What’s the Difference Between Psychologists and Psychotherapists?
Understanding the Different Types of Mental Health Professionals
If you reach out for help, it's important to know who you're reaching out to
Are you coming to therapy for the first time? Or have you been before but left unsatisfied? If so, it might be worth considering seeing a psychotherapist for the first time. Psychotherapists are less prominent in Australia than psychologists, but offer some important differences that can be beneficial for many people.
There is a diversity of mental health professionals in Australia, including psychologists, psychotherapists, psychiatrists, general practitioners, mental health nurses, social workers, occupational therapists, and peer support workers. This post will mostly focus on the first two, because while other professionals play crucial roles in the mental health system, they are typically more focused on medication or practical support and recovery than providing therapy.
In Australia, psychologists are the most commonly consulted type of therapist and most people think of seeing a psychologist when they seek out therapy. Interestingly though, this is a reverse of the norm in many other parts of the world. For instance, in the US and many European countries, psychotherapists are much more common than psychologists. In fact, the US has three times as many psychotherapists as psychologists, and in the UK there are six times as many psychotherapists as psychologists.
Psychotherapists vs. Psychologists: A Closer Look
Psychotherapists: Sometimes also referred to as counsellors, though the terms are not in fact interchangeable, psychotherapists come from a rich tradition of focusing on the quality of the therapeutic relationship rather than on diagnosis and assessment. The focus is on learning from and participating in the "lineage of kindness" that is the rich and diverse scope of psychotherapy. As a result, psychotherapist training usually involves a deep focus on the history and theory of psychotherapy, as well as lots of practice and assessment of practical therapeutic skills. Psychotherapists often focus on understanding the uniqueness of the client, rather than trying to fit them into an existing model.
As my friend and fellow psychotherapist Sally Gottlieb writes, the word “Psychotherapy” is derived from the two Greek words: "psyche" meaning soul and “therapeia” meaning “serve” or “attend to”. Psychotherapy therefore literally means; “to serve, or attend to, the soul”.
My own definition of psychotherapy is “the art and science of human change through relationship.” To me being a psychotherapist means balancing the need to be informed by scientific research, while also understanding that human relating is always going to be an art form that requires us to step into the messiness and uncertainty of being human with another person.
Psychologists: Typically trained as "scientist-practitioners," psychologists in Australia are adept in quantitative research and are expected to apply scientific knowledge to therapy. Aside from a more narrow training in providing therapy, they also learn to assess and diagnose mental health issues through the medical model, which seeks organic or physical causes for mental health concerns. While psychologists often do not diagnose their clients and may see mental illness through other lens than the medical model, there is no doubt that their training is heavily influenced by this model. While training as a scientific-practitioner has its own strengths, the tradeoff is that it usually means a lot less training in psychotherapeutic practice.
The Training Divide
The difference in training that psychologists and psychotherapists receive is mostly about applying the "medical model" versus a broader focus
In Australia, psychology degrees predominantly focus on teaching Cognitive Behavioral Therapy (CBT), often to the exclusion of other therapeutic approaches. While CBT is the most researched therapy, with substantial evidence supporting its effectiveness, it also is often criticised for oversimplifying mental health issues by focusing on symptom suppression rather than exploring deeper developmental and social contexts. Many clients, therapists, and academics argue that CBT is inherently superficial and offers a limited scope for treating more entrenched psychological issues. Perhaps most problematically, CBT is often assumed to be the best realisation of psychotherapy’s potential, when in fact a much more multi-disciplinary, varied field exists.
To compensate for the limited focus of their foundational training, many psychologists go on to train in additional therapies. This can greatly improve their scope as clinicians, because while CBT can be quite limiting as a standalone therapy, it can be very useful within an integrative framework, where its action-focused perspective can complement more insight-oriented therapies such as psychodynamic or emotion-focused therapy. Psychologists also have the skills of assessment and diagnosis, which can, if properly implemented, be useful in creating a clearer understanding of a client’s specific issue and guide treatment approaches. Nevertheless, most psychologists are not taught much about the history and broader context of psychotherapy, which is not easy to make up for outside of formal education.
In contrast to psychologists, psychotherapists usually undergo extensive training in therapeutic modalities other than CBT. While training varies across different educational institutions, my own training included subjects such as Models of Therapeutic Practice, Grief and Loss, Trauma and the Body, and Psychodynamic Psychotherapy. These topics, which are unlikely to be found in most psychology degrees, provided a more comprehensive understanding of different therapeutic approaches and incorporated practical skill development from the start of training. These practical skills are also strengthened by an explanation of the philosophy and science that have driven the development of these approaches. My training brought in evolutionary biology, cognitive science, and developmental theory to substantiate the philosophical claims of schools such as narrative therapy or techniques such as mindfulness.
Training in Practical Terms
Psychotherapist training is often less medicalised than psychologist training
Psychotherapist is not a legally protected term, meaning that anyone can call themselves a psychotherapist or counsellor. Therefore, the training and experience between therapists can differ dramatically. If you’re considering working with a psychotherapist, it’s worth enquiring about their educational background, as it is possible that they have done as little training as a one or two year diploma or certificate. However, many will at least have a Bachelors, which requires three years training.
Psychologists usually fit more naturally into the medical system, which is both a strength and weakness
Psychologists usually complete much more education than psychotherapists, although much of this is not psychotherapy training. A standard path for a psychologist is:
Three year undergraduate degree (such as a Bachelor of Arts or Science)
One year Honours degree
Two year Masters degree
The undergraduate component will contain very little that is relevant to mental health, instead focusing on topics such as social, cognitive, and biological psychology, and quantitative research skills. Actual therapist training will begin in Honours and continue in the Master’s, but the whole postgraduate component involves as much time learning to conduct research as it does learning how to be a therapist.
So, while it appears that psychologists receive a lot more education, this can be misleading. Even though a psychologist with a Master’s will have spent twice as much time in education (six years) as a psychotherapist with a Bachelor degree (three years), it is usually the latter who will end up spending much more time developing their psychotherapeutic knowledge and skills.
A Quick Word on Psychiatrists and Other Mental Health Professionals
Psychiatrists: These medical professionals specialise in the prescription and management of medication. While they are trained to understand complex biological mechanisms, their focus is often more on medication management rather than providing in-depth psychotherapy. Some psychiatrists do also provide therapy, but most do not, as it is generally too costly to see a psychiatrist on a weekly basis and the skills required for effective medication management differ significantly from those needed for empathetic, emotionally attuned therapy.
Other Mental Health Professionals: As mentioned above, while other professionals such as mental health nurses play crucial roles in mental health support, they typically are less involved in providing psychotherapy and more focused on practical support and recovery.
In Conclusion
The mental health field is diverse, with various professionals bringing different strengths to the table. Understanding these differences can help individuals seek the most appropriate type of support for their needs. Whether you're considering seeing a psychologist, psychotherapist, or psychiatrist, or exploring support from other mental health professionals, it's important to recognize the unique approaches and expertise each brings to the field.
If you’re looking for a diagnosis or more formal assessment of your issues, or you’re planning to only stay in therapy for 10 sessions or less, then getting a Mental Health Treatment Plan and seeing a psychologist may be more appropriate for you. However, if you think you’re going to need more than 10 sessions and you want help to achieve deep, long-standing psychological change, than a psychotherapist will likely be better equipped for this work and be increasingly cheaper as time goes on.
If you’re trying to decide which one to see and you still need advice, please reach out and I’ll see if I can help!