Counsellors, Psychologists, and Psychiatrists - oh my!
So you have finally decided to take the plunge and look for a therapist - this shouldn’t be too hard, right? Maybe you type “therapy in BC” into google or decide to peruse Psychology Today’s listings. Suddenly you’re flooded with therapists of all types, prices, and modalities - it’s enough to make anyone feel overwhelmed! It took years of working in the mental health system for me to understand, so I’m delighted that I can try to make this a bit clearer for you, dear reader. Some of the terms you may hear out in the world include: (psycho)therapist, counsellor, psychologist, psychiatrist, social worker, or coach — read on and I’ll explain some of the differences between these titles.
Therapists in BC
In British Columbia, the term therapist (or the longer but equivalent term psychotherapist) is an umbrella term that can describe anyone who provides therapy - you can think of this term being more about identifying the service a person provides (i.e., therapy) rather than their specific qualifications to do so. Commonly in BC the word therapy refers more specifically to talk therapy, though keep in mind that there are other types of therapy too (e.g., behavioural, occupational, speech, physical etc.)
Counsellors
Counsellors are one type of talk therapist. Typically they have a master’s degree in Counselling Psychology - this could be a M.A, M.Sc, M.Ed, M.C., etc (although there are many types of masters degrees they essentially mean the same thing) - which includes academic and clinical training and supervision. Counselling is not regulated in BC and many other provinces, meaning technically anyone can call themselves a counsellor even if they are not qualified. Fortunately, most counsellors have recognized this as an issue and have worked together to create their own registering bodies for qualified counsellors. The two you would encounter in BC are the British Columbia Association of Counsellors (BCACC) and the Canadian Counselling and Psychotherapy Association (CCPA). Even though they are not government regulated, these registering bodies have their own screening processes, training requirements, ethical guidelines, and complaint processes similar to regulatory bodies, which means you can feel a bit safer and more confident when you seek services from counsellors who identify themselves as either a Registered Clinical Counsellor (R.C.C) or a Certified Canadian Counsellor (C.C.C) respectively. You may be able to access free or accessibly priced counselling through the public or non-profit sector, though a large proportion of people seek counselling privately in BC due to availability, accessibility, and selection. In those instances, BCACC’s current recommended rate is $135-150/hr for individual counselling. Counselling is not GST exempt (though associations are working on changing that) and many extended benefits plans will cover RCC’s, CCC’s, or both.
Psychologists
Psychologists are another type of therapist, and have a Ph.D, most often in Counselling or Clinical Psychology. In addition to being trained to provide therapy, they can also conduct many types of assessments, administer psychological tests, and diagnose, though some diagnoses require specialized training in addition to their doctorate. They are regulated by the British Columbia College of Psychologists and their rate is typically $225/hour. Many extended benefits plans will cover Registered Psychologists.
Psychiatrists
In contrast, psychiatrists are first trained as medical doctors and then complete a specialization in psychiatry. Because they are doctors, psychiatrists can prescribe medication for mental health difficulties, conduct assessments to make diagnoses, and are trained in therapy. It is of note that it is far more common to encounter psychiatrists who focus on diagnosis and medication than providing therapy in BC. It is also of note that many family doctors also have training in supporting patients with the most common mental health concerns and can provide prescriptions for medication too; if they don’t feel qualified to support you with your mental health, they can refer you to a psychiatrist for more specialized support, as you would typically access psychiatry through our public medical system.
Social Workers
Social Workers can have either Bachelor’s or Master’s degrees in Social Work (BSW or MSW respectively) and are regulated as Registered Social Workers. Many MSW’s are trained to provide therapy similar to that of counsellors, and all have some training in therapeutic skills. Social workers differ in that their training and experience often zooms out to work within broader systems in addition to providing one on one or small group support; you can encounter social workers doing all types of individual, group, and systems work in areas of government, hospitals, non-profits, grassroots organizations, and privately.
Coaches
The term coach is another one you might encounter. It is important to understand that there is absolutely no regulation for the term coach in BC and they have far fewer established training programs (and absolutely no training requirements go with the title). As such, there is a much greater range in the services a coach may provide. Although some coaches may provide support pertaining to mental health, you must know that coaching is not therapy. That doesn’t mean it can’t be helpful, but I encourage you to ensure that any coach you work with is demonstrably aware of the differences in their role as a coach vs. a therapist, and very mindful of the boundary between the two. This expectation should also apply to people who work as both a counsellor AND a coach. Other things to look for are coaches who have sought out specific training and are clear about their areas of focus.
For coaches or any other provider who doesn’t have any sort of regulated profession, it’s best practice that they are a part of some sort of external registration body to ensure they have the training, ethical guidelines, or complaint processes in order to help decrease the risk to those accessing their services. Please remember that if you don’t know the answer to these questions through an informed consent process or a website, it is always your right - and best practice- to ask.
Now what?
Okay, so maybe you sort of get it now, but I’m guessing you’re reading all of this wondering how you actually apply this information to find the right therapist for you. Stay tuned for my next post where I’ll give you some more tips!
