If you’re relatively new to therapy it can be a little confusing as to who a therapist is, or what kind of therapist you need. Some forms of therapy are miles apart in their outcomes and what they can offer in terms of therapy.
Before delving into this topic it’s worth noting that some of the roles have changed over the years. I became aware of this during my studies in counselling and I surprised myself that most “classic therapists” from the 1960s like Aaron Beck, Albert Ellis, David Burns and Eric Berne were all psychiatrists. Their main focus of treatment was psycho-social talk therapy – this is something that is rarely seen in modern treatment of addiction or mental health. The main treatment in modern psychiatry a hark back to the bio-medical-model where medicine is the main tool, psychiatrists rarely include talk therapy unless it’s basic interventions that are very brief.
Psychiatrist is a medical doctor, meaning they have a medical degree and are able to prescribe medication. As stated above psychiatry has changed, evolved and devolved over the decades. As you may guess I have a rather cynical tone when mentioning psychiatry. Modern psychiatry is quite at odds with the work I have committed myself to. Modern psychiatry is the intellectual pursuit of right person for the right drug, then when they’ve made that match they will warehouse the patient’s hopes, dreams, ambitions, functionality and as long as they’re not killing themselves then a job well done!
Modern psychiatry unbeknown to the general public, has back-peddled from the early 2000’s to a “bio-medical-model”, the staple of 19th century medicine and treatment. That all disease and ills come from changes in the structure of tissues, and the only person responsible for help with that is a doctor with medicine or surgical ability. This isn’t a completely bad idea at heart, but when it becomes the only aspect treating mental illness and addiction it is certainly problematic.
It was very much surpassed by George Engle’s bio-psycho-social model in the 1970’s, which looks at the whole of a person’s systems and structures (or lack of) rather than which tissue is swollen today?
One terrifying aspect of Psychiatry is in countries like the UK they are the gate-keepers of services for the NHS, if you don’t like swallowing pills and toughing it on your own you’re going to be pushed to find answers here.
Counsellor (British spelling), a counsellor typically is someone in the UK who is trained to either higher-diploma, bachelors or masters degree level. Unlike the USA not every counsellor is “licenced”, most who use that name should be “accredited”. The USA laws on counselling and psychotherapy are very different, in the USA “licenses” to practice are state by state based and some are not transferable.
In the UK counsellors are strictly talk/art/dance/experiential based therapists, they do not give out medication and do not diagnose mental health conditions. There have been some talks about counsellors being given some specialist training in order to prescribe anti-depressants – akin to methadone prescriber roles.
Counsellor’s roles traditionally are to be roughly about 90% listener and 10% talker, however some counselling like addiction counselling and cognitive behaviour therapy the counsellor may talk a lot more in order to help a client design behaviour changes or problem solve.
Counsellors tend to work with people who have disorders in their life, however some counsellors use positive psychology in order to help those who are languishing in life.
In the UK and USA, a psychologist is a doctor of psychology. In a rather rough lay-mans terms they are a therapist at a doctorate level. Much of the work they do is similar to that of a counsellor, however they will often screen their clients more frequently as part of a psychological screening – this can also be used as the basis of a diagnosis of specific mental health problems.
Depending on the state or the country some psychologists can write prescriptions for certain medications.
In Australia the term Psychologist is often also extended to people who have a degree in counselling or a degree in Psychology.
Coach is a term used to describe someone with coaching skills who can help a person over-come a specific issue or just life in general. Sometimes nick-named “sober-poachers” in the rehabilitation scene, because these people will often charge clients for what is given away for free at 12 step meetings.
The model of coaching is however incredibly useful when dealing with specific problems that have a unique set of stressors. For instance a general counsellor will not the ability to talk someone into slimming down, because this may require a great deal of personal insight into eating habits or nutritional information. A psychologist might be over-kill in helping someone overcome their work-place lackluster.
These are just a few of the differences between different types of therapists. You’ll note that I didn’t go into different forms of therapy – that list would probably be in excess of 160 different styles and variations.
If you’re looking for an online therapist please check out: