Psychotherapist vs Psychologist vs Psychiatrist in Ontario: Who Should You See?
Three different professionals, three different colleges, three different price tags, and nobody explains up front which one you actually need. So people end up picking based on whoever had an opening, which sometimes works out and sometimes means six months before you find the right fit.
Here's the actual breakdown: what each profession is trained to do, what they're legally allowed to do, what they cost, and which one fits your situation.
What's the difference between a psychotherapist, a psychologist, and a psychiatrist?
The short version: a psychiatrist is a medical doctor who can prescribe medication, a psychologist is trained to assess and diagnose using specific testing tools, and a Registered Psychotherapist (RP) is trained specifically in delivering psychotherapy. All three can provide therapy. Only one can prescribe. Only one is generally covered by OHIP.
The confusion mostly comes from the word "therapist" getting used loosely for all of them, when it actually points to very different training paths and legal scopes of practice.
What is a psychiatrist, and what can they do?
A psychiatrist is a medical doctor (MD) who completed medical school and then a residency specializing in psychiatry. They're regulated by the College of Physicians and Surgeons of Ontario (CPSO), the same college that regulates every other physician in the province.
Because they're physicians, psychiatrists can diagnose mental health conditions, prescribe and manage medication, and provide psychotherapy. In practice, a lot of psychiatric care leans toward diagnosis and medication management, with talk therapy often handled by another provider working alongside them. Some psychiatrists do provide ongoing psychotherapy themselves, it depends on the individual practice.
Seeing a psychiatrist is covered by OHIP, typically with a referral from your family doctor. The trade-off is access: demand for psychiatrists in Ontario is high, and wait times for a new referral commonly run long.
What is a psychologist, and what can they do?
A psychologist holds a doctoral degree (or in some cases a master's-level registration as a Psychological Associate) in clinical or counselling psychology. In Ontario, they're regulated by the The College of Psychologists and Behaviour Analysts of Ontario.
Psychologists are trained in formal psychological assessment: standardized testing for things like ADHD, learning disabilities, autism, or diagnostic clarity in complex cases. They can communicate a diagnosis, which is a specific authority tied to their training. They cannot prescribe medication.
Psychologists also provide ongoing talk therapy, and many run full therapy practices without doing assessment work at all. But if you specifically need a formal diagnostic assessment, a psychologist is typically the right professional to ask for.
Private-practice psychologist sessions are not covered by OHIP. Typical fees in Toronto run $225 to $300 per session, reflecting the length of their training.
What is a Registered Psychotherapist (RP), and what can they do?
A Registered Psychotherapist is trained specifically in delivering psychotherapy, usually through a master's-level program in counselling or psychotherapy. RPs are regulated by the College of Registered Psychotherapists of Ontario (CRPO).
RPs provide the controlled act of psychotherapy: structured, ongoing talk therapy using evidence-based approaches (CBT, EMDR, attachment-based work, and others depending on the individual therapist's training). They don't perform formal diagnostic assessments or prescribe medication. Many RPs work with clearly diagnosed conditions and plenty who've never been formally diagnosed at all, since you don't need a diagnosis to benefit from therapy.
For most people looking for regular, ongoing talk therapy, an RP is the most common and often most practical fit. Private-practice RP sessions aren't covered by OHIP, but they're frequently covered under extended health insurance plans, and typically cost less than a psychologist. Toronto rates usually run $150 to $220 per session.
What about social workers?
Registered Social Workers (RSWs) with psychotherapy training are regulated by the Ontario College of Social Workers and Social Service Workers (OCSWSSW) and can also provide the controlled act of psychotherapy. Like RPs, they can't diagnose or prescribe.
What often sets social workers apart is a systems lens: training that considers your mental health alongside things like housing, income, family systems, or navigating other services. If your situation touches those areas alongside your mental health, an RSW can be a strong fit. Fees typically run $150 to $200 per session in Toronto, similar territory to RPs.
What is an RP (Qualifying)?
An RPQ (Registered Psychotherapist – Qualifying) has completed their master's-level training and met CRPO's requirements to register and practice. They're not "almost registered," they're registered, working under the RPQ category while they accumulate the supervised clinical hours required to transition to full RP status. Every RPQ case is also reviewed by a registered clinical supervisor, so you get two clinically trained perspectives on your care instead of one.
Interns are a separate category. They're in the final placement stage of their master's program, not yet registered with CRPO, and see clients under direct supervision as part of their degree requirements.
