Who is the right person for you to see? A counsellor, or maybe a psychiatrist? What's the difference anyway?
Most people in New Zealand don't understand what psychotherapists, psychologists, life coaches, counsellors, and psychiatrists are, how they work, and how they are (and aren't) different from each other. It does get a bit complicated, so hopefully this brief guide will help to steer you in the right direction.

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What is a Counsellor?

What is a Psychotherapist?

A wide variety of people call themselves counsellors, which is perfectly legitimate as the term counsellor is not a legally protected title as is the case with psychotherapists, psychologists, and psychiatrists. Though for this reason, there is no minimum training requirement, the majority of counsellors hold university diplomas, bachelors degrees, or masters degrees in counselling. If someone has done one of these forms of training, you can reasonably expect to receive a professional and competent service from them, though of course no amount of training or legislation can realistically guarantee this, or should replace your own judgement about what is working for you.

Like the other mental health professions, most counsellors are also members of professional associations. The largest New Zealand counsellor specific professional association is the New Zealand Association of Counsellors (NZAC). NZAC members will have met minimum training requirements, and practice according to the NZAC code of ethics. 

So that's a bit about counsellors. What about counselling? Here it gets a bit more complicated. All of the mental health professionals draw from a large pool of different ways of working, called modalities. If someone says they are offering counselling, and you want to know more specifically what they mean, you could ask what modality or modalities they are practicing. The different mental health professions tend to favour different modalities. Counsellors often practice person centered counselling, cognitive behavioural therapy (CBT), strengths based counselling, or solution focused counselling. (Though there are actually thousands of modalities!) If you want to learn more about any of these modalities, you could do a google search about them, or check out their wikipedia page. 

So if what really matters is the modality a practitioner is using, why do some professionals bother to call themselves by more than one term, ie psychotherapist and counsellor? This may just be marketing to appeal to a broader range of clients, but often it is indicative of a range of services. In the above example (which is the case here at Lucid Psychotherapy and Counselling), it is indicative that the practitioner is willing to work in a practical and short term way that counsellors are often known for, as well as the more long term of in depth work that is typically associated with psychotherapy. 

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What is a Psychiatrist?

Psychiatrists are at the top of the hierarchy of mental health professionals in terms of the responsibility that they carry, and influence they can exert. All psychiatrists are medical doctors, who have then completed further training in psychotherapy, psychiatric medications (which you can expect them to know more about than your GP), and the management of mental health issues. It takes many years of training to become a psychiatrist, and membership of the Royal Australian and New Zealand College of Psychiatrists (RANCP) is required. 

So how is psychiatry different from everything else we've been talking about in this series? Unlike counsellors, psychologists, life coaches, and psychotherapists, psychiatrists can prescribe medications. Many people with some of the more serious mental health diagnosis see psychiatrists for initial assessments, then only occasionally to have their medication reviewed or adjusted. Though they are trained in some of the styles of talking therapy that the other mental health professions practice, most psychiatrists do little if any ongoing talking therapy of any sort with clients, and may charge relatively high fees for this service in private practice. 

Unlike the title counsellor, the title psychotherapist is legally restricted in New Zealand. This means that anyone calling themselves a psychotherapist must be registered with the Psychotherapists Board of Aotearoa New Zealand (PBANZ.) (Please note, the term psychotherapy is not legally restricted, so anyone can say that they practice psychotherapy.) PBANZ registration has requirements regarding training, ethics, regular professional supervision, and unlike the other mental health professions, the psychotherapist having had their own experience of being a client in therapy, and therefore hopefully having addressed a lot of their own personal issues. Psychotherapists have had a range of training, which is typically equivalent to a university Masters or Doctorate degree in terms of intensity and time spent. 

Many psychotherapists are members of professional associations, the largest of which in New Zealand is NZAP (the New Zealand association of Psychotherapists.)

Psychotherapists typically practice psychotherapy, but what does that actually mean? It often but not always means working longer term and more in depth than counselling. It also depends on the modalities that the psychotherapist is working with. In Christchurch, common psychotherapy modalities include Gestalt therapy, psychodrama, transactional analysis, Jungian therapy, and object relations. You can research these online, but it'll pretty quickly get quite complicated to understand. Unless you know what you're looking for, you may be best served by asking someone for a recommended practitioner, or just meeting with someone to try out one session. 

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What is a Psychologist?

As with psychotherapists, the term psychologist is legally protected. This means someone must be registered with the New Zealand Psychologists Board, and meet their training and ethic requirements, in order to call themselves a psychologist. In addition, many psychologists are members of the New Zealand Psychological Society, which as a professional body regulates their practice.

Psychologists have the further complication of being divided by scopes of practice. You might be surprised to know that many people with the title of psychologist have little or no training or experience doing talking therapy. Clinical psychologists have been trained specifically in talking therapies, whilst psychologists without the additional clinical designation may or may not have had any training or experience in this area. Psychologists in New Zealand generally have Masters or Doctoral level university qualifications.

So that's about psychologists, what about psychology? This is an extremely broad term, that encompasses not only talking therapy, but many different fields such as ergonomics or brain functioning. As participants in Western culture, we all to varying degrees draw on psychological thinking, whether we know it or not. 

Because this post is related to therapy, I'll talk a little, very generally, about how psychologists tend to do talking therapy, in comparison to the other mental health professions. Psychologists often draw on cognitive behaviour therapy (CBT), but often know a number of modalities, and may practice at times similarly to counsellors of psychotherapists depending on their training and modality. Psychologists, more than counsellors and psychotherapists, are trained in the researcher-practitioner model, which like every approach has issues and benefits. From my experience of getting to know a range of practitioners, I feel that often psychologists seem a bit more like scientists to me, have a strong interest in research that draws on numbers and statistics, and may be less interested in the subtleties of relationships than psychotherapists or counsellors may be. Once again, these are very broad generalisations!

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What is a Life Coach?

Of the different professions I've covered on this page, Life Coaches are the newest. They are also, arguably, coming from a different framework in that they are not necessarily health care practitioners. (This distinction makes somewhat of a difference, as unregistered health care practitioners such as counsellors, and registered ones such as psychotherapists, psychologists, and psychiatrists, are all held to basic ethical practice requirements such as confidentiality, by New Zealand law as health care practitioners.) That said, many coaches will uphold similar or identical standards of practice.

There is no New Zealand professional body specific for Life Coaches, though some New Zealand coaches are members of the International Coaching Federation (ICF.) There are no minimum standards of training, meaning that some coaches have done a couple of months of training, whilst others, generally those who are also trained as counsellors, have a significant amount of training.

So enough about life coaches, what actually is coaching, and how does it differ from other forms of practice we've been discussing? Coaches tend to be strengths based in their approaches, inspiring their clients, teaching them skills, and helping them to be more effective in reaching specific goals such as business success or weight loss. In my experience, the approach of many life coaches draws heavily on self help, and occasionally new age concepts, though variety does exist. Coaching may appeal to those who are less interested in self disclosure or self-discovery, and are more focused on an external form of success. The metaphor of a coach is apt, as the therapist is training you to score the goal (whatever that may be).

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