The terms therapist and counsellor are often used interchangeably by the public, media and even mental health professionals. The term “therapist” can be used to describe someone with a counselling qualification, a mental health practitioner, or a registered psychotherapist. Even some Counselling or Clinical psychologists might casually refer to themselves as “therapists”. To make things more confusing – the terms “counsellor” and “therapist” are not legally protected titles in the UK, so theoretically anyone could refer to themselves by that name. 

If you’re looking for mental health support for the first time, all of this can be overwhelming and confusing. We’re here to help you: 

• make sense of the different types of mental health support available to you
• figure out which option is best for you 
• know what qualifications to look out for to ensure you’re receiving a high-quality service

What do counsellors or therapists actually do? 

 Counsellors are mental health practitioners who help individuals manage and overcome their mental health concerns. They work with a variety of clients who may be experiencing stress, relationship problems, bereavement, or other mental health issues. Therapists (often referred to as “psychotherapists”) work with similar clients and topics to counsellors but they may have more advanced training (e.g. a master’s degree in psychotherapy or other specialisation). 

No matter what, all counsellors and therapists aim to provide a safe and supportive environment for clients to discuss their concerns and feelings. They may use different types of therapy depending on the client’s needs. Their goal is to help individuals gain insight into their thoughts, feelings, behaviours and/or relationships in order to manage their mental health concerns.

The key difference to look out for is which, if any, specialisation the counsellor or therapist has. For example, some might be specialised in cognitive-behavioural therapy (CBT), mindfulness-based therapy, Interpersonal Therapy (IPT), Psychodynamic Therapy, couple therapy or a mix of several approaches. Sometimes you will see people refer to “talking therapies” – this just means that the mental health practitioner is working with you primarily through conversation (e.g. CBT), as opposed to through activities (e.g. art therapy). 

The specific type of therapy that you receive will impact:

• What topics or concerns you focus on 
• Whether it’s offered on an individual, group, family, or couple basis
• How long the therapy lasts (short-term or long-term)
• The extent to which you delve into past issues or traumas 

What kind of therapies are usually offered?

Cognitive-behavioural therapy (CBT): focuses on identifying and changing negative thought patterns and behaviours that cause distress. The client will start by setting specific goals and developing practical strategies to manage their mental health concerns.

Interpersonal therapy (IPT): focuses on helping people identify, process and mitigate any issues in their relationships (e.g. with family, friends, partners or any other people). 

Psychodynamic therapy: focuses on exploring the unconscious processes and early life experiences that may be influencing a person’s current behaviour, emotions, and relationships. They aim to help individuals understand the underlying causes of their mental health concerns and develop insight and self-awareness to make lasting changes.

Mindfulness-based therapies: focus on increasing an individual’s awareness of the present moment and reducing rumination about the past or anxiety about the future. For example, you may follow a mindfulness-based stress reduction programme or mindfulness-based cognitive therapy. 

Sex therapy: focuses on a client’s relationship with sex, and any problems they may be experiencing (e.g. change in libido, pain during sex, or difficulty maintaining arousal). 

Integrative therapy: combine different therapeutic approaches to provide a tailored and flexible treatment that suits the individual needs of their clients, and allows them to address a wide range of concerns.

Eye movement desensitisation and reprocessing therapy (EMDR): focuses on reprocessing trauma, phobias or difficult life experiences. The EMDR practitioner will ask the client to recall a memory. They will then use hand tapping, eye movement and/or sounds to help the client release their emotions and reprocess the memory.

Art, drama or animal therapy: combine activities with talking therapy to allow you to explore thoughts and feelings, and release them. Art therapy involves using painting, drawing, or sculpture. Drama therapy involves role plays and acting. Animal therapy involves spending time with, learning about and bonding with a specific animal (e.g. an alpaca). 

Speech and language therapy: helps individuals who have communication, and/or eating, drinking and swallowing difficulties. These can have both physiological and psychological causes – which the practitioner will explore with the client.

RESET therapy: Our approach is an integrative model that uses aspects of various therapeutic approaches. Mind-body-environment interventions are used to create long-term sustainable change. These include breathwork, meditation, strength training and yoga. 

Do psychologists also deliver therapy? 

There are two types of psychologists who provide mental health treatment: Counselling Psychologists and Clinical Psychologists. They have largely similar skill sets and have received a high level of training (usually a doctorate degree). Psychologists are able to assess their client problem through formulations or psychometric testing. They can then help their clients understand their thoughts, feelings, and behaviours, and develop strategies to cope with their mental health concerns. 

Clinical and Counselling Psychologists use a wide range of evidence-based interventions and therapeutic approaches. For example, they might have training in cognitive-behavioural therapy, psychodynamic therapy, cognitive-behavioural therapy, behavioural activation, and mindfulness-based therapy. There will be some variation in this based on which university they studied in, and if they received any additional qualifications throughout their careers. They can work with complex mental health concerns and can develop specialist expertise in areas such as addiction, trauma, personality disorders, psychosis, learning difficulties and eating disorders. 

