When people ask me what I do, I am often asked what the difference is between a psychotherapist and other helping professions. This is a topic I am super passionate about having trained in coaching, counselling, social work, psychology and psychotherapy!
When it comes to psychology, for many years in Australia, funded psychological services have been monopolized by symptom focused, pathologising and medically orientated approaches. Whilst appropriate for some people, Medicare funded psychological interventions are often solution focused, mind-orientated and top-down approaches and are not suitable for everyone.
Increasingly, people are looking further afield than a GP mental health care plan and are choosing to pay privately so that they can have a broader range of choice regarding their preferred practitioner, treatment style and length of therapy.
The clients who come to my private practice are looking for a more holistic and soulful approach to their health and well-being as well as one which is evidence based and firmly grounded in western psychology and eastern spirituality.
Psychotherapist, counsellor, social worker, life-coach, psychologist, psychiatrist – what’s the difference?
There is an increasing base of evidence which confirms what practitioners and clients of psychotherapy have known for years – psychotherapy really does work.
Psychotherapy is ultimately about healing the relationship we have with our self, others and the world. The therapeutic relationship the client has with the therapist is considered the change agent. If we think in terms of a house as an analogy for the psyche, a psychotherapist helps with structural problems in the basement (it’s where we recover the split off and deeply buried parts and do our psychodynamic/analytic process), on the ground floor (it’s where we do our here, now and how work), and in the top floor and on the roof terrace (it’s where we do our transpersonal and spiritual work, if one is so inclined). Psychotherapists also work with transference and countertransference which means working with the clients’ attachment and dependency injuries in the here and now within the therapeutic relationship. This is primarily what sets psychotherapy apart from counselling and the other professions. Some psychiatrists are also trained in psychoanalytic psychotherapy although this isn’t as frequent as it used to be.
Clients of psychotherapy report healthy lifestyle changes after just a few sessions and many see a significant difference in their lives within three to six months. However, psychotherapy does tend to be more long-term work. It is a soulful approach to healing which provides long lasting change and resolution of the pervasive, underlying issues that continue to impact on life and relationships. Psychotherapy works best when sessions are consistent and attended weekly.
There are many different schools of psychotherapy (behavioural, psychoanalytic, humanistic, existential, somatic, transpersonal etc) and standards of psychotherapy training range from diplomas to Master’s Degrees. Although classically trained psychotherapists will have their core model, most practice integratively and by using a multitude of theories and creative techniques, as do the other helping professions.
Psychotherapists, who have had a classic and rigorous training, would have trained at degree level for at least four years and sometimes up to eight years. Psychotherapists trained at this level are also required to have a significant amount of their own personal therapy per year (approximately 40 sessions per training year) and usually group therapy throughout the duration of their experiential training. This means that they have ’walked the path’ similar to that which their clients will be journeying along. This is one of the most important aspects of any helping profession training. If you are seeking depth psychotherapy, choose a psychotherapist who is trained in psychotherapy. Psychotherapy in Australia is self-regulated which means unfortunately anyone can say they provide psychotherapy when in fact they may not be trained in this very specific discipline.
PACFA Registered Clinical Psychotherapists® in Australia are required to have a certain level of training, supervision, clinical hours and an additional case study under their belt before they are accredited. To join the College of Psychotherapy, they are also required to have at least 250 hours of personal psychotherapy with a trained psychotherapist.
Many professions are taught ‘counselling skills’, however, a specific counselling training typically starts with a diploma level and PACFA Registered Clinical Counsellors® are trained in counselling at degree level as a minimum. A minimum level of training is an important step for counsellors and psychotherapists to gain recognition and to be seen and treated on a par with psychology and social work.
Counsellors work in a wide range of fields and counselling prides itself on being a holistic model for emotional and relational health and wellbeing. In private practice, counselling often focuses on specific issues and tends to be more short-term work, from 6 sessions to 6 months, though not always, I know many counsellors who work long-term! They might visit the basement like psychotherapists do; however, they are not restructuring the psyche. The therapeutic relationship is key but it is not used in the same way that psychotherapists use it. Just like psychotherapy, counselling works best when it is consistent and attended weekly. Not everyone wants or needs depth psychotherapy so counselling is the perfect choice for those clients who want to work holistically and creatively.
There are different standards of training for counsellors. Some train in a diploma and some for up to four years and at Master’s degree level. The three main types of counsellors are:
- Registered Clinical Counsellors®
Whilst there may be some overlap, psychotherapeutic counsellors (a term UKCP use to distinguish between the types of counsellors) are able to work at greater depth, using the therapeutic relationship. This does not mean one type is better or worse, just a different way of working with a different type of client.
Some counselling programs require their trainees to participate in their own counselling and some do not. PACFA Registered Clinical Counsellors® in Australia are required to have a certain level of training, supervision and clinical hours under their belt before they are accredited.
A life coach works to help clients maximize their potential (all other professions do this too!). The coach’s job is to provide support to enhance the skills, resources, and creativity that the client already has (ICF).
Coaches can gain qualifications through short online courses or at greater depth through private coaching organisations. Coaches are not trained in counselling or psychotherapy skills – this means they are not trained to work with the ‘why’ of their client’s behaviour, rather, they are trained to work with the here, now and how to get better. Many psychotherapy, counselling and psychology trainings contain coaching components and in fact, coaching grew out of the transpersonal and positive psychology movements.
The ICF requires members to have a certain level of training, supervision and clinical hours under their belt before being accredited. You can read a more in-depth discussion about the differences between psychotherapy and coaching in my blog Everything you need to know about the difference between therapy and coaching.
Social work’s primary focus is on the social determinants of health. Social workers advocate for social change. They take a holistic view of health and well-being and they work towards maximizing human potential (AASW).
Social workers often work in the fields of child protection, family welfare, youth, women’s and refugee services, hospitals and increasingly in private practice. In Australia, a Bachelor of Social Work takes four years and students are not required to participate in their own clinical social work, counselling or psychotherapy sessions. Social workers often provide support counselling in private practice and for those who practice psychotherapy, they should have a post qualification in clinical social work or psychotherapy.
AASW registered social workers in Australia are required to have a certain level of training, supervision and placement hours under their belt before they are accredited.
Psychological theory underpins all helping professions. All of the above have elements of psychology within their training.
Psychology is predominately a medically orientated model which often focuses on diagnosis and symptom reduction of mental illness. Psychologists also use scientific methods to study the mind and human behaviours. They work in many fields: research, health and welfare services, government departments, academic institutions, education, corporations, marketing, training and development and in private practice (APS).
Many psychologists provide cognitive behavioural therapy. Psychologists often provide support counselling in private practice and for those who practice psychotherapy, should have a post qualification in clinical psychology or psychotherapy. Psychologists are not required to participate in their own clinical psychology or psychotherapy sessions.
Psychiatry is a medically orientated model. It involves the study of medicine and then training in mental and psychiatric illness. A psychiatrist can prescribe medication.
Training in psychiatry sometimes includes depth psychoanalytic psychotherapy, however, there is an ever increasing focus on prescription based psychopharmacology. If you feel that a psychiatrist is the professional best suited to you, find one who also specialises in talk therapy. Alternatively, participate in psychotherapy alongside taking medication – this will help get to the root of the problem.
The latest evidence shows that psychotherapy works better than medication alone for symptoms such as depression and anxiety.
NB. Training standards vary from country to country. Please check with the appropriate associations and federations for the requirements of where you live.
Photo by Taylor-Hernandez
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