Do you know the difference between a therapist, counsellor, psychologist, and psychiatrist? We're clearing up the confusion and busting the myths that have created a stigma around therapy.
Just like we’d talk to our health care practitioner about persistent back pain or a cold that won’t go away, talking to a therapist about preserving our emotional wellness is important to support overall well-being throughout our lives.
What is therapy?
Broadly speaking, therapy—also referred to as psychotherapy, counselling, or talk therapy—provides a supportive environment to help people talk openly about their concerns. Evidence from countless studies has revealed that therapy is helpful for a wide range of individuals experiencing a diverse range of issues, embodying what Dr. Marion Perpick-Breton, a Calgary-based psychiatrist, has learned from experience.
“Good therapy can be one of the best investments a person can make,” Perpick-Breton says. “You treat one person and, the next thing you know, their spouse is affected, their children are affected, their co-workers are affected. The success is amazingly powerful.”
How can therapy help?
Therapists encourage people to explore the ways their emotions, thoughts, bodily experiences, behaviours, and environments contribute to their overall well-being, and aim to empower positive changes that contribute to a more meaningful and healthy life. Yanez Koenig, a registered clinical counsellor from British Columbia, stresses that “therapy can be beneficial for almost anyone,” adding that “taking the chance on therapy may be a good opportunity to work on past or current issues in a nonjudgmental atmosphere.”
Among other things, therapy can support people with
- making a big decision
- managing life transitions
- setting new goals
- coping with a crisis
- developing deeper personal awareness
- improving relationships
- managing mental illness
Like learning a new sport, every person will progress through therapy at his or her own rate. However, Perpick-Breton believes that therapy should be time-limited, stressing that “the goal of the therapist is to get clients out of therapy and doing the things they want to do in life.”
Types of therapists
Many different types of practitioners can provide therapy in Canada. The list below is not exhaustive; other professionals—such as clinical social workers and psychiatric nurses—also deliver valuable mental health support to Canadians.
What they do: Counsellors use different therapeutic approaches to facilitate self-knowledge, emotional growth, and the development of personal resources in their clients. A wide range of therapists work under the umbrella of the counselling profession, each with specialized training (for example, art therapists, school counsellors, and marriage and family therapists).
Training and licensure: At present, the term “counsellor” is not a protected term in Canada. Thus, it is important to ensure that your counsellor is certified by a provincial body, which requires, at minimum, a master’s degree in counselling or a related field.
What they do: Like counsellors, psychologists support mental health using a variety of therapeutic approaches. However, in some cases, psychologists may be more likely than counsellors to use psychological assessments and diagnose mental health concerns (for example, depression).
Training and licensure: Psychologists have completed graduate-level training (for example, in clinical or counselling psychology) and must be licensed in Canada by their province’s regulatory body (some require a master’s degree; others require a doctoral degree).
What they do: Psychiatrists are medical doctors who specialize in mental health. Unlike counsellors and psychologists, psychiatrists can prescribe medications to help their patients manage their symptoms. While some psychiatrists engage primarily in medical management, others integrate or emphasize therapy.
Training and licensure: Following medical school, psychiatrists complete a five-year residency in mental health. Psychiatrists must hold a provincial licence to practise medicine in addition to a specialist certification in psychiatry.
Types of therapy
There is not a “one-size-fits-all” approach to therapy, and there are as many different approaches as there are types of therapists. Most therapists blend elements from a variety of methods to meet the unique needs of each client.
Some common and widely researched therapeutic approaches include
- cognitive behavioural therapy , which helps clients shift detrimental thinking patterns toward healthier and more realistic self-talk, contributing to healthier emotions and behaviours
- emotion-focused therapy , which helps clients identify, understand, and positively transform their emotional experiences to achieve healthier functioning
- couples and family therapy , which works with families to assist with a specific concern (for example, a death in the family) or more generally to create more resilient relationships among family members
- expressive arts therapy , which uses creative processes (such as visual arts, creative writing, and music) to facilitate self-exploration and understanding
The therapeutic relationship
Koenig stresses that “finding a therapist is like finding a good pair of shoes—you want to find a good fit for you.” A large body of research suggests that a positive relationship between therapist and client is one of the most important factors contributing to a positive outcome in therapy.
Selecting the right therapist can feel daunting, but these tips can help.
Do some legwork
Peruse potential therapists’ websites to get a sense of how they work, or ask for a referral from a trusted source (such as a health care practitioner or friend who has found success in therapy). You may prefer a therapist with a similar cultural or religious background or who uses a specific approach, and some background research can help you scout one out.
Don’t be afraid to ask questions about the therapist’s licensure, training, areas of expertise, and approach to therapy. At the end of the day, go with your gut. Does the therapist seem nonjudgmental and kind? Do you feel listened to and understood? If your answer is no, Koenig advises that this may be a sign to find a different therapist.
Will I have to pay?
It’s good practice to discuss payment details prior to your first session. However, generally speaking, the following applies.
- Physician-referred therapy may be covered by your government medical plan, although waitlists for these types of services may be lengthy.
- Therapy provided at schools, post-secondary institutions, or charitable organizations is often offered free of charge or for a small donation.
- Private therapists typically charge for their services, although they may be covered under your employee health benefit plan. Some therapists offer services on a sliding payment scale based on income or ability to pay.
Getting the most out of therapy
Active engagement in therapy contributes substantially to successful outcomes. Here are some ways to maximize your time in therapy.
Determine your goals
Research suggests that therapists and clients who agree upon and work together toward goals see better therapy outcomes. Ask yourself honestly what you hope to get out of therapy, and work with your therapist to come up with a treatment plan and timeline for getting there.
Create a support network
Surrounding yourself with supportive people who genuinely want to see you happier and healthier is one of the best ways to maintain the helpful changes obtained in therapy.
As much as you feel comfortable, be honest with your therapist. Ask for clarification about things you don’t understand, and be truthful about what is and is not working for you in therapy.
Remember the mind-body connection
Nurture physical wellness by exercising regularly, eating healthy, getting enough sleep, and limiting intake of caffeine and alcohol. Talk to your health care practitioner to address any physical conditions that can affect mental wellness, or work with a naturopathic doctor or acupuncturist who can supplement mental health with nutrition, herbs, acupuncture, and other natural remedies.