What's the difference between a Therapist and a Psychologist?
Finding a suitable, qualified therapist is a difficulty that thousands (likely millions...) of people face every year. Unfortunately, there are many titles used to describe a therapist. In this article, I'll try to help explain the difference between the titles of "therapist", "psychologist", "counsellor" and "psychotherapist". Apologies, it is a complex question to answer, so this page is quite wordy! If you've only a few moments, please find below a quick summary of the article.
Quick Summary: In general, a clinical psychologist will have had more hours of training, a more diverse experience in different therapeutic modalities and have gained more clinical experience and 1:1 supervision upon completing their qualification compared to counsellors, psychotherapists or CBT therapists. Importantly, unlike the terms "counsellor", "therapist" and "psychotherapist", the title "clinical psychologist" is a protected title, meaning only someone who has completed a clinical psychology doctorate can call themselves a clinical psychologist. That aside, the therapeutic relationship is a key factor to improvement, so receiving therapy from any qualified therapist with whom there is a very strong relationship, could well be more helpful than receiving therapy from a more highly qualified, experienced clinician with whom the relationship is poor.
Therapist vs Psychologist vs Counsellor vs CBT Therapist
Protected titles
Firstly, and most importantly: none of the above titles are protected. A protected title means that only those that have passed a specific course or achieved set criteria can called themselves by those names. This means anyone can call themselves a therapist, psychologist, counsellor or psychotherapist. The only protected titles in the UK in mental health psychology treatment are: "Clinical Psychologist" and "Counselling Psychologist". There are others protected titles in the world of psychology relating to fields such as forensics, sports and organisational settings and these can be found on the HCPC's website.
What credentials to look for
Although it is easy to check the credentials of a Clinical or Counselling Psychologist, it is much, much harder to do this for counsellors, psychotherapists or CBT Therapists. Given this, I am going to simplify things a little here, and give you my subjective opinion on what to look for when looking for a therapist. [If you are one of the said practitioners who are not with the HCPC, BACP or BABCP, you'll know the therapist-credential system in this country is unfortunately flawed and I want to make this article as accessible as possible].
Clinical Psychologists and Counselling Psychologists
It is easy to find out if a Clinical or Counselling Psychologist is who they say they are: Anyone who practices as a Clinical or Counselling Psychologist in the UK must be registered with the HCPC. If in doubt, check the HCPC register.
Counsellors and Psychotherapists
For counsellors and psychotherapists, the main (in my opinion.....) membership body is the British Association for Counselling and Psychotherapy (BACP). However, it is important to recognise that within the BACP there are various different levels of membership. Page 13 of this pdf by the BACP is helpful to show the differences in memberships. As you can see, being a 'member' of the BACP is not specific enough. It is important to know what level of membership the practitioner has to gain an idea of their level of experience and training.
CBT Therapists
For CBT therapists (again, not a protected title), the main professional body is the British Association for Behavioural and Cognitive Psychotherapies (BABCP). If you are looking for a CBT Therapist, in my opinion, unless they are a Clinical or Counselling Psychologist (and therefore will likely have experienced extensive CBT training as part of their doctoral training), it is important to look for a CBT therapist who is accredited (not just a member) with the BABCP. By being accredited, they will have gained extensive training and clinical experience in CBT, often via a one-year full-time postgraduate diploma in adult settings.
Differences in Training
Clinical and Counselling Psychologists Training
There are some slight differences in the training between Clinical Psychologists and Counselling Psychologists. In general though, the three year full-time doctoral training (which is predominantly placement based) gives the trainee around 1500- 2000 hours of teaching and around 1000 hours of direct, supervised clinical experience in a large number of different therapies: cognitive behavioural therapy (CBT) (incorporating acceptance and commitment therapy and mindfulness), psychodynamic therapy, systemic therapy to name only three. Furthermore, on Clinical Psychology training, all trainees receive training and gain clinical experience across the lifespan, from child to adult to older adult as well as in neurodiversity.
It is important to add here that, unlike other trainings, the competition to get onto Clinical Psychology training is fierce and, as such, a Clinical Psychologist has often gained a wealth of clinical experience prior to training too. Years can be spent in mental health settings gaining the experience to get accepted onto a Clinical Psychology course and many talented individuals give up trying to get onto the training. Due to the competition, it is common for someone to have two years full time experience in mental health settings prior to the course (often conducting heavily-supervised therapy as an Assistant Psychologist or as another mental health practitioner), and not uncommon for this to be closer to five years. Furthermore, all of these individuals will have completed either a 3-4 year undergraduate psychology course or a one year postgraduate psychology conversion course prior to this experience. Therefore, by the time of qualifying as a Clinical Psychologist, it is common for a practitioner to have been gaining psychological knowledge and experience for eight full-time years, and have over 1500-2000 hours of direct clinical experience. The vast majority of practitioners will then take up a job in the NHS before starting private work some time later.
Counsellors / Psychotherapists Training
Unfortunately, training to be a counsellor or psychotherapist can vary widely. There are some exceptional, extensive courses, but also some very short ones (e.g., from a weekend course to a four year part-time course!). This is why it is so important to look for the BACP credentials (see above). For a registered member of the BACP, they will have completed a Level 4 diploma and a two year course, with 100 hours (minimum) of clinical experience over those two years. For an accredited member, this will be 450 hours. The training is generally adult based, although this can differ between individuals due to the placements offered.
CBT Therapists Training
Just like counsellor/psychotherapist training, there are, unfortunately, a large number of 'CBT courses' out there, and it is concerning that some courses advertise that a practitioner can be an 'expert' in CBT after a 7 hour course. This is simply not the case. Cognitive Behavioural Therapy is a complex treatment that is very easy to do badly. Outside of Clinical and Counselling Psychology, which both have high levels of CBT training on them, the main recognised training in CBT is the one-year postgraduate diploma. This is a full-time clinical diploma, which consists of at least 450 hours of training and 200 hours of supervised clinical practice - see here for full outline. Nearly all these courses are adult-based, although there are a couple of child courses in the country too.
So, going back to the main question: What is the difference between a therapist and a psychologist?. The answer: Potentially a huge amount!
Finally, I want to add something that may feel to some to be controversial but is something I say to many who call me up and ask me the question on this page, particularly because of the large price difference between counsellors and psychologists. That is, the although the experience, training and expertise of a therapist can no doubt make a big difference to the therapy, it is important to recognise the value of the therapeutic relationship. You can see the most skilled, qualified therapist, but if the relationship is not there, a huge variable that affects progress in therapy is lost. This is why, whenever I refer someone to one of my associates, I always say that I'll be on hand if any problems, and that I'll check in in a month's time to ensure all is going well. If the therapeutic relationship is not positive, this may be no fault of the patient nor the practitioner. It will likely just be due to the dynamic between them. Accepting this, I am then on hand to help think through this dynamic and to help think about whether it may be helpful to persevere for a little longer with the current practitioner or whether to change practitioners. In the latter case, we would then think about who may be a better practitioner to help you move forward. We may all be therapists, but we also have our individual personalities....
Finally, finally..... (sorry, someone just asked me this....): As for what an 'Online Psychologist' is - this is just a term I use to describe a psychologist (Clinical or Counselling) who offers treatment over an online video platform (such as Zoom or Teams).
As always, any questions about this or anything else, do feel free to ask