The differences between mental health professionals

You want to see a therapist, but counsellors, psychologists, psychotherapists, psychiatrists, and social workers all call themselves therapists… what are these professions and who should you see?

You might have been told you need to talk to someone or you feel that need yourself. You might be looking for a diagnosis or want to consider options like medication. Where do you start?

This is a brief overview of the different kinds of mental health professionals and why you might want to see them. I’ve also included a checklist at the bottom to help you choose the right person for you.

Counsellor & psychotherapist

These are strictly speaking different, thing but in Australia, counsellors may also do psychotherapy and use these terms interchangeably. Whilst there are many definitions for these terms, it could be said that a counsellor works in the here and now and a psychotherapist works on a deeper level. Again, this is not necessarily reflected in the title that a therapist uses, but rather the approaches that they use in their work. The approaches I use lend themselves to both counselling and psychotherapy [I use these terms interchangeably in the rest of the article].

A counsellor creates a safe and empathetic therapeutic relationship to help you with a range of things from increasing self-understanding, dealing with mental health issues, processing trauma or increasing well-being.

Counsellors may specialise in working with certain groups of people or with certain issues. They can be trained in a range of modalities from person-centred (Rogerian) therapy, Internal Family Systems, CBT, EMDR and many others. University degree training and above usually focuses exclusively on the therapy process and modalities, so tertiary qualified counsellors are very experienced in these processes.

However, in Australia, counsellor is not a protected title. This means that anyone can call themself a counsellor or psychotherapist. Two peak organisations in Australia provide a self-regulation framework for this profession. Counsellors registered with ACA have a minimum level of Diploma in counselling, counsellors registered with PACFA usually have a minimum of a degree in counselling). You can search for registered counsellors and psychotherapists on their websites. There are also other reputable associations that counsellors can be registered with.

If you are looking for therapy, seeing a counsellor can be a great choice.

Psychiatrist

These are medical doctors who have specialised in psychiatry. This means that as well as diagnosing, they can also prescribe medications, such as antidepressants or stimulants for ADHD. You will need a referral to see a psychiatrist, and like other medical specialists, you will receive a Medicare rebate.

Psychologists

Whilst not medical doctors, they do have to study for a long time before being able to claim the title of psychologist, which is a protected title (so it’s illegal to call yourself a psychologist if you are not one). Psychologists are registered with APRHA. There are different types of psychologists who specialise in different things, from diagnosing mental health conditions and learning disabilities, ADHD and Autism to using CBT-based treatments, EMDR or neurofeedback. Psychologists are well qualified professionals who can help you deal with a number of serious mental health disorders. Some will also run groups, such as DBT.

Mental Health Social Workers

Mental health social workers are social workers who have completed additional advanced training to help people with mental health issues. They conduct psychosocial assessments and use a range of therapeutic approaches to work with different issues.

Mental Health Occupational Therapists

Occupational therapists look at life through an occupation lens (whether that is work or home). They aim to help you engage successfully with everyday activities that you find meaningful. They use a person-centred, strength based, behaviour oriented and goal directed service to achieve this.

Mental Health Nurses

Though many work as part of GP practices or hospitals, some mental health nurses also have private practices that offer mental health services. Like MHSW and MHOT, they are nurses with extra education & experience with mental health.

So who do I see?

It depends on what you need.

Medications/diagnosis

If you need medications, then you will need to see a psychiatrist. If you require a diagnosis you will need to see either a psychiatrist or a psychologist.

It’s worth noting that other health professionals may also diagnose or prescribe medications, such as GPs (e.g. for antidepressants) or neurologists (e.g. for ADHD) + others.

Therapy

But if you are looking for therapy, then any of the above professionals may be able to help you. One of the biggest determining factors in outcomes is the therapeutic relationship that you have with your therapist. So finding the right fit is really important. I sometimes compare it a little bit to dating, in that the first one you meet might not be the one.

The type of therapy that they offer and the experiences that they have is also really important. If you have previous experience of therapy, you might already know what does or does not work for you. Therapists should explain clearly the therapeutic approaches that they use.

For Autistics/ADHDers I also recommend working with people who are neurodiversity affirming. Unfortunately, this has become a little bit of a label that everyone now uses, so it sometimes takes a little bit of investigating to ensure that someone actually is ND affirming.