Psychiatrist, Psychologist, Psychotherapist, Counsellor, Therapist: What's the Difference, and Who Does What?
Psychiatrists, psychologists, psychotherapists, counsellors and therapists all play an important role in mental health and emotional wellbeing — but what actually sets them apart, and who should you turn to?
It's heartening to see mental health increasingly recognised and valued in society. People are speaking up more openly, and many public figures now share their own struggles with real honesty, encouraging others to seek support when they need it.
Identifying the right professional — someone with the training and experience to meet your particular needs — really matters. But once you've decided to look for support, it's easy to feel lost. Psychiatrist, psychotherapist, counsellor, therapist… it's not always obvious who you should be contacting.
Here's a short, practical breakdown of each role, to help you find your way if you're in this position.
Psychiatrist
A psychiatrist has trained in medicine before specialising in psychiatry. During this specialist training, they study mental health conditions, including diagnosis, treatment and prevention. Psychiatrists are the only professionals on this list who can prescribe medication to help manage mental health conditions. They tend to work with people whose difficulties have a medical dimension that needs to be taken into account, and they often work as part of a wider team — alongside psychologists, speech and language therapists, occupational therapists or dietitians, for example — as part of a coordinated treatment plan.
Psychiatry includes a number of sub-specialities, each requiring further specific training.
Reasons someone might see a psychiatrist include:
Depression
Attention-deficit disorders (with or without hyperactivity)
Dementia
Schizophrenia (a loss of contact with reality)
Eating disorders (such as anorexia and bulimia)
Autism spectrum conditions
Bipolar disorder
Anxiety disorders
Psychotic disorders
Personality disorders
Neurocognitive disorders
Psychologist
A psychologist holds a recognised qualification in psychology, during which they study how people think, behave and interact, how the brain develops and functions — including learning and memory — as well as more complex mental health conditions.
Psychologists are trained to assess mental processes and behaviour, identify the most appropriate treatment, and carry out interventions depending on their training and specialism (cognitive behavioural therapy, systemic therapy, integrative therapy, and so on). A psychologist helps clients work through a wide range of difficulties — emotional, psychological and relational struggles among them. They work with clients to deepen their understanding of themselves, their feelings, their reactions and their relationships, and they also address past experiences and trauma that continue to affect day-to-day life.
Psychology itself branches into several specialisms. Educational psychologists work within schools; others specialise in occupational, social, sports or neuropsychology.
Psychotherapist
For the French readers: in France, a psychotherapist is a psychologist or psychiatrist who has gone on to train in a specific approach — cognitive behavioural therapy, systemic therapy, or psychoanalytic therapy, for example. In the UK, the route is a little different: it's possible to train directly in a particular therapeutic modality through a four-year specialist training to use this title. A psychotherapist works on similar issues to a psychologist, but does not carry out formal assessments or provide diagnoses.
"Psychotherapy" is really an umbrella term covering various forms of therapies. Psychotherapists train in a range of approaches to help you understand and explore your feelings, and many also teach practical tools you can use to manage overwhelming emotions more effectively.
While the title is legally protected in France, there's currently no legal restriction on using the title "psychotherapist" in the UK. However, the title "registered psychotherapist" is protected by bodies such as the UKCP and the BACP, which work to uphold high training standards and safe practice. Not every psychotherapist with accredited training is registered with one of these organisations, so if a practitioner isn't registered, it's worth asking which institution they trained with and whether that training is recognised by one of these accrediting bodies.
Counsellor
This profession can be unfamiliar to French readers, as it doesn't really exist as a distinct category in France. In the UK, people who don't necessarily feel they have a mental health condition — but who are going through a breakup, redundancy, bereavement, low mood, anxiety, a difficult period in life and want to do some introspective work — are often seeking counselling. A counsellor typically trains for two to four years in talking therapy and psychological support. Counsellors are trained to help clients experiencing psychological difficulties through talking or somatic therapy. Your counsellor will help you explore your thoughts, feelings and behaviour so that you can find your own solutions, working through whatever is getting in the way of your personal growth and wellbeing. This can look similar to psychotherapy, though training and scope of practice differ, particularly when it comes to more complex presentations.
As with the title "psychotherapist", the title "counsellor" is not legally protected in the UK. It's always worth checking a practitioner's experience, training and qualifications to make sure they're suitably qualified to practise. If you're ever unsure, professional bodies such as the British Association for Counselling and Psychotherapy (BACP) and the National Counselling and Psychotherapy Society (NCPS) promote and oversee this profession — their members have completed approved training and commit to a code of ethics.
Therapist / Practitioner
This title applies to people trained in a specific technique or tool — hypnotherapy, Emotional Freedom Techniques (EFT), neuro-linguistic programming, Thought Field Therapy, or EMDR, to name a few. The focus here is on the tool itself: training covers both theory and practice, so the practitioner understands how and when to use it most effectively, as well as its limitations and contraindications. These approaches tend to be very goal-focused and generally fall into the category of brief/short therapies.
Therapists and practitioners often work alongside the professionals described above, since their tools and skills are highly complementary and can support work that's already underway. They're also often sought out by people wanting to make progress on specific behaviours or thought patterns, or to work on particular areas of their life, without this necessarily involving a mental health condition.
Psychiatrists, psychologists, psychotherapists and counsellors can also train in these approaches, and for some professionals this counts as approved continuing professional development with their regulatory bodies — but not every therapist or practitioner is also a psychiatrist, psychologist or counsellor.
The titles "therapist" and "practitioner" are not regulated, although a valid qualification is required to obtain insurance. It's therefore essential to check a practitioner's training, certificates and references before starting to work with them. Beyond this, national and international bodies exist for each individual modality; they assess the credibility of training providers and require members to follow codes of conduct relating to safety and the ethical application of their techniques. When looking for a therapist, it's worth checking whether they belong to one of these professional bodies.
Whichever Path You Choose…
Whichever professional you decide to see, remember that this is, above all, a relationship you'll be building together. Finding someone you feel comfortable with really matters for the work to be effective — that relationship plays a key role in your progress and shouldn't be underestimated.
And if you're still not sure who to turn to, a good starting point is to speak to your GP, who can advise you on the most suitable next step.
If you'd like to talk through what kind of support might be the right fit for you, get in touch — I offer counselling, hypnotherapy, EFT and EMDR for adults (16+) in West Hampstead, Paddington/Lancaster Gate, and online.
