What is the difference between a counsellor, psychotherapist, psychologist and psychiatrist?
Many people are confused about the difference between these similar-sounding disciplines, so here is some information to help you understand. Bear in mind I wrote this some time back and training standards may have changed.
Counselling is a very generic term used to describe the process of discussion, assessment and treatment of a specific problem with a skilled professional. The counsellor listens empathically, reflects main themes and feelings and might even suggest strategies to deal with the problem or guide the person toward their own solution.
Psychotherapy encapsulates the basics of counselling but is focused on exploration of a problem as it pertains to an enduring issue in the person's life. The individual may seek to change an aspect of their personality, overcome a lasting problem and/or gain a deeper understanding of themselves.
Psychologists are behaviour scientists by training and are most likely to practice the Cognitive Behaviour Therapy form of counselling. They have the additional benefit of some sessions being eligible for medicare rebates if the person has a doctor's referral.
Psychiatrists are medical doctors with post-graduate psychology training. They can diagnose and prescribe medications for psychological disorders such as bi-polar and schizophrenia. Unlike a psychologist, a psychiatrist is a fully qualified specialist doctor, who has completed at least 13 years of medical education in medicine, surgery and psychiatry.
Training for the Different Kinds of Therapists
Counsellor training can vary widely. They may have completed a short training course by distance education or have attended a college for two years or more. Study will likely include looking at many models of counselling (e.g. Egan, Rogers, Alderian) and learning how to listen, provide non-judgemental feedback and, ideally, guide the client toward finding the best solution for their particular problem. To be certified, counsellors usually have to do a certain number of supervised clinical practice hours. This is where they will practice their skills under the guidance of a counsellor having many years of experience and training. You would need to check your counsellor's certification requirements to ensure this.
Psychologists attend university for four years covering a very broad range of subjects. They read a lot of research and learn how to conduct research. Undergraduate psychology is very theoretical and science focused, preparing the psychology student for further post-graduate specialization in several different branches of psychology (e.g., organisational, research, educational). It is not until their post-graduate years that a psychologist learns or practices counselling, and much of this happens on the job. Following two years of post-graduate study or 160 clinical hours the graduate becomes a registered psychologist and eligible to provide medicare-funded sessions. A clinical psychologist stays at university a further two years and attracts a higher medicare rebate.
Professional Standard Maintenance
To maintain registration a psychologist must complete 30 hours of professional development (workshops & seminars) and 10 hours of peer supervision, where they discuss clinical cases with other psychologists. They are not required to have any counselling of their own or individual supervision.
Therapeutic Modality
Most psychologists will use Cognitive Behavioural Therapy (CBT) as a basic therapeutic model but many go on to study further models such as Acceptance Commitment Therapy. These models are highly manualised and well-researched because they are step-by-step methods, and results are measured in terms of symptom relief.
Fees and Rebates
Medicare rebates are only available for 6-10 sessions a year and the person needs a mental health care plan from a doctor. You get this from your regular GP and will need to book a longer session to discuss the ongoing psychological issues for which you need the referral. Ultimately, this means you will need to have a preliminary psychological diagnosis of some form (e.g., Depression or Anxiety).
Professional Standard Maintenance
To maintain registration a psychologist must complete 30 hours of professional development (workshops & seminars) and 10 hours of peer supervision, where they discuss clinical cases with other psychologists. They are not required to have any counselling of their own or individual supervision.
Therapeutic Modality
Most psychologists will use Cognitive Behavioural Therapy (CBT) as a basic therapeutic model but many go on to study further models such as Acceptance Commitment Therapy. These models are highly manualised and well-researched because they are step-by-step methods, and results are measured in terms of symptom relief.
Fees and Rebates
Medicare rebates are only available for 6-10 sessions a year and the person needs a mental health care plan from a doctor. You get this from your regular GP and will need to book a longer session to discuss the ongoing psychological issues for which you need the referral. Ultimately, this means you will need to have a preliminary psychological diagnosis of some form (e.g., Depression or Anxiety).
Psychotherapists usually complete at least 2- 4 years of study, often on a particular model (e.g. Gestalt, Psychoanalytical, Jungian). Accredited training is intensively focused on a theory of personality and how disorders originate, coupled with training in specific interventions and the development of counselling skills. The governing organization of psychotherapists, PACFA, requires 350 hours of undergraduate training and 750 hours of post-graduate client contact for full registration (yes, that is 4.5 times more contact hours than a psychologist).
Psychotherapy training is so intensive because the therapist needs to be in a position to manage the innermost conflicts, emotions and deepest processes of the human psyche. This is not simple work that can be learnt from a training manual or in a weekend workshop. Psychotherapy deals with the deepest folds of the personality and recognises that symptoms in the client's life now can often be tracked back to deep wounds, splits in the personality, or trauma that occurred years ago. By virtue of the depth and scope of work, Psychotherapy is traditionally a long term venture.
