24 June 2022 Written by Tracy Shirvill
It can take a lot of courage for someone to ask for help, especially when it comes to mental health. Looking through the therapist directory on Psychology Today you will see listings for counsellors, psychologists, and psychotherapists. If you have ever seen these titles and been confused, you are not alone! Unfortunately, even for us working in this space it can be confusing. Depending on where in the world you are reading this from, some of the titles used by therapists may have clear-cut definitions. Mostly though some titles are used interchangeably. For this article, the descriptions I use relate primarily to Australian practitioners.
The difference between the different mental health practitioners can be viewed as a scale of support. At one end are psychiatrists, counsellors at the other and everyone else in between. Each space is important and has its own level of education and area of practice. Here is a brief description of each:
Psychiatrists[1]: are medical doctors who have completed additional training to specialise in mental health. They are the only mental health practitioners who can prescribe medication. Most people will not need to see a psychiatrist, but your GP may recommend doing so if they believe that you would benefit from a mental health diagnosis, your symptoms are severe or complex, and you may benefit from medication.
Clinical Psychologists[2]: are psychologists who are experts in mental health. They have completed at least 8 years of training, giving them an extensive knowledge of mental illnesses. Often working closely with psychiatrists and other health professionals, clinical psychologists also diagnose mental illnesses, assess levels of psychological distress, and offer treatment plans for short- and long-term health goals.
Psychologists[3]: generally, it is this area where people start to get confused about who is who. Psychologists in Australia complete a 4-year training program, being the minimum requirement to join the Australian Psychological Society (APS). Psychologists can choose to practice general psychology or continue into post-graduate training, often specialising in a particular area of psychology, such as neuropsychology or forensic psychology. Full membership of the APS requires at least 8 years of psychological training.
Psychotherapists[4]: psychotherapists work with their clients to improve their emotional, mental, spiritual, or relational health primarily using talk therapy. They often have at least a Bachelor’s degree, membership with a registered body such as PACFA, and abide by a code of ethics. While there is some discussion over the differences between psychotherapists and counsellors there are certainly overlaps in the services they provide to clients. Things can get confusing though, as psychiatrists who conduct talk therapy with their long-term clients also refer to themselves as psychotherapists. While this mostly occurs in other countries, you may see psychiatrists in Australia offering psychotherapy.
Counsellors[5]: the title ‘counsellor’ and ‘counselling’ is possibly the most confusing category. The reason for this is that counsellor is not a protected title in Australia, meaning that almost anyone can call themselves a counsellor, and counselling is essentially what all these categories do to some extent. It is not uncommon for 4-year qualified psychologists to advertise themselves as counsellors, as counselling is their primary focus. If you are seeing a counsellor under a mental health plan in Australia, then your therapist is a psychologist.
When I say that anyone can call themselves a counsellor, I unfortunately do mean anyone. There is currently no legal requirement for a person to hold a counselling qualification to call themselves a counsellor. The primary governing body for counsellors is the Australian Counselling Association (ACA). The ACA require a minimum of a diploma for their level 1 membership. Members of the ACA often refer to themselves as a ‘Registered Counsellor’ to denote their membership status and are also bound to a code of ethics. If you see someone advertising counselling services who does not also advertise their training and professional membership status, it is best to look for a counsellor who does.
Registered Counsellors do not diagnose mental illnesses and are not trained to manage complex mental health treatment plans. Similarly to psychotherapists, counsellors use evidence-based approaches such as cognitive behaviour therapy to provide a holistic service which assists clients to address the issues they are experiencing. While counselling is generally considered to be short-term, or up to 12 sessions, it can also be ongoing.
It is important to note that whether someone is a psychiatrist or a counsellor, they are required to complete annual professional development, clinical supervision, and abide by codes of ethics and the law.
Still confused? That’s ok. While it is good to be informed, it is our responsibility as therapists to guide you to who you need to see. Some people will even see all of us at one point or another. A general rule of thumb is to consult with your GP. They will let you know if you need a psychiatrist or counselling. If you are still unsure, counsellors and psychotherapists will always provide a free initial call to answer your questions, and refer you to an appropriate service if required.
[1] See www.yourhealthinmind.org/psychiatry-explained/what-s-a-psychiatrist
[2] See www.acpa.org.au
[4] See www.pacfa.org.au
[5] See www.theaca.net.au
