By Lydia Sterry | Submitted 2023
Clients often inquire about the differences between a psychologist, psychotherapist, counsellor, and psychiatrist. There are variations in the training and standards set by the professional bodies regulating these health professions. The following is a brief general discussion aimed at clarifying this confusion.
Psychotherapists
Psychotherapists usually work with their clients for months or even years and attempt to assist the client to experience some form of long term ‘change’ towards their presenting issues.
Psychotherapy can be seen as a developmental perspective in that it concentrates on how we change over time. The practice itself is increasingly supported and validated by well-known neurobiological research. This research highlights how certain parts of the brain are able to re-wire themselves during and after psychotherapy to assist change.
Psychotherapist is overall a broad term that encompasses professionals from different backgrounds who provide therapy to individuals, couples, families, or groups. Psychotherapists may include psychologists, licensed clinical social workers, licensed professional counsellors, or marriage and family therapists. They employ various therapeutic approaches to help clients address emotional difficulties, improve mental well-being, and develop coping skills. Psychotherapists may have different levels of education and training depending on their specific field.
Training
Psychotherapists usually range vastly in their qualifications from having a masters in Psychotherapy or a combined masters in counselling and Psychotherapy, to a tertiary degree, to simply having experience in the helping professions. Training for PSYCHOTHERAPISTS tends to involve concentrating on practicing psychotherapy concepts and this tends to continue throughout their profession.
It typically takes about 3 - 5 years and in addition to having a degree, you also need a minimum of 2 years of personal therapy. Lastly regular, (from monthly to two weekly) supervision by another experienced psychotherapist is compulsory.
Trainees are often taped whilst working with clients so that a microanalysis of their work can be done in order that they learn from closely scrutinising themselves. Other health professional training engage in this but it maybe with less intensity. Thus, self-awareness and an understanding of themselves are normally seen as a high priority before qualifying.
Standards
Legitimate qualified Psychotherapists are registered as CLINICAL members of an accredited ‘organisation’. They have an obligation to engage in a minimum of several hours a week of client contact, have regular supervision and undertake regular professional development in terms of reading, lectures, conferences and seminars. PACFA (Psychotherapists and Counsellors Federation of Australia) and ACA (Australian Counselling Associationi) are organisations to which most Counsellors and Psychotherapists in Australia are members of. Psychotherapists have to adhere to their standards by producing a certain amount of evidence each year to stay registered.
PACFA was especially created to promote professional excellence, to set clear guidelines for ethical behaviour and to set a minimum training standards for mental health professionals members.
Treatment methods
Psychotherapists are mostly trained in a number of theories such as Psychodynamic, Gestalt, Person Centred, Transpersonal, Existential and so on. The list is endless. Each theory though is very different as is each therapist qualified under these ‘sub’ psychotherapy headings. For example, two trained Existential Psychotherapist maybe experienced very differently by clients due to their unique style and different ways of ‘being’ towards another person. This is where it can get quite confusing and complicated.
There is an ongoing passionate argument about which theoretical modality, treatment or style is the most suited to a specific issue or person. However, many psychotherapists agree that the ‘therapeutic relationship’ is the most important part and is the basis for any type of therapy to flourish.
The norm therefore seems to be to ‘shop’ around for a Psychotherapist and ‘test’ out the different modalities or ‘treatment’ and styles available. Thus having brief chats with many therapists from a variety of backgrounds might be more beneficial before making a decision to commit to the sessions.
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Psychologists
Psychology can be defined as the scientific study of behaviour. Psychologists have a rigorous background in the scientific study of human behaviour and their training reflects a strong emphasis on validity of measures and reliable evidence of effective short term interventions and solutions. Some psychologists work as psychotherapists at times and tend to choose an integrated approach to assist their work for longer term clients. They may also specialize in areas such as clinical psychology, counselling psychology, or neuropsychology.
Training and professional standards
Psychologists typically undertake 4 to 6 years of formal tertiary study plus a prescribed number of years of work under professional supervision from another registered psychologist in order to qualify. It takes 4 years to register as a psychologist and 6 years with a master’s degree to be admitted to the A.P.S.(Australian psychology society) as a member.