Psychotherapy training is so intensive because the therapist needs to be in a position to manage the innermost conflicts, emotions and deepest processes of the human psyche. This is not simple work that can be learnt from a training manual or in a weekend workshop. Psychotherapy deals with the deepest folds of the personality and recognises that symptoms in the client's life now can often be tracked back to deep wounds, splits in the personality, or trauma that occurred years ago. By virtue of the depth and scope of work, Psychotherapy is traditionally a long term venture.
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Training Place Fees Medicare |
Psychologist
4 years university & 2 years post-graduate internship or masters degree, including a practicum (average 160 practical hours) doing some form of psychology work (recently these hours have raised considerably) University $160-$250, average is around $185 Yes, rebate for Registered Psychologist is $86.15, Clinical Psychologist $125.00 |
Psychotherapist
Usually 3-4 years part time. To join a registration organisation, 750 actual client counselling hours need to be completed. Private institutions (usually regulated). Some diplomas are conferred by universities. $90-$150, average $140 No, but some health funds might cover. |
Psychiatrist
Training in medical school 6 years. Post-graduate (hospital) internship 5 years University and Institution Up to or over $300 per hour Yes, specialist doctor rates vary. |
In summary
A psychologist may teach you skills and strategies in order to better cope with a problem; a psychotherapist will help you discover what is underneath the problem in the hope of healing or diminishing it and will also help you develop better coping skills to deal with life.
The psychologist learns a lot of their practical skills from a manual or training program or develops them on the job. A psychotherapist is required to learn through theory but also the experience of doing their own work and observing others engage in therapy.
There is no requirement for a psychologist to engage in any of their own therapy during or after training, or to undergo any personal supervision once they are qualified. Psychologists do, however, have to do 30 hours of supervised practice during the last 2 years of post-graduate training. Also, following registration, they must participate in 10 hours of peer supervision with other psychologists and do 20 hours of professional development (workshops, seminars etc.).
In order to maintain their credentials, a psychotherapist is required to work on their own issues during training and to attend regular supervision with a senior therapist (usually fortnightly) once qualified.
Clarissa's training meets the practice standards of a psychologist (four-year degree and two-year practicum) and she has completed over 450 hours in psychotherapy training. Clarissa updates her professional development in both fields regularly. She is a member of the Australian Psychological Society and The Australian Health Practitioners Regulation Association.
Read more about Gestalt psychotherapy here.
A psychologist may teach you skills and strategies in order to better cope with a problem; a psychotherapist will help you discover what is underneath the problem in the hope of healing or diminishing it and will also help you develop better coping skills to deal with life.
The psychologist learns a lot of their practical skills from a manual or training program or develops them on the job. A psychotherapist is required to learn through theory but also the experience of doing their own work and observing others engage in therapy.
There is no requirement for a psychologist to engage in any of their own therapy during or after training, or to undergo any personal supervision once they are qualified. Psychologists do, however, have to do 30 hours of supervised practice during the last 2 years of post-graduate training. Also, following registration, they must participate in 10 hours of peer supervision with other psychologists and do 20 hours of professional development (workshops, seminars etc.).
In order to maintain their credentials, a psychotherapist is required to work on their own issues during training and to attend regular supervision with a senior therapist (usually fortnightly) once qualified.
Clarissa's training meets the practice standards of a psychologist (four-year degree and two-year practicum) and she has completed over 450 hours in psychotherapy training. Clarissa updates her professional development in both fields regularly. She is a member of the Australian Psychological Society and The Australian Health Practitioners Regulation Association.
Read more about Gestalt psychotherapy here.
Explanation of terms
Supervision is the process of a therapist (psychologist, counsellor etc.) discussing client cases with a senior, more experienced therapist. Usually therapists take their more difficult or tricky client cases to supervision.
The supervisor will oversee the correct treatment of the client(s) and also deal with any issues the therapist might have in working with the client.
Supervision aims to ensure best practice standards and to support less experienced therapists in making the best treatment decisions for their clients. It also helps the therapist recognise other issues that can arise in the course of the therapeutic relationship, such as the issue of transference.
The supervisor will oversee the correct treatment of the client(s) and also deal with any issues the therapist might have in working with the client.
Supervision aims to ensure best practice standards and to support less experienced therapists in making the best treatment decisions for their clients. It also helps the therapist recognise other issues that can arise in the course of the therapeutic relationship, such as the issue of transference.
Transference is transfer of feelings (classically, of the clients parental figures onto the therapist) and counter-transference, where the therapist can unwittingly get caught in this same phenomenon and transfer feelings related to their family members onto the client.
Projection is similar to transference but relates to any characteristic of the client or therapist being transferred onto the other party.
In order to maintain a helping relationship, therapists need to keep their own thoughts, feelings and judgements from contaminating the treatment of their client. Supervision is a place for the therapist to deal with these and other issues that can and do arise in the context of the therapeutic relationship.
Projection is similar to transference but relates to any characteristic of the client or therapist being transferred onto the other party.
In order to maintain a helping relationship, therapists need to keep their own thoughts, feelings and judgements from contaminating the treatment of their client. Supervision is a place for the therapist to deal with these and other issues that can and do arise in the context of the therapeutic relationship.
