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Psychiatry, psychology, psychotherapy, counselling: what’s the difference?

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Problems of the mind can be overcome in a variety of ways says Dr Vasilios Silivistris


I am always asked the same question,‘What are the differences between psychology, psychiatry, psychotherapy and counselling?’

Very good question!

For people who are not in the field, it can be confusing to differentiate between a psychiatrist, a psychologist, a psychotherapist and a counsellor.

There are significant differences between psychiatry, psychology, psychotherapy and counselling roles and prople practising them tend to deal with different types of problems, although there is considerable overlap.

What is psychiatry?

Psychiatry studies mental disorders and their diagnosis, management and prevention. Psychiatrists are medical doctors who specialise in psychiatry and most postgraduate studies take four years to complete. Psychiatrists are the only professionals who can prescribe medication for clients/patients. They often combine a broad general caseload alongside an area of special expertise and research.

Here, clients are called ‘patients’.

What is psychology?

Psychology is the study of people: how they think, how they act, react and interact. Psychology is concerned with all aspects of behaviour and the thoughts, feelings and motivation underlying such behaviour.

Psychology is a discipline that is firstly concerned with the normal functioning of the mind and has explored areas such as learning, remembering and the normal psychological development of children. Psychology is one of the fastest-growing university subjects and is becoming more and more available in schools and colleges.

Psychologists deal with the way the mind works and motivation and can specialise in various areas such as mental health work and educational and occupational psychology. It is useful to remember that psychologists are not usually medically qualified and only a small proportion of people studying psychology degrees will go on to work with clients and or patients.

Sub-fields within the field of psychology include: Educational psychologist, Behavioural psychologist, Industrial and organisational psychologist, Clinical psychologists (these professions work within mental health), Occupational health psychologist, Criminal psychologist, Social psychologist, Sports psychologist.

What is psychotherapy?

Psychotherapy is conducted in several different ways: individual, group, couple and family psychotherapy. They are all ways of helping people to overcome stress, emotional problems, relationship problems or troublesome habits.

There are many different approaches in psychotherapy; these are ‘talking therapies’ which include Cognitive Behavioural Therapy(CBT), Psychoanalytic therapy, Psychodynamic therapy, Systemic and family psychotherapy, Arts therapy, Play therapy, Humanistic psychotherapy, Interpersonal psychotherapy, Rational Emotive Behaviour Therapy (REBT), Integrative psychotherapy, Eclectic psychotherapy, Gestalt psychotherapy.

A psychotherapist may be a psychiatrist, psychologist or counsellor, who has had further specialist training in psychotherapy. Increasingly, psychotherapists do not have any background in the above fields but have undertaken in-depth training in some of these fields. Most psychotherapists have post-graduate diplomas or degrees.

Furthermore, there are now courses in the United Kingdom where psychotherapists can pursue a higher academic qualification where they can study for a clinical doctorate in Psychotherapy (PsyD).

To train to become a psychotherapist, most educational establishments will not take on students who are younger than 28. The premise is that students must have some life experiences to be able to practise as a therapist. So, in theory, the older you are, the more life experiences you should have.

What is counselling?

Counselling and psychotherapy are interchangeable, however the term counselling is usually referred to short-term goal-setting therapy, whereas psychotherapy is generally referred for long-term therapy.

Most counsellors work in schools, colleges and universities.

In addition, some counsellors work for large organisations in their occupational health departments where they offer in-house counselling to employees. Most of the work is short-term and solution focussed.


Dr. Vasilios Silivistris (Vasos) is a psychotherapist, counselling practitioner.


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