Do you wonder who can help you feel better – a psychologist, psychotherapist, psychiatrist, or a counsellor? Are you trying to figure out what type of psychotherapy is right for you? If the answer to either question is yes, you are not alone. Many people struggle to figure out which mental health professional they should see. And if you are feeling overwhelmed already, this task can seem almost impossible.
So, how do you figure out who is the right mental health professional for you? The answer to this question depends on several factors, including where you live, the nature and severity of your mental health issues, your insurance coverage, whether or not you can afford to pay for psychotherapy, and, of course, your worldview and culture.
Let’s start with the first factor: where you live. In Canada, there are some differences between provinces in terms of what types of mental health practitioners are regulated and how they are regulated. In Ontario, a variety of healthcare professionals can help with depression, anxiety, and other common mental health issues: psychotherapists, psychologists, psychological associates, psychiatrists, counsellors, and even – to some degree – family physicians and social workers. All these professionals can provide psychotherapy (or simply therapy), which is often used as a catch-all term for all types of mental health counselling. They can all be called therapists (another catch-all term). And though there is a great overlap between these practitioners, there are also some important differences.
Psychiatrists are medical doctors who specialize in the assessment, diagnosis, and treatment of mental illnesses. They are the only mental health specialists in Canada who can prescribe medications and whose services are covered by provincial healthcare plans, such as OHIP. Although psychiatrists can provide psychotherapy for depression and anxiety, their focus is usually on serious mental illnesses that require medical intervention in the way of prescription medication or hospital admission. Another problem with seeing psychiatrists is the wait time. In Ontario, the wait time to see a psychiatrist can be up to a year.
Unlike psychiatrists, all other mental health professionals – psychologists, psychological associates, psychotherapists, and counsellors – are not medically trained. Even though all these professionals can do psychological assessments and provide psychotherapy, psychotherapists and counsellors are not authorized to assign diagnoses. If you live in Ontario and, for some reason, need someone to formally diagnose your mental health issues, you should see a psychiatrist, psychologist, or a psychological associate.
As a general rule (but not always), counsellors tend to work on particular issues that involve practical advice. They are usually available to provide help in specific areas, for example drug and alcohol counselling, or grief counselling. Working with a psychotherapist tends to be a bit deeper: You are looking for the root cause of your issues, rather than just resolving problems at a conscious level. Currently, the only provinces in Canada where psychotherapy and/or counselling are regulated are Ontario, Quebec, Nova Scotia, and New-Brunswick.
In Ontario, psychologists and psychological associates are registered with the College of Psychologists of Ontario. As a rule (but not always), psychologists have a PhD, and psychological associates have a master’s degree in psychology. As a rule (but not always), psychotherapists and counsellors also have a master’s degree in psychology. However, each group of professionals is registered with a different college. For example, psychotherapists are registered with the College of Registered Psychotherapists of Ontario.
One reason why you should care about these different titles and registrations is if you’d like the cost of your psychotherapy to be reimbursed by your extended healthcare insurance (often known as work benefits). In Ontario, most extended healthcare plans provide coverage for the services provided by psychologists and psychological associates. Some plans also provide coverage for the services provided by psychotherapists, social workers, and/or counsellors. Even though psychologists and psychological associates are recognized by more insurance companies, their fees are often higher than those of psychotherapists and counsellors. If, for example, your extended healthcare plan is with Great-West Life, Green Shield Canada, Manulife, Sun Life, Equitable Life, or Blue Cross, then your plan can cover more sessions of psychotherapy if you see a psychotherapist than if you see a psychologist. Check with your insurance provider to see which mental health practitioners are recognized by your plan.
In either case, choose the mental health professional you like as a person and with whom you feel most comfortable. According to research, how you connect with your therapist and the strength of your relationship are more important than the therapist’s theoretical orientation (or the types of psychotherapy he or she practices), his or her level of psychological education, and even years of practice. Try to find a person you feel like you can talk with and trust; someone who has solid life experience, and ideally, has been where you are and has gotten where you want to be. Most therapists are clear in their marketing about what they can best help you with and their therapeutic approach. You can figure out the rest during your initial conversations.