A PsyD (Doctor of Psychology) is a doctoral degree focused on clinical practice—training psychologists to diagnose, assess, and treat mental health conditions in real-world settings. If you've seen this credential after a therapist's name and wondered what it means for your care, here's what you need to know.
Both PsyD and PhD psychologists are doctoral-level clinicians. The main difference is emphasis: PsyD programs prioritize direct clinical training, while PhD programs emphasize research. Both routes produce highly qualified psychologists—but the PsyD path is specifically designed for practitioners who'll spend their careers treating patients, not running labs.
This matters because the type of training shapes how a psychologist approaches your care. Let's break down what that actually looks like.
PsyD vs. PhD: What's the Real Difference?
Here's the distinction that matters:
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PsyD programs train you to be a practitioner first. Clinical hours, supervised therapy, assessment training, and complex decision-making are the core of the curriculum. Many PsyDs accumulate upwards of 5,000 hours of supervised clinical hours before licensure. Research is an integral part of the curriculum and is applied to clinical work—focused on evaluating treatment outcomes and understanding what works in practice.
- PhD programs train you to be a researcher/scholar first. The emphasis is on conducting original research, publishing studies, and advancing the science of psychology. Many PhD psychologists do extensive clinical work, but the training is built around generating new knowledge, not primarily delivering care.
Both are rigorous. Both lead to licensure. But if you're looking for a clinician whose training is centered on the lived experience of sitting with patients—understanding patterns, navigating complexity, and applying evidence-based treatments in the messy reality of people's lives—that's what a PsyD degree is built for.
What Does Doctoral-Level Training Actually Add?
Most mental health care in the U.S. is delivered by master's-level clinicians—licensed social workers, counselors, and marriage and family therapists. They're a vital part of the system, and most are excellent at what they do.
Doctoral training builds on that foundation in specific ways that matter when problems are complex, chronic, or high-stakes:
1. Deeper Assessment and Diagnostic Precision
Psychologists receive extensive training in differential diagnosis—the ability to distinguish between overlapping conditions and understand how they interact. Is what you're experiencing 'just' anxiety, or is it also tied to unprocessed trauma, ADHD, sleep disruption, or a medical issue? Are depressive symptoms primary, or are they secondary to chronic substance use or relationship patterns?
This is never about slapping a label on you. While the DSM-5—the diagnostic manual used by the medical field to categorize mental disorders through discrete symptom clusters—can be a useful tool, it's also highly limited and often problematic when attempting to understand an individual in the context of their unique life. Clinical psychologists work with, but beyond, the DSM-5 to provide truly personalized care that isn't limited to symptomology. It's about understanding the whole system—so treatment targets the right things at the right time.
2. Handling Complexity Without Getting Lost
Most people seeking therapy aren't dealing with one clean issue. They're dealing with combinations: panic attacks and social withdrawal, perfectionism and burnout, addiction and shame, relationship conflict and avoidance patterns.
Doctoral training prepares psychologists to hold multiple threads at once—zooming out to see the bigger picture while staying grounded in what needs to happen this week. It's the ability to work with ambiguity, contradictions, and evolving presentations without losing the plot.
3. Evidence-Based Treatment, Not Just Support
Therapy isn't just a supportive conversation. At its best, it's a method—an intentional process based on what research shows actually produces change.
Psychologists are trained to know the difference between approaches that have strong evidence and those that may sound appealing but lack backing. More importantly, they're trained to translate that science into practical steps you can take in your actual life—not just talk about problems, but actively work to change them.
4. Clinical Judgment Under Pressure
One of the less visible aspects of doctoral training is learning to make sound decisions when the path forward isn't obvious: navigating safety concerns, coordinating with physicians or psychiatrists, knowing when to involve family, recognizing when someone needs a higher level of care, and managing risk without either overreacting or missing warning signs.
Why Specialization Matters More Than Credentials
Here's something worth understanding: credentials tell you the level of training. Specialization tells you depth in the specific problem you're facing.
A lot of therapy is marketed broadly—'anxiety, depression, stress.' And sometimes general support is enough. But when problems are persistent, intense, or interfering with your ability to function, the quality of care often comes down to whether your therapist has real expertise in that specific area.
Two examples from our practice:
OCD Isn't Just 'Bad Anxiety'
OCD involves a specific cycle: intrusive thoughts → distress → compulsions or avoidance → temporary relief → stronger OCD. Generic anxiety treatment often makes OCD worse because it focuses on reducing distress rather than breaking the cycle.
Specialized OCD treatment—like Exposure and Response Prevention (ERP)—requires precision, confidence, and a willingness to guide exposure work rather than just provide reassurance. It's not about being 'tough' on clients. It's about understanding the mechanism well enough to help someone stop feeding the disorder.
