I'm Confused! Please Explain the Differences Between...
Psychotherapy, Therapy, and Counseling?
Psychologist, Therapist, Psychotherapist, Psychiatrist, and Counselor?
It is confusing! Let me try to untangle it for you. Originally,
the term
"counseling" was used to mean sessions where the focus
was on helping a
person deal with everyday problems or meeting educational and personal goals,
whereas
the terms "therapy" and "psychotherapy"
were frequently used when there was a diagnosable illness being treated or when
the sessions were with a Psychologist or Psychiatrist. For that
reason, you will typically see Clinical Psychologists whose training allows them
to diagnose, assess, and treat diagnosable disorders use the terms psychotherapy
or therapy. However, the terms psychotherapy, therapy, and counseling can
really be used interchangeably.
The second set of terms (Psychologist, Therapist, Psychotherapist, Psychiatrist, and Counselor) are a little more difficult to explain. Some titles, such as Psychologist and Psychiatrist, are protected by law so that you know that when a person is using those terms that they have had to meet very stringent requirements in terms of education and training. However, the terms "psychotherapist," or "therapist" and "counselor" are a little stickier since they are too often used by individuals who have little or no training. Although there are many well-trained, licensed mental health professionals who use these terms (for example, psychologists, psychiatrists, social workers, marriage-family counselors), the lack of consistency with meaning of these terms make it very important that consumers look behind these terms and find out the educational level, training, and licensure of a potential provider.
While I cannot address all of types of mental health practitioners and the various mental health-related degrees, I will try to address the most common ones. Let's start with the difference between Psychologists and Psychiatrists, both of which are referred to as "Doctor / Dr." PSYCHOLOGISTS (particularly those with degrees in Clinical Psychology) have obtained a doctoral degree (e.g., Ph.D.), meaning that they have spent typically 9-12+ years in college and graduate-level training in the science of psychology; behavior; and the assessment, diagnoses, and treatment of mental illness. Most Psychologists have gained supervised experience during their graduate training and all have gone through a rigorous year of supervised training during a 1-year internship. In addition, most states also require Psychologists to obtain an additional year of supervised experience after they complete their doctoral degree and their internship. It is Psychologists who are trained in assessment (although in many states Master's Level providers can do testing under the supervision of a Psychologist). A PSYCHIATRIST, on the other hand, is trained in medicine and holds an M.D. degree. Their focus is on the biological aspects of mental disorders and primarily use medication (e.g., Prozac, Lithium) to treat emotional problems and mental illness. They obtain the same training as any other physician and often begin training in the treatment of mental illness during their 3-year residency. Although some have training in psychotherapy (usually of the type called "psychoanalysis" based on the theories of Sigmund Freud), most psychiatrists now have a practice where they only provide medication for the treatment of mental illness. For the most part, only Psychologists and Psychiatrists are allowed to diagnose. For that reason, it is not uncommon for individuals with more serious mental illnesses to see both a Psychologist (for therapy) and a Psychiatrist (for medication).
There is more variety in the mental health providers who hold a Master's Degree (typically 5-6+ years of college and graduate-level training) and therefore there is a wider variety in the type of licenses they hold. In Georgia, the licenses available to those with a Master's Degree (and on rare occasion, someone with a higher level degree whose training does not meet the requirements for licensure as a Psychologist) are: Licensed Professional Counselors (LPC), Licensed Marriage and Family Therapists (LMFT), Licensed Clinical Social Workers (LCSW), and Licensed Master Social Workers (LMSW). The differences in these titles lie mostly in the focus of their degree and experience. For example, Social Workers (LCSW and LMSW) typically hold a Master's Degree where they obtained specialized training in linking patients to community and institutional resources. Marriage and Family Therapists (LMFT) have training similar to that of social workers, but their training and focus is specifically on relationships and family issues (although others mental health providers, including many Psychologists, have specialized training in these areas).
