Trying to work out who to see can get confusing pretty quickly.
Do I need a counsellor or a psychologist? Is a psychotherapist different from a counsellor? What makes someone a clinical psychologist? And where do coaches and psychiatrists fit into all of this?
There’s plenty of crossover between these professions, but there are also some important differences in their training, scope of practice and the type of support they provide.
So, let’s start with the short version.
By Anna, Beehyve Health
The long and the short of it
Therapist
A broad term for someone who provides therapy, rather than one specific profession. A therapist might be a counsellor, psychotherapist, psychologist or another health professional. It’s worth checking their actual qualifications, registration and experience
Coach
Helps you work towards goals, develop strategies and make practical changes. Coaching generally focuses on where you are now and where you want to go, rather than diagnosing or treating mental health conditions.
Counsellor
Helps you work through emotional, personal, relationship or mental wellbeing concerns. Counselling may explore both what’s happening now and experiences from your past, while helping you develop understanding, coping strategies and ways forward.
Psychotherapist
Similar to counselling, but often with a greater focus on deeper or longer-standing patterns, relationships, identity and how earlier experiences may be affecting you now.
Psychologist
A registered health professional trained in psychological science. Psychologists can work across many different areas, including mental health, therapy, assessment, behaviour, learning and neurodevelopment. What they do depends on their particular training, scope and experience.
Clinical psychologist
A psychologist with specific postgraduate clinical training. Clinical psychologists are trained in psychological assessment, formulation, diagnosis and psychological therapies. They are not medical doctors and don’t prescribe medication.
Psychiatrist
A medical doctor who has specialised in psychiatry. Psychiatrists can assess and diagnose mental health conditions, provide treatment and prescribe medication. Some also provide psychological therapies.
So, who should I see?
There isn’t necessarily one right answer, and you don’t need to start with the person whose title sounds the most specialised.
Start with what you need help with.
If you want practical strategies, help making changes or support working towards particular goals, coaching might make sense.
If you want support with something happening in your life, relationships, emotions or mental wellbeing, counselling may be appropriate.
If you want to explore longer-standing patterns, relationships or experiences in greater depth, you might consider psychotherapy.
If you need psychological assessment or want to work with someone trained in psychological science and psychological interventions, a psychologist may be appropriate.
If you need specialist clinical psychological assessment, formulation or treatment, you might see a clinical psychologist.
And if you need medical assessment or medication as part of your mental health care, a psychiatrist may be involved.
But these aren’t rigid boxes. There is a lot of overlap.
Sometimes the answer is also more than one person.
You might, for example, see a psychiatrist for medication and work with a psychologist, psychotherapist or counsellor for therapy. Or you might see a psychologist while also working with a coach on practical strategies in your everyday life.
Perhaps the most important thing
Find the right person for you.
Qualifications matter. Registration and professional accountability matter. Experience matters.
But so does the relationship you have with the person sitting opposite you.
It’s okay to ask:
What are your qualifications?
Are you registered or a member of a professional body?
Do you regularly work with people experiencing what I’m experiencing?
What approach do you use?
Why do you think that approach might be useful for me?
Is this within your area of expertise?
And it’s okay if someone isn’t the right fit.
You don’t have to absolutely love your therapist, psychologist, coach or psychiatrist. But you do need a relationship where you feel able to communicate, ask questions and work together.
The title tells you something important about someone’s training and scope. It doesn’t tell you everything about the person, the way they work or whether they’re going to be right for you.
Ready to take the next step?
If you’re ready to meet with one of our practitioners, get in touch with the Beehyve team and we’ll help you get started.
Want the longer version?
If that’s all you needed to know, you can stop here.
But the differences between these professions aren’t quite as clear-cut as a six-line summary might make them sound.
There’s crossover between counselling and psychotherapy. Not every psychologist does therapy. Not every psychologist is a clinical psychologist. And people with the same professional title can have quite different areas of experience and ways of working.
So, if you want to understand those differences a little better, here’s the longer version.
Coaching
Coaching generally focuses on helping someone make changes, work towards goals and find practical ways of doing things that work for them.
A coach might help you:
understand what is getting in your way
identify what you want to change
recognise and use your strengths
develop strategies and systems
build skills
work towards personal or professional goals
turn what you know about yourself into something practical.
The emphasis is generally on where you are now and where you want to go, rather than diagnosing or treating a mental health condition.
That doesn’t mean mental health or past experiences never come up in coaching. People aren’t that neatly compartmentalised. But a coach needs to recognise the boundaries of their own competence and know when something is outside their role.
