Who Can Help? Understanding the Difference Between Social Workers, Psychotherapists, Psychologists, Psychiatrists, and Counsellors

By

Layla Team

July 23, 2024

When beginning the search for the right therapist, many of us have the same question: what are the different types of mental health care providers and which one is right for me? There are both similarities and differences between the various mental health care providers. As you navigate through the information in this post, keep two questions in mind: “What do I need?” and “What might this provider offer me?”

Note: Regulations apply at a provincial/territorial level and therefore each province may differ in requirements. For full information on professional regulations, please visit the provincial and professional regulatory body websites.

Registered Social Workers (RSW) and Registered Clinical Social Workers (RCSW)

A social worker is a mental health professional who supports people to manage and overcome various life challenges. Social Workers can work in different roles, including treatment and clinical assessment, case management, research, and policy development. Social workers who provide psychotherapy complete a Master’s Degree in Social Work (MSW). 

Registered Clinical Social Workers (RCSW) exist in British Columbia (BC) and Alberta (AB). They hold a master's degree in social work and have completed advanced clinical training and supervision. This designation allows them to use the Diagnostic and Statistical Manual of Mental Disorders (DSM) independently to make mental health diagnoses.

Social work education focuses on systemic issues and within an MSW program, one can choose to specialize in a specific area of Mental Health. This can include social policy, therapeutic intervention, or focusing on supporting specific populations. Social workers are trained to conduct a thorough assessment of an individual's overall well-being focusing on their physical, psychological, social, emotional, and cultural needs and to utilize resources, psychotherapy interventions, and/or social interventions to help address individual challenges. Social Workers are able to practice psychotherapy under the Psychotherapy Act. Social workers who are completing psychotherapy address individual issues using various therapy modalities, which they can review with you at the beginning of your therapy journey.
 

  • Regulated by: Provincial Regulatory Body
  • Education Level: Master’s level degree (MSW) for clinicians providing psychotherapy 
  • Provide Diagnosis: RSW - No; RCSW - Yes
  • Prescribe Medications: No
  • Conduct Assessment: Yes, diagnostic capabilities dependent on designation
  • Therapy Treatment: Yes
  • Session Fee: Typically ranges from $120-$195. Prices vary depending on location and therapist.
  • Coverage: Covered by most employer benefits plans
  • Waitlists: Generally short or none

Registered Psychotherapists (RP or RP(Qualifying))and Registered Counselling Therapists (RCT or RCT-C)

Registered Psychotherapists (RP) or Registered Counselling Therapists are trained and licensed to provide psychotherapy, having completed the necessary training and supervision recognized by their province's relevant College. However, not all provinces have a college for counsellors or psychotherapists. These practitioners specialize in counseling on interpersonal, social, and psychological obstacles and can practice under the Psychotherapy Act. An RP has completed a designation exam and the required clinical and supervision hours set by their regulatory College, while an RP (Qualifying) is in the process of completing these requirements. Both RP and RP (Qualifying) are licensed to practice psychotherapy. An RCT has to complete a specified number of client care hours post education as set out by the regulatory college to complete their designation. 

Each psychotherapist or counselling therapist has their own approach and areas of specialization based on their experience and training. They can have a holistic approach, incorporating systemic and environmental factors into their practice. However, these professionals often have a different educational background, usually holding a Master’s Degree in a Psychological Field, like Counselling Psychology. Upon completing their education, Registered Psychotherapists often begin their careers in a counselling position. 

  • Regulated by: Provincial Regulatory Body (ON ; NB; NS; PEI )
  • Education Level: Master’s degree (M.Ed, M.A, M.Div, M.Sc, MPS) or degree in counselling and psychotherapy  
  • Provide Diagnosis: No
  • Prescribe Medications: No
  • Conduct Assessment: Yes, not diagnostic
  • Therapy Treatment: Yes
  • Session Fee Typically ranges from $120-$190 
  • Coverage: Covered by some employer benefits plans. 
  • Waitlists: Generally short or none

Psychologists (C. Psych) and Psychological Associates (C.Psych.Assoc)‍

Psychologist requirements differ across provinces. Some provinces require a PhD, extensive supervised practice, and passing a licensing exam, while others accept a master’s level education with a specified amount of clinical practice hours set by the regulatory college. Psychologists work in various settings such as research, clinical practice, correctional facilities, schools, and hospitals, each with unique approaches and specializations. They are trained to assess and diagnose cognitive, emotional, and behavioral challenges, and many also provide ongoing psychotherapy. However, while psychotherapy and diagnostic assessment are within their scope, not all licensed psychologists practice psychotherapy or provide diagnostic assessments.

