Despite attempts to destigmatize mental health and therapy, a few terms still confuse people. What is psychotherapy? How is it different than counselling?

I want to quickly clear up some language so you know what your getting yourself into (or at least who you’re getting help from), should you be looking for a professional. We’ll delineate the following terms: 

  • Counselling
  • Therapy
  • Psychotherapy/Psychotherapist
  • Psychologist
  • Psychiatrist

Before I ever saw someone, I’d never heard the term “psychotherapy”. I’d heard the term as “counselling”, and I knew the term “therapist”, although by the sound of the words I assumed the latter was someone I would see if my situation got more intense. Like many, I thought of a lie-down couch and maybe even hypnotism. “Counselling” seemed more palatable. 

When most people say “counselling”, at least in my experience, they mean mental health talk therapy. That is, they mean talking to someone who can help them deal with anxiety, depression, or any other number of emotional and cognitive issues that might be affecting their mood or daily functioning. 

More on the term “counsellor” in a moment. 

So why do we need anything more than this term, especially when the general population seems to understand intuitively what counselling is? 

Why fancy terms like psychotherapy? Jeez, why not just therapy? 

Imagine for a moment that someone calls me a “counsellor”. Inevitably, questions arise around the nature of my counselling. What do I counsel people about? Why do other counsellors use different terms? 

Even if you’re one of many who understands counselling to be mental health specific inevitably you will ask the question… well, how do I know this person is legitimate? How does one become a counsellor anyway? Can I trust this person? What about the hundreds of others using the same title? 

These questions are inevitable, and not just in the mental health field. Any time you see a healthcare professional, it is natural and reasonable to want to understand the exact expertise and legitimacy of that professional. 

Thus, the primary reasons for the titles psychotherapy and psychotherapist are distinction and regulation. 

DISTINCTION

“Therapy” can mean all kinds of things. Therapies exist for the treatment of physical conditions or injuries, like physiotherapy or physical therapy. Massage therapy treats the muscles directly. Hydrotherapy uses water; cold therapy uses cold. 

Psychotherapy, as the name implies, is psychological in nature. It shares a lot with the other therapies, though, namely that it aims at improving psychological health in slow, minimally invasive ways through scientifically supported methods. It’s far more than giving people “counsel” or advice, too, which is why it’s a better term than “counselling” in this case. 

Psychotherapists cannot diagnose mental health issues, but they assist in carrying out their treatment. 

REGULATION

Next, “psychotherapy” is usually a regulated term (though this depends on where you live). This means that if you are receiving psychotherapy, it is from a professional who has met a minimum standard of training and qualification. 

Technically, anybody can be a “counsellor.” You don’t need any education, training, or experience to use the title, at least legally speaking. Same thing with a life coach – there’s no regulation behind it. This doesn’t mean such folks are snake-oil salesmen or liars in any way. But it does mean you may find higher variability among the knowledge or quality of such practitioners, as they are not required to complete any formal training to earn their title, nor do they have a regulatory body ready to reprimand them for malpractice. 

What about Psychologists and Psychiatrists? 

Bonus round!

Psychologists and Psychiatrists are once again distinguished by regulation and education (although once again this can depend on your region). 

Psychologists generally have higher education in the form of a doctorate (i.e. PhD), and in some cases (like Ontario), can make diagnoses. They tend to work in more clinical or academic environments, but can also provide psychotherapeutic treatment. 

Psychiatrists have medical doctorates (i.e., an MD, which means they are medical doctors), and so they alone can prescribe medications. Not everyone with anxiety or depression or more common mental health concerns need to see a psychiatrist. 

 

Any questions about the above? Hit me up on socials: 

Instagram: @corey.sleep.psych

Twitter/X: @coreysleeppsych

 

Hope this helps, and that you find the right professional for your needs.