Counsellor, psychotherapist, psychologist, or mental health social worker?
There are many different types of mental health workers including counsellors, mental health nurses, support workers, GP’s, and mental health advocates. It can be confusing figuring out who does what! For this post, I’ll briefly focus on different types of mental health therapists.
Counsellors
Counsellors study from a 1-year diploma, up to a master’s or Doctorate. Every type of counsellor has their place in mental health work, though if people are wanting therapy, they should seek the expertise of a counsellor who holds at minimum a bachelor’s degree. Many health professionals can be trained in counselling including nurses, occupational therapists, social workers, and psychologists.
Counsellors work with all sorts of people and problems, including identity issues, trauma, domestic violence, child abuse, anxiety, and depression. Counsellors support people to overcome problems, create new insights, enhance their capacity, develop new awareness of feelings, regulate emotions, and establish new actions and behaviours.
Psychotherapists
Psychotherapy involves an advanced level of study and training generally at a master’s degree or doctorate level, including significant components of practical/clinical skill development in psychotherapy. The trainings are generally called a master’s in counselling/psychotherapy/psychology, and/or be multi-year experiential training programs. Psychotherapy is more in-depth than counselling, and primarily focused on processes of meaning making. It is holistic and integrative, incorporating multiple experiences of a person’s world including their current and historical psychological, emotional, relational, and spiritual health.
Psychotherapists work with all sorts of people and problems, potentially exploring anxiety/depression, trauma, child abuse, domestic violence, abuse, and personal development. Outcomes of psychotherapy include developing meaning making, increased purpose, enhanced capacity, deeper insight, empowerment, and liberation.
Psychologists
There are many types of psychologists. At a minimum, psychologists study a bachelor’s in psychology and do an extra year of study – this is to work towards becoming a general psychologist. Many psychologists, but not all, go on to study at a master’s or doctorate level in various types of psychology. Not all psychologists are trained in counselling or psychotherapy, though others do significant training in cognitive behavioural therapy and other psychotherapeutic approaches.
A different type of psychologist who has specialist training in assessment, diagnosis and treatment of a mental health disorder is a clinical psychologist – they are master’s or doctorate trained. Other therapists cannot do a formal medical diagnosis such as ADHD, or PTSD. If you need a diagnosis for special medication or a Centrelink payment, you will need to see a clinical psychologist.
Mental Health Social Workers (MHSWs)
MHSWs study a 4-year bachelor’s degree in social work, then an additional 2-years of practical training in mental health. Many MHSWs in private practice undertake a master’s degree or doctorate to specialise in counselling and/or psychotherapy. Some social workers choose to do a master’s in narrative therapy because it’s a complementary modality of psychotherapy that focuses on meaning making and wider power relations.
Whilst MHSWs are often trained in focused psychological strategies for mental health problems listed elsewhere in this post, their training is a little broader to focus on social determinants of mental health. For example, they are likely to have more training on understanding feminism and masculinity on mental health, and work with co-existing problems such as domestic violence, disability, discrimination, racism, and sexism.
What to choose?
In some instances, you will want to choose a specific type of therapist. For example:
- Counsellors may be better at engagement and doing therapy that feels less formal
- Psychotherapists and psychotherapy-trained psychologists may be better for working with childhood trauma
- Clinical psychologists are required for a mental health diagnosis
- MHSW’s may be better for when there’s also other issues like domestic violence
In other instances, for mild-moderate mental health problems it sometimes doesn’t matter what type of therapist you choose. Research says that up to 70% of positive outcomes in therapy come down to a strong therapeutic relationship. This means that it’s extremely important to have a good relationship with your therapist where you feel respected, dignified, safe, and supported. Further, there will variably be crossover between different type of therapists.
Extra reading
Counselling: https://pacfa.org.au/common/Uploaded%20files/PCFA/Documents/College-of-Counselling-Definition_of_Counselling.pdf
Psychotherapy: https://pacfa.org.au/common/Uploaded%20files/PCFA/Documents/Definition-of-Psychotherapy.pdf
Psychology: https://psychology.org.au/psychology/about-psychology
Mental Health Social Worker: https://www.aasw.asn.au/document/item/4372
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