What type of therapist do I need?

If you’re looking to speak with a professional mental health specialist, working out what you need can be tricky.

There are different terms to describe the different approaches that practitioners take, and the qualifications they have, and these are often used interchangeably. It can be confusing so here we explain what the different terms mean, helping you make the right choice that fits your specific needs. We explore therapist, counsellor, psychologist and psychiatrist.

How is a therapist different to a counsellor? 

Perhaps the most confusing terms are ‘therapists’ and ‘counsellors’. There is some overlap between how they work and some believe the terms can’t be differentiated. Both approaches use talking therapy to help people improve their mental health.

Generally speaking, a counsellor will be more focused on specific issues, such as relationships or grief, and is often shorter-term compared to a therapist. They may explore your day-to-day feelings rather than the root causes of issues.

A therapist will typically be associated with a specific therapeutic technique, such as CBT, and therefore may describe themselves as a CBT or psychodynamic therapist, for example. They can also help treat diagnosed mental health conditions.

What is a psychologist?

Psychologists have a postgraduate doctorate in psychology. They tend to follow a scientific approach but they cannot issue prescriptions or perform medical procedures.

There are two types of psychologists: counselling and clinical. Counselling psychologists will work in a similar way to therapists and may employ similar techniques such as CBT, helping their clients to overcome emotional challenges. They can also diagnose mental health conditions, which therapists are not qualified to do. A clinical psychologist will generally work with patients who have more complex conditions and often work in hospitals or other medical settings.

What is a psychiatrist?

Psychiatrists are medically qualified doctors who have chosen to specialise in psychiatry. They can diagnose mental health conditions and prescribe medication as well as recommend other forms of treatment. They often work in community mental health teams, clinics or hospital wards.

Training and qualifications

In the UK, counsellors typically complete a 2-4 year accredited training programme, including a diploma or degree in counselling. During their training, they are required to complete 100 hours of supervised clinical practice. Most counsellors are registered with the British Association for Counselling and Psychotherapy (BACP), which ensures they meet ethical and professional standards. Search the online directory here.

Therapists usually hold a degree in counselling, psychotherapy, or a related field. They may also have completed a postgraduate degree. After completing their education, therapists must accumulate 450 supervised clinical hours. These hours may vary depending on the specific type of therapy they specialise in. Registered or accredited therapists can be found on the BACP website, using the online directory.

In the UK, clinical psychologists must complete a doctoral degree (DClinPsy), which takes around 8-10 years of training (including a bachelor's degree in psychology and 3-4 years of doctoral training). They are required to complete 450-500 hours of supervised practice as part of their doctoral programme. Clinical psychologists must be registered with the Health and Care Professions Council (HCPC) and are listed on its online directory.

Psychiatrists need a degree in medicine, a two-year foundation programme of general training, three years core training in psychiatry and further specialist training which can take up to three years. You can see a psychiatrist privately although most private psychiatrists will prefer a referral from your GP. The Royal College of Psychiatrists is the professional body responsible for supporting psychiatrists through their careers. It has a members directory here.

Choosing the right professional

When selecting a mental health professional, consider the following factors:

Your needs: If you're dealing with specific, short-term issues, such as stress or a relationship conflict, a counsellor might be a good fit. For more complex or long-standing issues like depression or trauma, you might prefer a therapist or psychologist.

Training and expertise: If you require a professional with advanced skills in psychological assessment and treatment for serious mental health disorders, a clinical psychologist might be the best choice due to their extensive training and experience.

Therapeutic approach: Different professionals use different approaches. Therapists and counsellors may focus on talk therapy and emotional support, while clinical psychologists are trained to conduct in-depth psychological assessments and can treat more severe mental health conditions.

Supervision and ethics: Ensure that the professional you choose is properly licensed and supervised. In the UK, professionals like counsellors (BACP) and clinical psychologists (HCPC) must meet strict ethical guidelines, ensuring they provide safe and effective care.

Rapport: Regardless of the professional's qualifications, your rapport with them is key. If you don’t feel a connection after a few sessions, it’s okay to look elsewhere and try a few out. A strong therapeutic relationship is crucial for effective treatment.

Cost and availability: Consider your budget and how frequently you need to meet. Clinical psychologists, due to their advanced training, tend to charge more than counsellors or therapists. Many professionals also offer online therapy, which can be more flexible and accessible.

To sum up

Having some understanding of the issues you are looking for help with is an important starting point. You can then make an informed choice that best suits your needs and preferences. Ultimately however, the most important aspect is getting the right fit so make sure preliminary sessions are built in so you can discover this before committing.