Dr. Lindsey Salerno specializes in this work—trained at the University of Pennsylvania and certified in ERP and trauma-focused approaches. [Learn more about Dr. Salerno's approach to OCD treatment]
Co-Occurring Substance Use and Mental Health
When substance use overlaps with depression, anxiety, trauma, or identity-level shame, progress rarely comes from treating one symptom in isolation. Add family dynamics—complex patterns, mistrust, conflict cycles—and the work becomes even more layered.
This kind of care requires understanding relapse patterns, working with ambivalence, navigating family systems, and treating the whole person and family in context—not just the substance use or just the mood disorder.
Dr. Patrick Mullen has built his career in this space—leading integrated treatment programs and working with individuals and families navigating co-occurring conditions. [Learn more about Dr. Mullen's approach to substance use and family therapy]
Training Doesn't Stop at Licensure
Becoming a licensed psychologist requires years of supervised clinical work—typically 3,000 to 4,000 hours at minimum depending on the state. After licensure, psychologists are required to complete continuing education to maintain their license.
But beyond the formal requirements, the best clinicians keep learning: consultation groups with other specialists, advanced training in specific treatment models, ongoing supervision in complex cases, and staying current as the field evolves.
That ongoing development is part of what keeps clinical work sharp, especially in complex areas like trauma treatment, OCD/ERP, family systems, and addiction care—where methods continue to be refined and improved.
Frequently Asked Questions About PsyD Psychologists
Is a PsyD a 'real' doctor?
Yes. A PsyD is a doctoral degree—the same level as a PhD or MD, just in a different field. PsyD psychologists earn the title 'Doctor' and are fully licensed to practice independently. The training involves 6-7 years of graduate coursework, thousands of hours of supervised clinical work, comprehensive exams, and a doctoral dissertation.
Can a PsyD prescribe medication?
Not in most states. Psychologists (both PsyD and PhD) are not medical doctors and generally cannot prescribe medication—though a few states (Louisiana, New Mexico, Illinois, Iowa, Idaho, and Colorado) allow psychologists with additional specialized training to prescribe.
That said, clinical psychologists receive extensive training in psychopharmacology, which helps them understand how medications work and communicate effectively with psychiatrists and other medical providers about treatment. While psychologists don't provide medical advice on specific medications or dosing, they often collaborate closely with physicians when medication is part of treatment. Some patients benefit most from a combination of therapy and medication, and a good psychologist will help coordinate that care.
Do PsyD psychologists take insurance?
It depends on the practice. Few psychologists are in-network with insurance companies, while many operate out-of-network and provide superbills for reimbursement.
Commonhealth operates as a direct-pay practice so that care is guided by clinical need rather than administrative constraints. Working outside of insurance allows us to avoid diagnosis-driven treatment requirements and rigid structures that can interfere with thoughtful, responsive care. It gives us the flexibility to work with greater depth, continuity, and collaboration, especially when care involves complexity and lasting change.
While we operate out-of-network, we provide detailed superbills so clients can submit for reimbursement. Many people find they get better out-of-network reimbursement rates for doctoral-level care. Our fees reflect the level of training, time, and clinical expertise involved in this work. And we're always happy to discuss this during a free consultation to help you understand your coverage.
What's the difference between a psychologist and a therapist?
'Therapist' is a general term for anyone providing mental health 'therapy'—this can include psychologists, social workers, counselors, and marriage and family therapists. 'Psychologist' is a specific protected title for someone with doctoral-level training (PhD or PsyD) who is licensed to practice psychology. All psychologists can be therapists, but not all therapists are psychologists.
Sometimes a distinction is made between 'counseling' and 'psychotherapy,' with the latter being more intensive, longer-term work focused on deeper psychological issues and personality patterns, while counseling tends to be shorter-term and focused on specific problems or life transitions. However, today these terms are often used interchangeably.
At Commonhealth, what matters most isn't the label but rather what each person needs. Whether treatment is short-term and problem-focused or deeper and more complex depends entirely on the individual's present needs and context. Our model matches clients with personalized care that addresses the whole picture of their life.
The Commonhealth Approach: Treating the Whole Person
At Commonhealth Psychological, we take a whole-person view. That means we don't just focus on symptoms in isolation—we look at how your mind, body, relationships, sleep, physical health, and daily routines all interact.
Our approach is:
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Direct and collaborative. We're not here to keep you in therapy forever. We're here to help you build traction—stability, function, connection, and a life you can actually live.
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Evidence-based. We use treatments with strong research backing: CBT, ERP for OCD, trauma-focused therapy, ACT, mindfulness-based approaches, and family systems work.
- Practical. We help you engage with the real world—your relationships, your work, your community, your physical health—not just process feelings in a therapy room.
Whether you're struggling with OCD, anxiety, trauma, substance use, or navigating a major life transition, we're here to help you get unstuck and move forward.
Not Sure If We're the Right Fit?
We get it—choosing a therapist is a big decision. That's why we offer free phone consultations where you can talk with a clinician, discuss your needs, and see if our approach makes sense for you.
No pressure, just a conversation about what you're dealing with and whether we can help.
Schedule a free consultation or call us at (267) 270-2118.
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