Psychological Associates also undergo supervised practice and must pass an exam to be licensed. Like psychologists, they are trained to assess and diagnose cognitive, emotional, and behavioral challenges and may use various psychotherapies in their practice. Educational and training requirements for psychological associates vary by province.

  • Regulated by: Provincial Regulatory Body 
  • Education Level: Educational requirements differ across provinces.
    Psychological associates have completed a masters level degree in a psychology related field, followed by a set amount of time completing supervised practice.
    Psychologists are required to have a PhD in BC, QC, MB, NB, and PEI. All other provinces (excluding the Yukon) require a Master’s level education. 
  • Provide Diagnosis: Yes
  • Prescribe Medications: No
  • Conduct Assessment: Yes
  • Therapy Treatment: Yes
  • Price Per Session: Psychologist prices typically range from $160-$250 with an average above $200. 
  • Coverage: Covered by most employer benefits
  • Waitlist: Vary by provider. There can be no waitlist or up to several months

Psychiatrists (MD)

A psychiatrist is a medical doctor specializing in the diagnosis and treatment of mental health conditions. Psychiatrists often focus on more complex mental health issues, and will typically perform a diagnostic assessment when first meeting with a patient. Psychiatrists are able to prescribe medication and generally provide follow-up medication management until a patient is stable on medication. Psychiatrists are able to practice psychotherapy but do not commonly offer ongoing therapy. They may hold expertise in a specific area of mental health, for example Psychiatrists who specialize in Borderline personality disorder (BPD) or Obsessive-Compulsive Disorder (OCD). Typically, a referral from your family doctor is required to see a psychiatrist. Psychiatrists services are covered by provincial and territorial health plans. Unfortunately, the waitlists to see psychiatrists has the potential to be quite lengthy. 

  • Regulated by: Provincial Physician Regulatory Body 
  • Provide Diagnosis: Yes
  • Prescribe Medications: Yes
  • Therapy Treatment: Yes, but will often defer to other resources for therapy 
  • Coverage: Public Health Coverage (i.e. OHIP) 
  • Waitlists: Generally long

Counsellor

Psychotherapy and counselling are interrelated. Both involve a focus of helping the client achieve changes within themselves and in their lives. Counselling does address well-being, mental health, and individual challenges. However, counsellors are not able to implement specialized mental health interventions as would be defined in the Controlled Act of Psychotherapy. Simplistically, one can think of psychotherapy as a subset of counselling that also incorporates more specialized treatments. Unlike psychotherapy, counselling is not regulated anywhere in Canada. “Counsellor” is a broad term that can include some of the professionals listed above. This term also includes providers who are not licensed/regulated. 

Additional regulation created in recent years in Ontario prohibits unlicensed providers from performing the controlled act of psychotherapy. Counsellors who are not licensed providers of psychotherapy generally focus on everyday life issues through the provision of information, advice, encouragement, and spiritual counselling.

Choosing the Right Provider 

While this post provides useful information on each designation, more detailed information on designation requirements, ethics, and training can be found on the respective regulatory body websites mentioned above. While each designation is different in their own way, the practice of psychotherapy is similar. For instance, training in specific therapy approaches such as CBT, EMDR, or ACT is consistent regardless of designation, assuming psychotherapy is within scope for the practitioner. However, the designation is sometimes important depending on your specific needs. Here are some guiding questions to help you choose the right provider:

  • Do I need a provider who can diagnose mental health conditions? If so, do I want/need the person diagnosing me and the person treating me to be the same?
  • Is medication recommended as part of my mental health treatment? If so, do I need a psychiatrist for specialized medications or is this something my GP can address?
  • What type of training and qualifications are important to me in a mental health provider?
  • Which therapy designations are covered by my benefits plan?

Finding the right therapist involves more than selecting a designation. Remember, choosing the right designation for a mental health provider is only one aspect of your therapy journey. Your relationship with your therapist, how comfortable you feel with them, and the specific approaches they use typically dictates more about your therapy journey than what designation they have. 

 

- Facing mental health challenges? Layla is here to help - Individuals, couples, and families use Layla for personalized, convenient therapy. Layla matches you to a suitable therapist and manages the therapy process in a warm, dependable manner, supporting you on your journey to better health. Learn more here

- New to therapy? Here's your beginner guide - Starting therapy can evoke feelings of vulnerability, but knowing what to expect can help. The journey is individualized, with no exact right or wrong way. During the first session, typically administrative matters are discussed, goals are set, and you and your therapist will get to know each other. Fit between you and your therapist is very important for your outcomes, and it's okay to switch if the fit isn't right. Therapy is adjusted to your timeline and constraints, and can range from weekly to monthly sessions. Reflecting on what you wish to accomplish can guide the process.