Karuna Psychotherapy and Counselling Harrogate

1. Home
2. Client Info
3. Fees
4. Therapy Contract
5. Articles
6. Downloads
7. Qualifications
8. Contact
9. Room Rentals

Differences Between Psychiatrists, Clinical Psychologists, Psychotherapists and Counsellors

Who is the best person for you?

So you think you may want to see someone about your depression, anxiety, insomnia…. Where do you go? Who do you see? Whilst I would always recommend you visit your GP as your starting point, for all sorts of reasons, perhaps you wish to find someone for yourself, people may enter therapy without really knowing who is the best person for them. This article explains some of the differences between psychiatrists, psychotherapists, psychologists and counsellors.

However, it is only intended to be used as a guide, there will be some psychotherapists who practice more like how I have described psychologists and vice versa, as there are many exceptions to the differences between the disciplines. Also this article only looks at the four main professions. However, in psychotherapy in particular, these are typically sub-divided according to the specific therapeutic approach they adopt, e.g. client-centred, psychodynamic, cognitive behaviour therapy (CBT) etc.. Nonetheless, I hope this is a useful starting point for those of you who know nothing about the therapy profession. If once you have gained some understanding of the general area, you wish to understand more about the specific psychotherapeutic approaches and which you feel may best suit you, some information is available in the different approaches in psychotherapy and counselling.

The field of mental health is a mine field. As a psychotherapist, one of the most commonly asked questions is what’s the difference between a psychologist, a psychotherapist, and a psychiatrist and what about counsellors? There are differences in relation to the background of the professional, the type of training each has received, the qualifications attained, where they are most likely to work, the methods of treatment and the type of therapy they employ. As a general rule of thumb, if you are in a hospital, you are more likely to be seen by a psychiatrist and have drug treatment, whereas if you’re receiving support in the community, this will most likely be from a counsellor or psychotherapist, and involve talking through your problems. However, remember that you can see a psychiatrist without being in a hospital, and you can see a psychotherapist whilst in hospital. The distinctions I have made are generalisations and should be used as a heuristic rule of thumb and not seen as definitions cast in stone. The descriptions of the four professions have been summarised in table 1 at the end of the article.

Psychiatrists

Psychiatrists have a medical background, training as doctors initially. This usually takes seven years, (five years taking a medical degree followed by two foundation years) and then six years specialising in psychiatry (see www.rcpsych.ac.uk for more information). Psychiatrists therefore typically take a medical approach, however some specialise in psychotherapy as part of their training and use a talking cure in addition. The patient (psychiatrists tend to talk of patients, whereas psychotherapists, psychologists and counsellors tend to talk of clients, unless the person is an in-patient in a hospital) tends to be diagnosed with a specific disorder based on the diagnostic criteria laid out in the diagnostic and statistics manual (for example, depression). Treatment is usually with psychotropic drugs (in this example, antidepressants) which are prescribed and regularly monitored. Psychiatrists tend to work in hospitals, people’s own homes, residential centres for older people or homes for people with special needs. They generally have large case loads and a limited amount of time with each person. Although as mentioned above, some psychiatrists qualify in psychotherapy and practice privately seeing patients weekly for approximately fifty minutes.

Psychotherapists

Psychotherapists, registered with the United Kingdom Council for Psychotherapy (UKCP) have completed a relevant undergraduate degree and taken four years post graduate training, usually part time in the first year before they see clients, looking at multiple psychotherapeutic approaches. They typically will have specialised in one specific psychotherapeutic approach throughout, for example, client-centred, or cognitive behaviour therapy (CBT) and focus their practice accordingly, for more information see www.psychotherapy.org.uk Most psychotherapists work either in primary care at the GP’s, or in private practice, although more are beginning to work in hospitals. Psychotherapists typically see clients for an hour a week. Psychotherapy tends to take a relational approach, with a strong emphasis on the therapeutic relationship which the client and therapist build with one another. From this relationship, clients unburden themselves of their problems and they search for solutions together. The psychotherapist may also teach the client strategies for helping them to cope in times of future stress and clients may learn to understand themselves better as a result.

Psychologists

There are many different types of psychologists, for example, clinical, counselling and occupational. However, for the purposes of this article I refer to clinical psychologists and not counselling psychologists although both provide support to people in psychological distress. Interested readers can find out more about the other areas of psychology from the British Psychological Society website at www.bps.org. Clinical psychologists have normally completed an undergraduate degree in psychology, and then specialised in clinical psychology completing three years full time post graduate training. Their training involves practice in several psychotherapeutic approaches (CBT, client-centred therapy and psychodynamic therapy). Psychologists are more likely than the other professions to use assessment tools, such as depression questionnaires in order to diagnose, or formulate, your problem. They may then devise a treatment plan based upon the diagnosis which typically targets symptoms, or specific problems. Psychologists, like psychiatrists tend to work in mental health teams, either in hospitals, or in the community. They usually see clients or patients for fifty minutes on an approximately weekly basis, although this to a large extent depends on resources and where the psychologist is practicing.

Counsellors

Counsellors typically gain accreditation through the British Association for Counselling and Psychotherapy (BACP). Counselling is still sometimes viewed as therapy for clients with less severe difficulties than psychotherapy and treatments received from the other professionals. However, in reality counselling and psychotherapy (whether received from a psychotherapist or a psychologist) are very similar. Nonetheless, it is to be expected that clients with more severe difficulties will enter hospitals and the higher number of the other professions in secondary care compared to counsellors reflects this emphasis. Counsellors can seek accreditation with BACP after two years post graduate training (rather than three years for psychologists, and four years for psychotherapists (see www.bacp.co.uk for further information). Their therapeutic approach is likely to be very similar to that of a psychotherapist, again with a heavy emphasis on the therapeutic relationship.

Table 1. Summary of the Differences