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Counsellor vs psychotherapist vs psychologist vs psychiatrist — who is best for you?

5 January 2022

Wondering what kind of mental health support would be best for you? Our quick guide will cut through all the jargon and help point you in the right direction...

Man in a therapy session with a male psychologist

Deciding to get mental health support is a brave and important step. Yet it can also be a confusing one as you could soon be faced with a dizzying variety of choices. For instance, should you see a ‘counsellor’, ‘psychotherapist’, ‘psychologist’ or ‘psychiatrist? Just what exactly is the difference between them all? And most importantly, what kind of support would be best for you?


To make things a little bit simpler, here is our guide to the different kinds of mental health professionals, the approaches that they take and the key accreditations to look out for...


What is a counsellor?

In general, a counsellor offers mental and emotional health support in a talk therapy format. Some specialise in a particular area like bereavement, while others offer more general support. Overall, a counsellor will work with you to identify any issues that are causing you distress, while also helping you to uncover solutions for dealing with them. Many counsellors offer Person-Centred Counselling, which is a client-led approach — the client brings whatever they wish to discuss and the counsellor listens with an accepting, authentic and empathic stance.


Counselling is often a free or low cost service offered either via the NHS, charities or community organisations. It is also usually a short term approach, often taking place between six to twelve weeks. Bear in mind that it may not always be the best option to deal with more serious or complex issues such as PTSD or psychosis (although this also depends on the individual counsellor’s training, experience and setting).


In the UK, a counsellor is someone who can have widely varying levels of training, sometimes only lasting a few days. It is advisable to look for a counsellor who has completed a training that has been accredited by the British Association for Counselling and Psychotherapy (BACP) or the United Kingdom Council for Psychotherapy (UKCP) as they will have completed a training of at least 450 hours plus around 400 practice hours. This could include a diploma level (often an evening per week for one or two years) or degree level (often a day per week for three or four years). 


Often, counsellors work on a fairly ‘immediate’ level, focusing on developing coping strategies for one particular issue that is affecting you right now, like depression, or simply listening and providing support. But if you feel that you would benefit from deeper, longer term or more specialised support, then you might want to consider some of the other options listed below.


What is a psychotherapist?

A psychotherapist will have a degree in psychology or a related subject like social work, medicine or nursing, as well as an accredited postgraduate qualification such as a Masters degree or equivalent — meaning they can have trained for years. They will also need to complete a number of hours of practice to gain their qualification. As with counsellors, anyone can call themselves a psychotherapist regardless of their training so it’s advisable to look for someone who is accredited — the key UK accrediting bodies for psychotherapists, depending on their approach, are BACP, UKCP, British Association for Behavioural and Cognitive Psychotherapy (BABCP) and British Psychoanalytic Council (BPC).


As a rule of thumb, aim to find a psychotherapist who is accredited (rather than registered) with the British Association for Counselling and Psychotherapy (BACP). After completing a BACP-accredited course, a therapist can apply to be on the BACP register. However, to be an accredited member, in addition to completing an accredited course, the therapist has to have been in practice for more than three years and provide evidence of their work so it can be assessed to meet the necessary standard. You can tell if someone is an accredited member as they will use these initials: MBACP (Accred). The UKCP does not make this distinction on their register — all members on it are considered to meet the necessary standard.


A psychotherapist might specialise in one particular therapeutic approach, such as Psychodynamic, Body-Focused or EMDR — having completed an in-depth training. Or they might have training in a number of different ones, such as Cognitive Analytic Therapy (CAT), Acceptance and Commitment Therapy (ACT), Cognitive Behavioural Therapy (CBT), Compassion Focused Therapy (CFT), Dialetical Behavioural Therapy (DBT) and Schema Therapy. They might also specialise in supporting couples, families, children or people with specific mental health issues. 


Psychotherapists who are trained in CBT, a talk and task-based approach that explores how your thoughts, emotions and behaviours all affect each other, tend to offer time-limited therapy, focused on a particular issue that’s causing difficulties at the moment. However, in general psychotherapists usually offer longer term support, particularly if the therapist has trained in psychodynamic or body-focused approaches. 


