When looking for mental health support, finding the right person for you is important. But what is the difference between a Psychologist, a Psychotherapist, or a Psychiatrist? Know the difference and what you need for yourself.
Why you should care
Making the decision to get help is a courageous one – it can also be a complex one. Your options for mental health support are either a) within the healthcare system, or b) within the realm of private practice. With option A, you can go to your doctor, who will most likely refer you to a Psychologist or a Psychiatrist – more on this later. If you get lucky, you can get help right away, and it’s free and covered under Alberta Health. If you get unlucky or are average luck – you will most likely wait weeks, if not months to get help.
So you might decide to get support privately. This means you are hoping to use your employee benefit plan to pay for sessions. You also want to find the right person to help you get better. Psychologists, Social Workers, Clinical Counsellors, Psychotherapists, and occasionally, a Psychiatrist are generally who you will find in private practice. What on earth is the difference?
Psychology vs Psychiatry
The major difference between a Psychologist and a Psychiatrist is the capacity to prescribe and manage medication. A Psychiatrist is a Medical Doctor (MD) who chooses to specialize in Psychiatry – the study of pharmaceuticals to support mental health. Psychiatrists are specialists in helping you find appropriate medication for diagnosed disorders like Bi-Polar Disorder, Schizophrenia, Obsessive-Compulsive Disorder, and many more. Increasingly, Psychiatrists are enlisted to prescribe medication for people suffering from depression and anxiety as well.
Psychologists cannot prescribe medication. Registered Psychologists have completed registration with the College of Alberta Psychologists (CAP). That means they have taken a large ethical exam and completed a number of hours of practice. Psychologists often, but not always work using a model of intervention called Cognitive Behavioural Therapy (CBT). CBT has been widely studied, and for a while was the absolute gold standard of practice in the mental health profession. It was tidy. People could be taught skills to manage their thoughts, and as a result, feel better.
However, longer-term studies on Cognitive Behavioural Therapy are only now coming out with less than rosy reviews. Long term, CBT has been shown to be less effective. If it was as simple as changing your mind about feeling bad, people would be able to just look up resources on the internet and feel better.
Psychology vs. Psychotherapy/Counsellors
The difference between a Psychologist and a Psychotherapist is more complicated, and not cut and dry. Let’s talk first about the regulatory differences. Psychologists are regulated by the College of Alberta Psychologists (CAP). Psychotherapy, until very recently, was an unregulated term. That meant anyone could call themselves a Psychotherapist with no standard of practice.
That is no longer the case. Currently, the Association of Counselling Therapy of Alberta (ACTA) exists as a precursor to regulation for counsellors and Psychotherapists. This summer, the ACTA is set to be proclaimed by the Alberta government and will become the College of Counselling Therapy of Alberta (CCTA). When that legislation passes, Counsellors and Psychotherapists will have to be registered and will be regulated under this College.
This brings us to another difference between Psychologists and Psychotherapists – insurance coverage. Most private insurance companies providing you employee benefits only cover Registered Psychologists or Masters of Social Work. Since COVID, and with the regulation of the Counsellors and Psychotherapists, more and more insurance providers are recognizing the value they bring to the profession. Insurance companies will increasingly cover Counsellors and Psychotherapists now that we are also regulated under a College.
How they practice
The last major difference between a Psychologist and a Psychotherapist/Counsellor is where things get messier: how they are trained and how they practice.
The field of mental health is quite divided in terms of “what works” to help people feel better. There are literally thousands of therapy ‘modalities’. Cognitive Behavioral Therapy is popular and well studied. However, there are more, many of which are highly effective anecdotally but not well researched. The list is staggering – narrative therapy, CBT, attachment-based, energy-based, EFT, Transactional Analysis, Re-decision Therapy. For every practitioner you find, they will talk about the effectiveness of their technique – Therapy for People included!
Psychotherapists generally are trained in the Psychodynamic field. This means they are trained in how to use the relationship with the client to support the client in making changes. It is messier, it is longer-term. They recognize that what happened in your past has shaped how you are today, and sometimes that needs to be addressed. They tend not to use as much CBT as Psychologists, but again, this really is just a personal preference or how they are trained. Not all Psychologists use CBT.
A note on Social Workers: Social Workers are trained to see that people’s difficulties are a result of the system in which they operate. Social Workers are interested in making changes in the broader system to affect change. As therapists, they are wonderful practioners and also often get coverage.
How do I choose?
As a buyer of mental health supports – this gets overwhelming. Suddenly you need to become an expert in Psychology to figure out how to get help.
Here is the good news: research has shown that the modality of your therapist is actually not what helps you get better. The healing magic is in the relationship with your therapist. Find someone you like. Find someone who believes in therapy and actually goes to therapy themselves. None of us get through ‘unscathed’ – we all have difficulty we need help with, including your psychologist, psychotherapist, or counselor. Find someone who can be emotionally attuned to you, who you feel supported by.
Use the free consult options to check people out. If they don’t have that, have a phone conversation with them. Trust your instincts, if the first interaction feels off, that can be important to pay attention to. Ask a potential therapist/psychologist their views on how people get better. Do they believe someone can change, or are they just going to teach you to manage your symptoms? There is a big difference – because change is possible. And that responsibility is a joint one between you and your therapist. You bring your courage and your desire to be different, and your therapist brings their expertise to help you get that.
What is most important though is that if you are suffering – reach out. Help is available and you don’t have to suffer alone.