Types of Counselors

Dr. Suzanne LaCombe, March 28, 2007.

The term therapist, psychotherapist or counselor may refer to any of the professions listed below. However some professionals choose their professional or educational title, or designation, when they refer to themselves. The latter are usually from those professions that are regulated by law.

As a psychologist, I have refered to myself as a psychotherapist only occasionally. I ususally refer to myself as a (registered) psychologist. Similarly, a psychiatrist probably uses the term psychiatrist over the term psychotherapist.

Highly-trained practitioners are more likely to work with populations who are suffering from severe problems, particularly if medications are involved in the treatment.

So for example a psychiatrist is more likely to work with someone who is suffering from psychosis than a Master's level counselor. However, there are no hard and fast rules on the matter. Generally speaking you are more likely to see a psychiatrist if you are receiving medication. But in recent years in a few selected states, psychologists have been allowed by law to prescribe medication to their clients.

Here's a few of the professions that may practice psychotherapy.

• Clinical social worker
• Associate clinical social worker
• Pastoral Counselor
• Marriage and family therapist
• Marriage and family therapist registered intern or trainee
• Physician specializing in the practice of psychiatry or practicing psychotherapy
• Psychologist
• Psychological assistant
• Psychiatric Nurse
• Psychiatrist

Though they are similar, each profession has a distinct emphasis and scope of practice.

Frequently Asked Questions:

What's the difference between counseling and psychotherapy?

This is a question for which there is no clearly defined answer. So I'll tell you what I believe most have traditionally seen as the difference.

Counseling is considered to be of a short term duration and more proactive in dealing with the effects of a problem. Let's say you're in an abusive relationship. A counselor might help you extricate yourself from the relationship and help you get set up in a better living situation. She might offer suggestions for support groups, or recommend agenices who deal with special housing needs or alternative funding sources for education.

A counselor also makes very specific recommendations based on the problem you are addressing. So a career couselor might recommend doing some information interviews. or an addictions counselor might help you identify specific tasks associated with a 12 step program.

Psychoherapy might also include the above elements but the pace of the therapeutic process is usually slower. In the example above, a therapist would help you to identify the pattern in your relationships and promote changes within you so you are at less risk for finding yourself in the same situation in the future. The root of the problem might stem from a poor sense of self worth but the effect of the problem is a bad relationship.

There is considerable overlap between the two professions. Some counselors do deep therapeutic work, and quite a few psychotherapists do short term work. Neither profession requires a specific level of education. You as the consumer can determine this by looking at the practitioner's credentials.

Editor's Note

You'll notice on this site that I use the word counseling where the more common terminology might be psychotherapy. I have chosen to do so very specifically.

It's my impression that the term counseling is less stigmatizing. I believe the use of the term counseling makes it easier for those unfamiliar with therapy to accept it as a legitimate and effective option.

So, even though this site is mostly about psychotherapy--as described above--I have used the terms interchangeably.

What can a psychologist do that a counselor cannot?

Well that's an interesting question. One of the distinguishing characteristics is that there are some specific tests where only psychologists can adminsister.

Regarding Canadian psychologists, the most distinguishing feature is that psychologists can provide a formal diagnosis.

In the USA as I understand it, some Master's level practitioners who are not psychologists can also provide a formal diagnosis.

A formal diagnosis entails using the descriptions of clinical disorders and their appropriate coding from a manual known as the Diagnostic and Statistical Manual IV ("DSM IV"). Often, but not always, a formal diagnosis requires testing. While many tests can be administered by other practitioners, the more complicated ones are only available through psychologists who have taken the training required to interpret the tests appropriately.

Master level practitioners can also administer these tests if they are supervised by a psychologist. However, by and far, most testing is done by qualified health professionals usually with a minimum Master level qualifications.

In Canada a formal diagnosis comes in handy if you need a completed insurance form for extended health or long term disability insurance, or for a government application (e.g. for CPP long term disability). A formal diagnosis is also often necessary for purposes related to litigation.

Nonetheless, several categories of health care professionals in Canada have also been given the power to officially diagnose. This is a contentious issue as it is questionable whether these practitioners have sufficient training to make these determinations, particularly decisions involving custody arrangements.

Keep in mind that most health care professionals make a diagnosis for treatment.

As mentioned above, a few States have allowed psychologists with the appropriate training to prescribe medications.

What about therapy, are there treatments only psychologists can do?

All advanced courses for treatment that I am aware of are open to practitioners who have a Master's level degree. For example. you need not be a doctoral level practitioner if you want specialized training in EMDR, hypnosis, CBT etc.

Related Reading

Find a Therapist

Related Health Care Counselors

Counselor Credentials

External Resources

Types of Therapists

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