I work with adults over the age of 18 years old I advise people who have significant issues relating to risk to self or others to seek NHS assessment and treatment. I can work alongside NHS services if required. Please see my 'Resources' page for such support in a crisis.
What is the difference between a psychiatrist, psychologist, psychotherapist and counsellor?
Clinical Psychologists A clinical psychologist is trained to deliver a number of evidenced based therapies and to integrate these to form a bespoke intervention tailored to complex difficulties. This is different from counselling which is a less directive approach and typically enables a client the space to think and reflect on their difficulties. In addition to working with individual or groups of people, clinical psychologists are trained to offer clinical supervision, training, consultation and research.
'Clinical Psychologist' is a legally protected title and only those who have met a high level of doctoral level training, competence and expertise can use it. This is unlike the title 'psychologist' which is not regulated and anyone can use it regardless of their competency level.
A typical training route for a clinical psychologist is a three year undergraduate degree and two or there years working as an assistant psychologist or research assistant until they are eligible to apply for the three year postgraduate doctorate in clinical psychology (DClinPsy).
In the NHS there are different grades of clinical psychologist which represent years of experience. A Consultant grade is the highest grade of clinical psychologist of which there are several bandings in the NHS.
Psychiatrists A psychiatrist is a medical doctor who has specialised in mental health by doing additional training. Psychiatrists diagnose mental health conditions and can prescribe medication. Some Psychiatrists may take additional training to offer therapy.
Counsellors, therapists, psychotherapists and psychologists Many people use the terms counsellor or therapist as a generic term for a variety of different mental health professionals that offer talking therapies. These terms, along with psychotherapist and psychologist are not protected or regulated titles. Anyone can adopt these professional titles regardless of their experience or qualifications. There are many highly experienced professionals using these titles, but there are also many who have limited qualifications and may cause more psychological harm than they do help.
When choosing a therapist from these categories it is important to research whether they belong to reputable professional bodies such as:
The British Psychological Society (BPS)
British Association for Counselling and Psychotherapy (BACP)
The British Association for Cognitive and Behavioural Psychotherapies (BABCP)
UK Council for Psychotherapies (UKCP)
Counsellors deliver a type of therapy called 'counselling' which can take the form of a number of specific approaches or models. It is often short term and less directive which means that the counsellor usually facilitates you to express how you are feeling and come to your own solutions.
Psychotherapists traditionally deliver a type of psychotherapy such as Dynamic Psychotherapy, Analytic Psychotherapy, Dynamic Interpersonal Therapy and many more variations. These therapies aim to help clients to understand how their early experiences have created unconscious feelings about themselves or others that influence the way they interact with the world. These therapies are best provided by someone who has significant psychodynamic / psychoanalytic training, including participation in their own personal therapy to ensure they are aware of their own unconscious feelings / patterns.
How does therapy work?
Therapy enables a person to have a safe space to build trust and explore their difficulties, such as when they began and how they have tried to influence them. Often people come to therapy experiencing a problem and find that the problem is serving a function in their life that they were not aware of, or it served a function for them in earlier life without their full awareness. Most therapies require some time to think through early life experiences and to think through ways that you have tried to improve your difficulties. More structured psychological therapies tend to have a directive approach that is active and helps you to understand your difficulties and to find ways to change how you are living your life or how you are feeling about yourself.
Therapy involves understanding yourself better, as well as learning techniques to make changes. However, another significant aspect to therapy is building a trusting therapeutic relationship with a professional that can sit alongside you and your struggles in a way you may never have experienced before. For many people, showing their authentic selves and feeling accepted, validated and supported by a professional in this way is a very powerful experience.