This means that you might go into more of a ‘deep dive’ than you would with a counsellor, exploring issues, traumas and unconscious drives that could have been building your whole life. For instance, a psychotherapist might (although not always) invite you to more fully explore your childhood to understand how early influences could be affecting your wellbeing today. Overall, they tend to look at how your experiences have affected things like your personality, perspective of the world and relationships with others. This could be explored through methods ranging from dream analysis to getting in touch with any trauma trapped in the body.

What is a counselling or clinical psychologist?

Counselling and clinical psychologists are similar professions with similar qualifications. In the UK, a counselling or clinical psychologist is someone who has completed a doctorate, which means that they will have trained for around seven years full time (undergraduate and postgraduate combined). Their training covers several different types of therapeutic approaches, assessment techniques, an understanding of the challenges people may have across their lifetimes and the completion of a research thesis.


After completing their training they must also be registered with the Health and Care Professions Council (HCPC) and many choose to be registered with the British Psychology Society (BPS). Counselling and clinical psychologists are both protected titles, meaning that no one can use them unless they have done the specific training. Clinical and counselling psychologists adhere to high professional standards which require ongoing training and professional development as well as regular supervision — discussing their work with an experienced colleague to ensure high quality interventions.


Like a psychotherapist, a counselling or clinical psychologist will work with you in exploring any psychological and emotional issues that might be affecting you. A key difference is that a counselling or clinical psychologist can provide an assessment and diagnosis of more serious mental health issues, such as personality disorders. They will also create a unique and tailored treatment plan for every person that they see, based on their ‘formulation’ of what’s happening — a suggested explanation that takes into account all the factors that may have contributed to the development and maintenance of the presenting issue. This means that they might be particularly helpful for people with complex or longstanding mental health needs or for people who are looking for an in-depth understanding of their issues and a therapy that’s tailored around them. It can also be helpful to people who want to understand themselves and their struggles better but not from the perspective of a psychiatric diagnosis. 


Another difference is that while a psychotherapist might use research and evidence-based practices, a counselling or clinical psychologist absolutely has to as a professional standard. Clinical and counselling psychologists are trained to be ‘scientist practitioners’ who evaluate the efficacy of their interventions. For this reason, they are unlikely to use non-conventional therapeutic approaches without a rigorous body of literature to prove their effectiveness.

What is a psychiatrist?

A psychiatrist is a medical doctor who tends to view mental health issues as medically diagnosable conditions. They might deal with more serious, long term mental health issues, such as psychosis. One of the key differences between a psychiatrist and the other professions listed above is that a psychiatrist can prescribe medication. Additionally psychiatrists tend not to have training in providing therapy, unless they have specifically done an additional psychotherapy qualification.


In the UK, a psychiatrist is registered with the General Medical Council (GMC), just like a GP or surgeon. They will have spent four years at medical school, followed by a one year internship and three years of training as a psychiatric resident. Overall, a psychiatrist is less focused on the therapeutic side of mental health support and more on diagnosis, medication and case management. Whereas counsellors, psychotherapists and psychologists will usually meet with people every week (or sometimes more) for therapy, appointments with a psychiatrist will tend to be every few months or as and when they are needed, often due to a crisis or deterioration in mental health. 


Hopefully, this guide has given you a better idea of the different types of mental health professionals available. Often, a good starting point is to consult with a psychologist or psychotherapist and go from there, because they are able to work with a range of presenting issues and complexities, but if your therapist thinks that you need a different type of support than they can provide, then they can refer you on. MTA offers quick access to psychotherapists, clinical psychologists and counselling psychologists. All are highly trained and fully accredited with recognised bodies such as the BACP.


Finally, we know that seeking support is a big step, so you might find our other posts on Finding the right therapist for you and Five reasons to try therapy useful. Just don’t be afraid to reach out and get help, no matter how daunting it might feel. Sometimes, a listening ear and a fresh perspective can make a big difference in working through the many challenges that life throws at us, both big and small.

Need someone to talk to? Connect with an experienced, world-class MTA therapist or psychologist today for an in-person, video or live chat appointment.

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