Counsellor, psychologist, and psychiatrist may conjure up similar images for us — someone is sitting in a comfy chair with a professional across from them gently asking the question, “and how do you feel?” However, they are distinct professions and limits to what services they can provide to you. If you are seeking support for your mental health, it is important to understand the difference between the three.
There are many differences amongst these three professionals to consider in addition to what they actually do. There may be varying levels of accessibility due to availability of practitioners in your area, cost of their services, and whether or not that specific profession is covered under some kind of health benefit. All of these are important considerations, but it is also worth knowing what exactly sets these professionals apart in terms of their practice so that you know what to expect.
Below is a brief overview of the roles of a psychiatrist, psychologist, and counsellor to help get you started.
According to the American Psychiatric Association:
“Psychiatry is the branch of medicine focused on the diagnosis, treatment, and prevention of mental, emotional and behavioural disorders.”
One of the biggest distinctions between a psychiatrist and other mental health professionals is that a psychiatrist is a medical doctor (M.D.). This means that these individuals have completed medical school in the same way that a general practitioner (GP) or family doctor would have. Once they completed the general medical school requirements, they would have decided to pursue psychiatry in the same way other doctors decide to pursue plastic surgery or pediatrics.
Since they are medical doctors, psychiatrists can perform a broad range of psychological tests. They will also talk with their patients to deepen their understanding of their patient’s physical and mental health. Since they have medical training, they may understand the role of genetics and other medical illnesses and mental health and can use this information when making a diagnosis.
Treatments that Psychiatrists Use
Psychotherapy — or talk therapy — is just one of the treatments that a psychiatrist can offer. They also use medications and other evidence-based treatments, for example, electroconvulsive therapy or ECT. The degree to which a psychiatrist relies on the various treatments will depend on their approach and beliefs.
I’ve heard of some psychiatrists who believe strongly in medication as the answer, and will use regularly scheduled appointments with patients to change the dose of their medication, checking in with them through discussions on their overall functioning. I’ve also heard of psychiatrists who engage heavily in talk therapy, and who are conservative when it comes to prescribing medication. It really just depends on the individual psychiatrist but it is important to note that they have the ability to diagnosis, prescribe medication, and engage in psychotherapy.
According to the Canadian Psychological Association (CPA):
“A psychologist studies how we think, feel and behave from a scientific viewpoint and applies this knowledge to help people understand, explain, and change their behaviour.”
Whereas psychiatrists go to medical school, psychologists have a PhD, which means that they have completed both a Masters and Doctorate degree. The doctorate degree, which involves research and advanced study, would have been in clinical psychology, counselling psychology, clinical neuropsychology, or educational/school psychology.
Psychologists are trained to assess and diagnose problems in thinking, feeling, and behaviour, and to support people in managing or overcoming these problems. They are trained to administer psychological tests and assessment, and are able to provide a diagnosis to their patients. The treatment provided by psychologists is psychotherapy or talk therapy.
How is a psychologist different than a psychiatrist?
Aside from a different educational background, there is a key difference between a psychologist and psychiatrist that is important to understand when seeking treatment. A psychologist can provide you with a diagnosis, but they cannot prescribe you medication. A psychiatrist or your family doctor can prescribe you medication. The CPA recommends that if someone needs medication, that they consult with a physician about medication while seeking a psychologist for psychotherapy.
Counsellor can mean different things depending on where you are located. Your best bet is to check to see who a counsellor is licensed or registered with and refer to that association or regulating body for more information. Unlike a psychologist or a psychiatrist, counsellors can not provide diagnosis and unlike a psychiatrist, they are not able to prescribe medications.
According to the Canadian Counselling and Psychotherapy Association (CCPA):
“Counselling/psychotherapy is the skilled and principled use of relationship to facilitate self-knowledge, emotional acceptance and growth and the optimal development of personal resources. The overall aim is to provide opportunity for people to work towards living more satisfyingly and resourcefully.”
You might notice that this definition does not focus on diagnosis. While counsellors most likely have base knowledge of the Diagnostic and Statistical Manual (DSM-5-TR), it is not as central to their practice as it is for many psychiatrists or psychologists. According to the CCPA, counsellors may be “concerned with development issues, addressing and resolving specific problems, making decisions, coping with crisis, developing personal insight and knowledge, working through feelings of inner conflict or improving relationships with others.”
Another main difference is the educational background of counsellors. Many registering bodies, such as the CCPA mentioned above, require counsellors to have a Masters Degree in Counselling Psychology or equivalent. However, because the profession is not regulated in the province of British Columbia, anyone can call themselves a counsellor, regardless of their educational background. Some counsellors may have completed a diploma or certification program, whereas others may have not completed any training at all. Again, this is why it is important to do a bit of research into what exactly it means when someone in your area is calling themselves a counsellor.
If you are unsure which professional is right for you, you are not alone. It can be overwhelming to know what exactly we need, especially if we have limited experience with mental health providers. For many people facing problems related to daily living, counselling can be a good place to start. Counsellors should also be able to connect you with mental health resources should counselling not be sufficient for optimal care.
Knowledge is power so hopefully this high level overview can empower you to make the best decisions for you and your mental health.