What do psychiatrists do? 

Though psychologists can work with a wide range of problems and formulate psychological assessments, they can’t prescribe medication. Thus, there may be cases where you need to see a psychiatrist. Psychiatrists are medical doctors who specialize in the diagnosis and treatment of mental health conditions, and they are the only mental health professionals who can prescribe medication for mental health conditions. If you have severe or complex mental health conditions, you might need a formal diagnosis from a psychiatrist. They can provide more extensive assessments and prescribe medication to manage your symptoms. 

Medication is not always necessary for the treatment of mental health conditions, but for some people, it can be a helpful tool when used in addition to therapy. 

What qualifications should I look out for in my counsellor, therapist or psychologist? 

There are benefits to finding a counsellor or therapist accredited by a professional body such as:

• British Psychological Society (BPS) 
• British Association for Counselling and Psychotherapy (BACP) 
• The UK Council for Psychotherapy (UKCP)
• Health and Care Professions Council (HCPC)

These accreditation bodies typically have strict requirements for membership – for example, needing to receive considerable hours of training, receiving clinical experience and supervision, and adhering to a strict code of ethics. 

Many counsellors, therapists and psychologists also undergo personal therapy for themselves as part of their training. This allows them to develop their own emotional coping techniques, and therefore be fully present, engaged and compassionate with their clients. 

How much can I expect to pay? 

If you seek treatment via the National Health Service (NHS), you may be offered free therapy from a qualified mental health practitioner such as a counsellor. 

If you go via the private route, the session costs can vary considerably depending on the practitioner, their qualifications, and the location. For counsellors or therapists, you can expect to pay between £50 to £120 per session. Private practice psychologists may charge between £80 and £150 per session. Private psychiatrists will cost upwards of £150 per half an hour – but a session to receive a diagnosis can cost several hundred pounds. 

Private health insurance may cover the cost of therapy, so it is worth checking with insurance providers before seeking therapy services. Some counsellors, therapists or psychologists offer sessions remotely, either by phone or video call, which might be more cost-effective – though not always. Additionally, some therapists offer a sliding scale fee, which allows clients to pay based on their income.

Which therapy is right for me?

Deciding whether to see a counsellor, therapist or psychologist can be a difficult decision. The answer may depend on a number of factors, including the severity of your mental health concerns, your personal preferences and your budget.

If you are experiencing mild to moderate mental health issues, such as relationship problems, stress or anxiety, you may benefit from seeing a counsellor. Counsellors are trained to provide support, guidance and practical advice to help individuals manage their mental health concerns. They typically have a shorter period of training compared to therapists and psychologists, which can make them a more affordable option. Counsellors are more likely to work for shorter durations with clients and provide time-limited sessions, as opposed to long-term therapy without a pre-agreed end date. 

If you are experiencing more complex or severe mental health issues, such as trauma, you may benefit from seeing a psychotherapist or counsellor who specialises in your specific area of concern.  You may also consider seeing a Clinical or Counselling Psychologist, who can provide evidence-based treatment even for long-term or complex mental health concerns. 

It is worth noting that more expensive does not necessarily mean higher quality. It’s worth looking at the profiles of the mental health practitioner you will be working with to understand how many years they’ve been working, what therapies they offer, and if they focus on certain mental health concerns. The most important thing is choosing a mental health professional who you feel comfortable working with and who has the expertise to meet your needs. 

Getting the most out of your treatment

The therapeutic relationship is an essential component of therapy, and finding a practitioner that you feel comfortable with is crucial. It is okay to shop around and try different therapists until you find one that is a good fit for you. Ask yourself: is this someone I could trust and be vulnerable with? 

You should also consider their approach and whether it meets your goals for therapy. Being clear about your goals for therapy at the start of your sessions can help to ensure that you and your therapist are on the same page. This can help to establish a clear direction for your therapy and make the most of the time that you have with your counsellor, therapist or psychologist. 

Finally, remember that it’s okay to change therapists if you are not finding the relationship helpful or if it is not meeting your needs. Sharing your feedback can help to build a stronger therapeutic relationship and ensure that your sessions are focused on your goals.

If you are struggling with mental health concerns, seeking professional help can be extremely empowering. While the decision of who to see may depend on the severity of your symptoms, personal preferences, and cost, it’s important to remember that there is a range of mental health professionals available to help. It might take a bit of trial and error, but you can absolutely find someone you will enjoy working with, and who will genuinely help you.

Disclaimer: This article is written from a UK perspective – the terms used and qualifications will vary for other countries.

Victoria Chappell is an Assistant Psychologist at the RESET Health Group. She runs the RESET addiction recovery programme at Changes UK.