Psychologists, psychotherapists, therapists, psychiatrists, counsellors… what’s the difference?

These terms are often used interchangeably… and a question I often get from clients and people generally is “What is the difference between a psychologist and a psychiatrist, and between a clinical psychologist and psychologist… and what is the difference between...”. 

A therapist is an umbrella term referring to psychologists, psychotherapists, and counsellors. Psychologists, psychotherapists, and counsellors are all licensed mental health professionals whom are trained in providing support to clients experiencing difficulties with mental health. The differences lie in the education or training, and the therapeutic approaches, that each therapist has. 

What is a counsellor? 

Counsellors can work with clients to help them better understand and improve their thoughts, emotions, and behaviours contributing to their present difficulties in everyday life. 

What is a psychotherapist? 

While counselling and psychotherapy can overlap, there is a slight distinction. A psychotherapist is more focused on helping a person understand parts of their self that may be contributing to some of their difficulties, in a deeper and more reflective way. Psychotherapy is typically longer in duration than counselling. 

Unlike psychology and psychiatry, counselling and psychotherapy are not regulated in Australia, meaning that anyone without training or skills can call themselves counsellors or psychotherapists. Whilst this is not ethical nor typical, it is not illegal. Most counsellors and psychotherapists have undergone extensive training and are registered with professional bodies that ensure a high level of qualification and expertise. Currently, one is unable to receive a Medicare rebate for seeking therapy from a counsellor or psychotherapist. For this reason, often their fees are typically lower than a psychologist. 

What is a psychologist? 

Psychology is the scientific study of the human mind and behaviour. Psychologists can provide the same support that counsellors and psychotherapists provide. Often psychologists will work with clients in a clinical setting (e.g., hospital) to assist with complex mental health conditions. 

Not all psychologists choose to provide support (e.g., therapy) to individuals or groups in public or private settings. Some psychologists go down the research and/or teaching path and hold academic positions at universities. 

All psychologists need to be registered with the Australian Board of Psychology (Australian Health Practitioner Regulation Agency; AHPRA). Psychology requires more extensive education than counselling and psychotherapy, with a minimum of six years of study and work experience. However, there are different pathways one can take to becoming a registered psychologist, such as undergoing further university study or by gaining experience in the workplace under supervised practice.

So what is a clinical psychologist? 

Clinical psychologists are trained in the assessment and diagnosis of mental health conditions and psychological problems. Clinical psychologists seek to develop an understanding of why and how a problem has developed. A clinical psychologist undertakes a two-year Master’s degree in the specialised area of clinical psychology after completing the required four years of study. 

The key difference between a registered and clinical psychologist is that a registered psychologist is someone who has completed four years of university study plus two years of supervised practice in a workplace setting. A clinical psychologist has undertaken a further two years’ post-graduate study alongside supervised clinical training. 

What is a psychiatrist? 

A psychiatrist is a medical doctor. Psychiatrists typically diagnose and treat mental health conditions primarily through the use of medication. Psychiatrists typically do not have specific training in providing therapy. However, some psychiatrists undertake further psychotherapy training  

So, which “talking therapist” should you choose? 

When seeking therapy from a mental health professional, it can be helpful to find out more information about their training and experience, as well as which psychological frameworks of therapy they use. But to give you some reassurance in what may be a difficult decision for some, what’s most important is not the training or expertise the professional has, or the framework they use… but the relationship between the client and therapist. Research shows that the therapeutic alliance (the relationship between therapist and client) is a key predictor of successful treatment outcomes. 

At the end of the day, what most of us need is to feel heard and understood. To feel validated. Humans have an innate need for connection. So when we feel validated, it has the profound power to reduce worries, calm fears, increase a sense of hope and optimism, and much more. So back to the question of which mental health professional to choose, I invite you to tune into the feelings you have when you engage with the therapist… how do you feel during the interaction with them, and how do you feel once you leave? Perhaps use these feelings to help guide you to whether it feels like the right fit for you to continue with them.