An undergraduate degree in psychology has a strong experimental and research basis. In the third and later years, areas of study that reflect specialisations are undertaken, thus psychologists can be found working in areas such as; clinical and counselling psychology, industrial psychology, educational psychology, sports psychology, consumer psychology, community psychology, organisational psychology, forensic psychology, environmental psychology, experimental psychology and so on.
It is not a requirement for psychologists to have their own psychotherapy and to undertake regular clinical supervision or consultations to review their work with clients. However some do engage with supervision voluntarily and are increasingly recognising the importance.
Treatment
Clinical and Counselling psychologists usually provide psychological treatment from mainly a cognitive behavioural (CBT) orientation which is sometimes integrated with humanistic, client-centred and/or psychodynamic approaches. What does this mean? Its means the focus is mainly on an idea or theory of what could be ‘wrong’ with you and provides, in a directive and sometimes non directed way, step by step strategies on how you could make more positive changes.
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Psychiatrists
Psychiatrists are medical doctors who have undertaken extra training in mental disorders. They are qualified to diagnose mental health conditions, provide psychotherapy and prescribe medications (unlike psychologists, counsellors and psychotherapists). They often work with clients who have complex or severe mental illnesses and may collaborate with other mental health professionals to provide comprehensive care. Psychiatrists overall mainly provide medical interventions and prescribe medications. They may work in a number of settings such as; hospitals, prisons, and private practice. Other specialties include the medication management of schizophrenia, chromosomally induced mental disorders and legal work.
Training
Initially to train as a psychiatrist the individual must gain a medical degree followed by 5 years of psychiatric studies. Once an individual is qualified, regular professional development is discretionary. The professional organising body is the Royal Australian and new Zealand College of Psychiatrists (a psychiatrist is a Fellow of this body- FRANZP). This body maintains standards and guidelines for ethical behaviour.
Some psychiatrists work as psychotherapists at times but are not required to have had their own psychotherapy or to undertake regular supervision. However, more experienced psychiatrists may undertake regular supervision voluntarily. Psychiatrists like other mental health professionals employ a range of therapeutic interventions according to their detailed assessment of what they believe their patient needs.
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Counsellors
Counsellors tend to work with individuals, couples, or families to address emotional, mental, or behavioural issues. Counsellors often provide guidance, support, and practical advice to help clients cope with challenges, make decisions, and develop healthier coping mechanisms. They may specialize in areas such as substance abuse counselling, career counselling, or marriage and family counselling.
Training
Counsellors have very varied training, from a masters in counselling to a few weeks training by correspondence with an online training institute. At present in Australia any one can call themselves a Counsellor or a Psychotherapist without appropriate credentials. This is due to change in the future but until then it may be important to do a background check on the therapist you choose.
PACFA have been set up to protect the public with regard to the standards and ethical training that Counsellors and psychotherapists have to adhere to.
Overall, Counsellors tend to work in areas that are as broad and varied as those undertaken by psychologists, psychiatrists and psychotherapists. Contrary to what you might think, the main focus for Counsellors is NOT surrounded by ‘listening’ to the issues and supporting their clients. Yes, this is part of the work but it may involve many others techniques/theories and/or applications.
Lastly, seeing a Counsellor may involve short-term treatment/therapy for a particular problem. However, this could be extended into longer term therapy where more complex issues are explored, depending on the therapists training.
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Conclusion
It is probably wise to ask your mental health consultant about their; experience, training, supervision, own personal therapy and what type of therapy they favour, before you begin. Looking up the organisation to which they are affiliated with maybe a place to start, to verify whether they are registered with PACFA, ACA, APS or FRANZCP.
If you are contemplating some form of therapy, it may be better to have it with a ‘type’ of therapist who suits your style. Once a rapport is made, you have a good chance of progressivily working through your struggles. It's important to note that while all psychiatrists, psychologists, psychotherapists, and counsellors provide some form of therapy and support, their specific roles and responsibilities can vary depending on their chosen specialist field. Remember, any health professional who has had their own therapy, who seeks regular supervision and is able to separate their own issues from yours maybe worth considering.
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