find detailed information about what happens in the first session and how to prepare in the article on the first therapy session.
Setting goals: After the first few meetings, the psychologist shares their assessment with you and you set goals together. Concrete goals such as "being able to speak up in meetings", "finding it easier to fall asleep" or "not shouting when arguing with my partner" set the direction of the process.
Later sessions: Sessions usually last 45–50 minutes and are most often held once a week. They include a review of the week, work on the agreed subjects and, where needed, small tasks to carry out between sessions.
Ending: When the goals have been reached, or the person has reached a point where they can move forward on their own, the process is ended by mutual agreement.
Let's say an engineer who has been unable to sleep for months because of pressure at work, and who is constantly tense and irritable, goes to a psychologist for the first time. In the first session he talks about his sleep, his pace of work, his family and his expectations of himself. The psychologist doesn't simply tell him to "reduce stress"; they propose a plan in which they will look together at the habits disrupting his sleep, the belief "I must do everything perfectly" and his body's state of alarm. A few weeks later, the engineer notices that for the first time he has been able to go to sleep without checking his work emails at midnight.
A psychologist doesn't give you a new life; they accompany you as you make more room within the life you already have.
What a Psychologist Doesn't Do
Some common misconceptions about psychologists can make people hesitant to get in touch.
- They don't prescribe medication. A psychologist does not recommend medication or write prescriptions. In situations where medication may be needed, they refer to a psychiatrist.
- They don't read minds. A psychologist cannot know everything about you without you telling them. They don't "figure you out" at a glance; they work with you in order to understand.
- They don't judge. They do not subject what you tell them to moral evaluation. Their aim is to understand you.
- They don't make your decisions for you. For major decisions about your life, they don't offer a ready-made answer; they help you clarify your options. We looked at this separately in the article do psychologists give advice.
- They don't share your secrets. Confidentiality is one of the core principles of the profession. There are exceptions only in limited situations, such as a serious safety risk, and these are discussed at the outset.
- They don't apply the same method to everyone. Every client's story, needs and pace are different; therapy is shaped around these differences.
What Methods Do Psychologists Use?
Psychologists use therapy methods based on different theoretical approaches. Some of the most common are:
Cognitive behavioural therapy (CBT): Focuses on the relationship between thoughts, feelings and behaviours. It helps a person notice unhelpful thought patterns and try out new behaviours. Its effectiveness in many areas, such as anxiety disorders, depression and obsessive-compulsive disorder, is supported by research.
Schema therapy: Focuses on deep patterns of belief and emotion that form in childhood and repeat in adulthood. It is used to work on long-standing relationship problems and personality patterns.
Play therapy: Based on children expressing themselves through play. In child-centred play therapy, the therapist follows the child's lead and offers a safe relationship.
Couples and family therapy: Looks at how a problem is maintained not only within the individual but within relationships and the wider system.
Beyond these there are other approaches, such as acceptance and commitment therapy, EMDR and emotion-focused therapy. Asking which approach a psychologist works with is a fair and appropriate question when you get in touch.
When Should You See a Psychologist?
You don't need to have a "serious problem" to see a psychologist. Getting in touch can be helpful in situations such as:
- Sadness, anxiety, anger or restlessness lasting several weeks,
- Marked changes in sleep and appetite,
- Noticeable difficulties with responsibilities at work, school or home,
- Recurring conflicts in relationships,
- Struggling to adjust to difficult life events such as a loss, a separation, a move or a job change,
- Concerns about a child's or teenager's behaviour, sleep, schooling or emotional regulation,
- Wanting to get to know yourself better and to grow.
These signs alone do not amount to a diagnosis, but they do suggest that talking to a professional could be valuable. If you are having thoughts of harming yourself or ending your life, in an emergency call 112 (emergency services) or go to the nearest emergency department.
If you are curious about how work with adults is structured, you can take a look at the individual therapy page.
Frequently Asked Questions
Do I need a referral from a doctor to see a psychologist?
You don't need a referral to see a psychologist in a private practice or counselling centre; you can book an appointment directly. In public hospitals, the process usually runs through the psychiatry outpatient clinic and may vary depending on how the institution works. Finding out the arrangements of the place you plan to go in advance makes the process easier.
Can a psychologist make a diagnosis?
A clinical psychologist can carry out a comprehensive psychological assessment through interviews and tests and form a clinical opinion. Making a formal medical diagnosis and arranging medication, however, fall within the remit of a psychiatrist. The two professions work together when needed.
Do psychologists work with children too?
Yes. Psychologists who work with children and adolescents use age-appropriate methods: with young children, play and drawing; with teenagers, work that relies more on talking but in a language that suits them. Meetings with parents also play an important part in this process.
Are online sessions as effective as face-to-face sessions?
Research shows that for many problems online therapy can produce results close to those of face-to-face therapy. Online sessions are a practical option in situations such as difficulty travelling, a demanding work schedule or living in another city. Even so, in some situations, for example when working with young children, face-to-face sessions may be preferred.
Bu yazı genel bilgilendirme amaçlıdır; tanı veya tedavi yerine geçmez. Yaşadığınız güçlükler için bir ruh sağlığı uzmanına başvurmanız önerilir. Acil bir durumda lütfen 112'yi arayın.
Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
Eğitimler