Both RPQs and interns typically charge less than fully registered clinicians, since they're earlier in their training and building hours, which makes either option strong value if cost is a factor. Our intern therapy page has current availability and pricing.
Psychotherapist vs psychologist vs psychiatrist at a glance
Psychiatrist
Training: Medical degree + psychiatric residency
Regulatory college: CPSO
Can diagnose: Yes
Can prescribe medication: Yes
Typical Toronto fee: OHIP-covered
OHIP coverage: Yes, with referral
Typical wait for a new client: Often long
Psychologist
Training: Doctoral degree (or master's-level Psychological Associate)
Regulatory college: College of Psychologists and Behaviour Analysts of Ontario
Can diagnose: Yes
Can prescribe medication: No
Typical Toronto fee: $225–$300
OHIP coverage: No
Typical wait for a new client: Weeks to months
Registered Psychotherapist (RP, RPQ)
Training: Master's-level psychotherapy training
Regulatory college: CRPO
Can diagnose: No
Can prescribe medication: No
Typical Toronto fee: $150–$220 (RPQ/intern: $50–$125)
OHIP coverage: No
Typical wait for a new client: Often days to a few weeks
Social Worker (RSW)
Training: Master's or bachelor's in social work + psychotherapy training
Regulatory college: OCSWSSW
Can diagnose: No
Can prescribe medication: No
Typical Toronto fee: $150–$200
OHIP coverage: No
Typical wait for a new client: Often days to a few weeks
Which one should you see?
You think you need medication, or you're already on it and need it managed. See a psychiatrist. Start with a referral from your family doctor, since that's typically the route into OHIP-covered psychiatric care. If the wait is long and you also want to start talk therapy in the meantime, that's not an either/or, you can do both.
You need a formal diagnosis or assessment, for ADHD, a learning disability, autism, or diagnostic clarity for something like a workplace or school accommodation. See a psychologist. This is really the one thing only they're equipped to do among the three, since it requires standardized testing tools specific to their training.
You want ongoing therapy for anxiety, depression, relationship patterns, trauma, grief, or just wanting to understand yourself better. See an RP, RPQ or a social worker. This covers the large majority of what people are actually looking for when they search for a therapist, and it's typically the most affordable route with the shortest wait to get started. If a systems lens (housing, income, navigating other supports) is relevant to your situation, lean toward a social worker; otherwise an RP (RPQ) is the more common starting point.
You want to start soon and cost is a real factor. Working with an intern gives you real, supervised clinical care at $50 to $125 per session, often with faster availability than a fully registered therapist's full caseload.
You can also always start with one and switch. A lot of people begin with an RP for general talk therapy, and get referred to a psychologist later if an assessment turns out to be useful, or to a psychiatrist if medication becomes part of the conversation. None of these are locked-in, one-time decisions.
What about cost and insurance?
OHIP covers psychiatrists. It doesn't cover psychologists, RPs, or social workers in private practice.
Most extended health insurance plans fill part of that gap, and many specifically list "psychotherapist" as a covered category, alongside separate coverage for psychologists. It's worth checking your specific policy before booking anywhere, since the wording and the number both vary a lot by employer.
Direct billing, where your therapist submits the claim to your insurer directly so you pay only the difference, isn't offered everywhere. Ask when you book if it matters to your budget.
Frequently asked questions
What is a Registered Psychotherapist? A Registered Psychotherapist (RP) is a professional regulated by CRPO in Ontario, trained specifically to deliver psychotherapy. RPs provide ongoing talk therapy but cannot diagnose conditions or prescribe medication.
Should I see a psychologist or a psychotherapist? See a psychologist if you need a formal diagnostic assessment. See a psychotherapist (RP) if you want ongoing talk therapy. Many people only ever need the second one, since a diagnosis isn't required to benefit from therapy.
Can a psychotherapist prescribe medication in Ontario? No. Only a psychiatrist or another physician can prescribe medication. If medication is part of what you need, start with a referral to a psychiatrist through your family doctor.
Is a psychologist or psychiatrist covered by OHIP? Psychiatrists are covered by OHIP, typically with a referral. Psychologists in private practice are not covered by OHIP, though many extended health insurance plans include psychologist coverage as a separate category.
Not sure which one fits your situation? That's a completely normal place to start. Book a free consultation with Feel Your Way Therapy and we'll help you figure out the right fit, whether that's with us or a referral elsewhere.
