Counsellor, Therapist, Psychotherapist, Psychologist or Psychiatrist? How do I find the right mental health support, and what’s the difference between these professions?*

Title:

What they do:

Education:

Main accrediting bodies:

How to seek this kind of help:

Price:

Counsellors and Psychotherapists:

These titles are not protected in the UK, which means someone can use them without any training at all. Be sure that you seek out someone who is accredited or registered with a recognised body.

Counsellor

Counsellors generally offer “talking therapy” and work with clients to cover a wide range of mental health concerns, such as depression, anxiety, stress, loss, relationship problems, eating disorders, addiction, trauma, change and much more.

You can expect a counsellor to provide a safe space for you to talk about your concerns and support you in finding solutions (which might include finding acceptance or new ways of looking at a problem).

Traditionally counsellors have been associated with shorter term work (between 6-12 sessions) but may work longer-term depending on their training background and client needs.

Counsellors are typically educated to degree level and have then undertaken an additional qualification such as a certificate, diploma, or master’s degree in counselling..

Once a counsellor has reached a minimum standard of education and experience, they can apply for accreditation from a professional organisation that will ensure they abide by ethical standards, get appropriate further education and support, and are subject to a complaint’s procedure (see tab to right).

BACP

UKCP

NCP

HPCP

Counsellors and psychotherapists should display their accreditation and/or qualifications on their professional profiles.

If they don’t, it is okay to send a message asking about these – it’s important to know.

The easiest way to work with a counsellor or psychotherapist is in “private practice” – where you pay for your own treatment. Counselling and psychotherapy can take place face-to-face, or via the phone / a video conferencing platform.

Word of mouth is often the best way to find a counsellor or psychotherapist, so ask around. If you can’t do that there are several directories you can search such as Welldoing.org.  There are also directories for specific needs – for instance, the Black, African and Asian Therapy Network (BAATN) is great for finding a BIPOC counsellor or Pink Therapy for LGBTQI+ clients or the Neurodivergent therapist network. If you are based in London, Berlin, or Paris, you can check Stillpoint’s local directories.

While counsellors and psychotherapists are sometimes available on the NHS, wait times are often long, and are generally limited to Cognitive Behavioural approaches (which won’t appeal to everyone). You can talk to your doctor or search online for NHS-funded mental health support.

Varies depending on location and level of experience of your counsellor / psychotherapist.  

Typically, you can expect to pay between £55-100 / session.

Counsellors and psychotherapists often offer a discount for students, the retired and the unemployed. You might be able to access free counselling via your employer or through a charitable organisation like MIND.

If money is tight, it may be worth reducing the frequency of your sessions – perhaps seeing your counsellor / psychotherapist once every fortnight instead of weekly.

Psychotherapist

As above.

Traditionally, psychotherapists are associated with working over the longer term with their clients, as their trainings are geared towards this practice. Longer term can be from several months to several years – though like counselling, many will engage in shorter term work.

Like with counselling, there are a myriad of approaches (from CBT to body centred or dynamic therapies) but for the most part, these consist of regular (generally weekly) confidential discussions.

Qualified psychotherapists are typically educated to post-graduate degree level over a period of at least four years. Most are required to have undergone psychotherapy themselves.

As above, always look for a psychotherapist who is accredited with a recognised governing body.

Please note that the terms “counsellor”, “psychotherapist”, and “therapist” are often used interchangeably. A practitioner will typically choose the professional title in which they were trained and feel most comfortable. The most important thing is that your professional is a good “match” so it might be worth speaking to a few before settling into your choice.

Psychologists:  

You might hear the term “psychologist” being used a lot. There are many types of psychologists, who work in many sectors such as business, education and research. When referring to a mental health professional, most people are referring to either a Counselling or a Clinical Psychologist.

Counselling Psychologist

Like counsellors and psychotherapists, counselling psychologists offer talking therapy, though you typically find them working within an organisation.

Counselling Psychologists may also be asked to make diagnoses about someone’s mental health condition. They may work with more serious, long term mental health conditions such as bipolar disorder and schizophrenia.

They cannot prescribe medication.

Must have a doctorate level qualification in Counselling Psychology (however, Counselling Psychologists are not medical doctors).

BPS

HPCP

Often, Counselling Psychologists work for the NHS or within the education sector (providing counselling to young people), therefore you are typically referred to them by your doctor or someone working in pastoral care.

Some Counselling Psychologists do work in private practice, and you can find them in the usual directories; for instance, Welldoing.org.  

If accessed via the NHS, it will be free to see a Counselling Psychologist, but please note that typically only individuals with severe mental health problems will be referred.

In private practice, you can expect to pay around £75-£120 / hour.

Clinical Psychologist

Typically, Clinical Psychologists are focussed on diagnosis, and thinking up treatment plans to improve clients’ quality of life.

They cannot prescribe medication.

Must have a doctorate level qualification in Clinical Psychology (however, Clinical Psychologists are not medical doctors).

BPS

ACP-UK

HCPC

Clinical Psychologists typically work within the NHS or in prisons, therefore you must normally be referred to them.

N/A

Psychiatrists:

Specialist medical doctors, who can prescribe medication

Psychiatrist

Medical doctors focused on preventing, diagnosing and treating mental illnesses. Similar to Clinical Psychologists, Psychiatrists are more involved in diagnosis and prevention of mental health disorders than the therapeutic treatments (such as talking therapy). However, psychiatrists can prescribe medication.  

It is not uncommon to have both a psychiatrist and a talking therapist who will liaise every now and then about your treatment with your consent.

Psychiatrists are medical doctors (trained for 5 years + 2 years general training in a hospital), with (at least) an additional 3-year training in psychiatry.

Though some psychiatrists are also trained in psychotherapy, most are not and will focus mostly on assessment and pharmacological treatment and support

General Medical Council

Royal College of Psychiatrists

Psychiatrists typically work for the NHS or in private hospitals and prisons. You must usually be referred to them.

Private consultations can be very expensive and vary across the country. However, treatment is usually coordinated via your NHS GP or private healthcare who generally cover the costs of prescriptions if necessary. Outside of acute situations, visits with psychiatrists tend to be less frequent than those with talking therapists.

Emergency Help:

Emergency help

There are many hotlines for mental health emergencies, the most famous being The Samaritans. You can call them, for free, on 116 123, at any time of day or night.

This site has some alternative hotlines that may be of interest. Such hotlines are intended for crisis situations, after which you can access longer term mental health support in one of the ways described above (with the support of your doctor - if you choose to).

Remember, if you are feeling so low that you’re worried you may be a danger to yourself or to someone else you should call 999 or check yourself into your local A&E department.

Please do not be afraid to seek help, in whichever form is most useful to you.