What’s the difference between a counsellor, a therapist, a psychotherapist, a psychologist and a psychiatrist?

Hi, I’m Sarah and I’m a private psychotherapist, living in Manchester in the UK and working online via Zoom. I specialise in working with childhood trauma and CPTSD.

Although the question about the differences between a counsellor, therapist, psychotherapist, psychologist and a psychiatrist sounds like the beginning of a bad joke, perhaps with a punch line about a God complex or changing lightbulbs, it can be really helpful to have some more details about who does what. After all it’s hard to make the decision counsellor vs therapist or counsellor vs psychotherapist if you don’t understand what you’re deciding between!

Therapy in the UK

As I’m based in the UK, this post only applies to the UK. There are different rules and regulations depending on the country you find yourself in so please note that outside of the UK it might be quite a different situation.

What is a counsellor?

Counsellor (spelled counselor in the US and not to be confused with councillor which is a member of a council), therapist and psychotherapist are often used interchangeably in the UK. Although my official title is psychotherapist (more on that in a minute) I quite often refer to myself as a therapist as it can sound less formal and some people are intimidated by official sounding titles.

What is a mental health counsellor?

A mental health counsellor is just a different term for a counsellor who works with mental health.

Can anyone call themselves a therapist or a counsellor?

Neither counsellor, therapist nor psychotherapist are protected titles in the UK which means that in theory at least, anyone can wake up one day and decide to call themselves a counsellor and nothing can be done (since it isn’t illegal). Now in reality, most people are not doing this and most professionals take their responsibilities very seriously but it is something to be aware of.

‘Qualified’ counsellor is also not an official title, although I’ve seen it used a lot especially in adverts. Since there is no mandatory regulation of psychotherapy or counselling in the UK, the main bodies that offer regulation are voluntary so there is no obligation to join.

Who regulates therapy in the UK?

There are also no nationally agreed rules on what constitutes a therapist, counsellor or psychotherapist in the UK. In order to attempt to police people who offer counselling or psychotherapy, therapists are encouraged to become a member of a governing body. The main ones are UKCP and BACP (which is the largest).

Counselling qualifications

All therapist training should be comparable across the board by looking at the level (although this is not something that people always disclose.) So a counsellor qualified at level 4 will have received less academic training than someone at level 7.

Level 6 is considered degree level equivalent, level 7 Masters level and level 8 Phd level.

What is a psychotherapist?

Some bodies, such as the UKCP, require that in order to call yourself a psychotherapist, you must be trained to level 7 which is normally a 4 year post graduate course. Below level 7, UKCP members are permitted to use the title Psychotherapeutic Counsellor, this is normally a 3 year training. Other bodies such as BACP allow members to choose whether they call themselves a psychotherapist or a counsellor.

What is a psychologist?

A psychologist is normally someone who has studied Psychology at university, but again has no legally protected status. Other titles such as Counselling Psychologist or Educational Psychologist are protected and require specific training. These protected names are governed by an organisation called HCPC. A Clinical Psychologist is a health professional who offers therapy often in a healthcare setting such as within the NHS. You can also see a Clinical Psychologist privately as with therapists.

What is a psychiatrist?

A psychiatrist is a medical doctor who has further specialised in psychiatric medicine and helping with psychological problems. They are able to prescribe medication. They might also offer psychotherapy depending on their training. They can also provide an official diagnosis of a mental health issue.

Who do I need, a therapist, psychotherapist, counsellor, psychiatrist or psychologist?

I think what most people are really interested in when they ask what the differences are, is ‘who should I ask for help’ and ‘will this person help me?’ Who you get to see will largely be dictated by whether you stay within the NHS system (which in the UK is free) or whether you seek therapy privately.

NHS treatment

Psychologists and Psychiatrists are most often found within the NHS, with most people only seeing a Psychiatrist for a diagnosis or more complex medication prescriptions. Within the NHS, you might also see a CBT therapist, a psychological wellbeing practitioner or a counsellor depending on your issues or the help available in your area. If you do not feel that the help you are getting within the NHS is suitable, you can ask to be assigned a new therapist or to someone at a higher level, although this may or may not be honoured.

A doctor is often the first person people consider when looking for help. NHS waiting lists are often long for therapy, but there is no cost to be treated so this is a good option if you can’t afford to pay for therapy.

Private therapy

The benefit of private therapy is that you have much more choice in your treatment, although this can also make choosing more confusing. Waiting times are also likely to be much lower, depending on the therapist you might be able to get an appointment immediately.

Specialist therapists

If you’re looking for help with a particular issue, you can often filter for this on a directory or try searching on Google. If you want someone who has experience in the area you need, feel free to ask what experience they have in working with your problem.

Not all therapists specialise in a particular issue, some work with any type of issue.

The best indication of the success of therapy is the connection you have with your therapist. So think about whether someone looks approachable, whether you can ask them questions, whether they have experience working with the problem you’re experiencing and whether you can afford to see them on a regular basis. This is a good enough start and later you can consider how effective your therapy is.

More resources

For more information about which factors to consider you can also read How do I choose a therapist.

I specialise in working with childhood trauma and CPTSD, find out more about CPTSD here What is CPTSD and do I have it?

If you’d like to find out if I can help you, you can book a free 15 minute call by clicking here Book Now