Counsellor, Psychologist, Psychiatrist.. Oh My!

(Do you know the difference?)

The past few years have seen a drastic increase in demand for mental health services. According to the Australian Bureau of Statistics (ABS, 2022), there has been a 21% increase in mental illness in people aged between 16 -85.

This increase in demand has put a strain on our current mental health system, and it has become increasingly difficult to find a mental health professional to help. Partly, because we assume that if we are struggling with mental health difficulties, we need a psychologist. The truth is that we have many options, and to begin with, it helps to understand the difference between psychology, counselling and psychiatry.

Counselling is appropriate if you are facing situational challenges, or anxiety and depression stemming from life events. Counselling is usually a shorter-term treatment, however some of my own clients have been seeing me long term, sometimes fortnightly and others for a check-in when needed. A well trained, registered, counsellor will be able to help with self-esteem issues, already diagnosed anxiety and depression (if they have the appropriate training), grief and trauma, repetitive patterns (to name a few), or simply helping you gain a better understanding of yourself. In a nutshell, if you do not require a diagnosis, or you have no indications of clinical symptoms, an accredited counsellor should be able to help you, and if they recognise any of these symptoms, they will refer you to someone else.

I stress ‘registered’ because, in Australia counselling is not a regulated therapy and almost anyone can refer to themselves as a counsellor without the appropriate training. Therefore, it’s a good idea to check on the credentials of your therapist and if they are registered with an appropriate (and recognised) accrediting body such as the ACA or PACFA.

If you are struggling with severe symptoms of anxiety and depression, and have not been diagnosed or require a diagnosis, this is a good time to see a general or clinical psychologist. This is the main difference between a counsellor and a psychologist, a psychologist will diagnose and a counsellor will not. A clinical psychologist will tend to specialise in a particular area, and will have extensive training in severe and chronic mental illness. Both psychologists and clinical psychologist will generally work within a scientific framework and draw from evidence-based treatment methods, for example Cognitive Behavioural Therapy (CBT), depending on their training and skill, this may also be an option with your counsellor.

The other main difference is the fee structure between counselling and psychology. At present, Medicare offer a rebate for psychology if you have a mental health care plan from your GP. This will give you 10 rebatable sessions. Some psychologists bulk-bill, however you can expect to pay approximately $240 for a psychology session, for which the Medicare rebate will differ depending on the psychologist (roughly between $80 - $120). On the other hand, counselling fees can be much less as there is no Medicare rebate available for this service at present. You can expect to pay roughly $90 - $150 for a regular counselling session.

Neither Counsellors, psychologists nor clinical psychologists can prescribe medication. This is the job of psychiatrists or doctors. If you have severe, clinical symptoms requiring medication, you may choose to see a psychiatrist for a prescription, and perhaps a psychologist or clinical psychologist for ongoing treatment.

The biggest indicator for therapeutic success is the therapeutic fit, or connection between patient and therapist. Many people have asked, what is better, a psychologist or a counsellor. In my opinion, qualifications are important because we all want to know that we are in competent hands however, the most qualified therapist will not be able to get you results if you have not formed a secure therapeutic bond. Connection is important! For this reason, if you find that it’s not a good fit for you, find a new therapist. A good therapist will check-in with you on a regular basis to gauge your level of comfort in the therapeutic space. As mental health professionals, I promise that we will not be offended if you move on to someone else, because you as the client must always be the priority.