The relationship should also be collaborative. A good coach isn’t there to tell you how to live your life. They’re there to help you understand what you’re trying to achieve and find approaches that make sense for you.
Counselling
Counselling is probably the term most people recognise when they think about talking to someone for mental health or emotional support.
Counsellors work with a wide range of things happening in people’s lives, including relationships, grief, stress, work, self-esteem, addiction and other emotional or personal difficulties.
Counselling can help you explore:
what you’re experiencing
how you’re feeling
things that have happened in the past
patterns that may be affecting you now
relationships
ways of coping
things you’d like to change.
It might be relatively short-term and focused on something quite specific, or it may continue for longer. There isn’t a set number of sessions that suddenly makes something “counselling”.
And counselling isn’t about somebody giving you advice or telling you how they think you should solve your problems.
The idea is to work together so that you develop your own understanding, resources and ways forward.
Psychotherapy
This is where the lines can start to look a little blurrier.
Psychotherapists also use talking therapies, and there can be significant crossover between psychotherapy and counselling.
Psychotherapy will often involve exploring not only what is happening, but also some of the patterns and experiences underneath it.
You might find yourself exploring questions such as:
Why do I keep finding myself in this situation?
Where did this pattern come from?
How have earlier experiences shaped the way I see myself or other people?
What happens in my relationships and why?
What would I like to be different?
Psychotherapy can involve exploring deeper-rooted emotional issues, childhood experiences, trauma, identity, relationships and longstanding behavioural or emotional patterns.
It may be longer-term, but that doesn’t mean all psychotherapy is long-term or that counselling can’t explore these same areas.
That’s one reason the individual practitioner’s training and approach matter as much as the label.
Psychology
“Psychologist” covers more territory than many people realise.
Psychology is the scientific study of behaviour, thinking, emotions and other aspects of how people function.
In New Zealand, psychologist is a regulated profession. Psychologists must be appropriately registered and practise within their professional competence and scope.
And importantly:
Not every psychologist is a clinical psychologist.
Psychologists work in different areas and scopes of practice.
Depending on their particular training, scope and experience, their work may involve:
mental health and wellbeing
psychological therapy
everyday problems and distress
relationships and families
learning and educational difficulties
psychological assessment
ADHD or other neurodevelopmental assessment
rehabilitation
organisational or workplace psychology
behaviour and performance.
That doesn’t mean every psychologist does all of these things.
So if you’re considering seeing a psychologist, it’s worth looking beyond the word psychologist and asking about their particular scope, training, experience and area of practice.
Clinical psychology
A clinical psychologist is a psychologist with specific postgraduate clinical training.
Clinical psychologists are trained to work with emotional, mental, developmental and behavioural difficulties using psychological assessment, formulation and diagnosis as well as therapeutic interventions.
Their work may include:
psychological assessment
formulation
diagnosis
psychological therapy
complex mental health difficulties
behavioural or developmental difficulties.
But it’s important not to turn this into a hierarchy where clinical psychologists deal with “serious” problems and everyone else deals with “less serious” ones.
That’s too simplistic.
Psychologists working in other scopes may also provide psychological therapy and work with mental health difficulties, depending on their training, competence and scope of practice.
Clinical psychologists are not medical doctors and don’t prescribe medication.
Psychiatry
Psychiatry is different because a psychiatrist is a medical doctor.
Psychiatrists complete medical training and then specialist training in psychiatry.
Because they’re doctors, psychiatrists can prescribe medication.
Their work can include:
assessing and diagnosing mental health conditions
considering physical and mental health together
prescribing and managing medication
developing treatment plans
providing psychological treatment.
And psychiatrists don’t only prescribe medication. Some also provide psychological therapies as part of their practice.
A psychiatrist may work alongside psychologists and other mental health practitioners, particularly where someone benefits from a combination of medical and psychological support.
There’s more crossover than the titles suggest
Perhaps that’s the real takeaway.
These professions don’t sit in six perfectly separate boxes.
A counsellor and psychotherapist might work quite similarly. Two psychologists may have completely different areas of expertise. A psychiatrist may incorporate psychotherapy into their practice. Someone might see one practitioner for assessment or medication and someone else for ongoing therapy or practical support.
That’s why asking“What do you actually do?” can sometimes tell you more than the letters after somebody’s name.
And if you’re not sure where to start, that’s okay too.
Understanding what you need help with is often a much better starting point than trying to work out which professional title you’re supposed to choose.
Ready to take the next step?
If you’re ready to meet with one of our practitioners, get in touch with the Beehyve team and we’ll help you get started.
