Counsellor? Psychologist? Psychiatrist? Social Worker? Psychotherapist? What's the difference

July 24, 2019

By Layla Team

When our clients begin their search for the right therapist, many of them have the same question - what are the different types of mental health care providers and which one is right for me? There is both significant overlap and important differences between the various mental health care providers. Each category has their own scope - although they all aim to help individuals, couples and families achieve their various treatment goals. When learning about providers who can support your mental health, we encourage individuals to reflect on two main questions: “what do I need?” and “what might this provider offer me?” Keep these in mind throughout this article.


Note: Given some regulations apply at a provincial/territorial level, for simplicity this article focuses on Ontario.


Family Physicians (MD)

Also referred to as General Practitioners (GPs), family doctors can screen for mental health symptoms and provide a diagnosis if applicable. Keep in mind, GPs have varying levels of familiarity with mental health issues. Many GPs will only diagnose a clear and evident mental illness, often referring out to a psychiatrist for more complex presentations. Family physicians can prescribe medication and/or refer their patient to a psychiatrist, community resources, and/or psychotherapy. It is important to note that a referral from a family physician is not required to engage in therapy with a Psychologist, Registered Clinical Social Worker, or Registered Psychotherapist.

Some GPs have pursued additional training in counselling techniques and provide ongoing psychotherapy. Given this is relatively rare and covered by OHIP, the waitlists to see a GP-psychotherapist are generally quite lengthy.

Regulated by: College of Family Physicians
Provide Diagnosis: Yes
Prescribe Medications: Yes
Therapy Treatment: Generally no


Psychiatrists (MD)

A psychiatrist is a medical doctor specializing in the diagnosis and treatment of mental illness. 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 the medication. Psychiatrists also often integrate psychotherapy into their practice. 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, but unfortunately, the waitlists to see psychiatrists in Ontario are usually lengthy (up to months). 


Regulated by: Royal College of Physicians and Surgeons
Provide Diagnosis: Yes
Prescribe Medications: Yes
Therapy Treatment: Yes, but often refer to other resources
Coverage: OHIP
Waitlists: Generally long


Registered Social Workers (MSW, RSW)

Social work is a broad profession, and Registered Social Workers may take on a variety of roles including: case management, research/policy, and clinical assessment/treatment. A subset of Social Workers who have focused their education and experience on clinical assessment and treatment are often referred to as Clinical Social Workers or Psychotherapists, practicing psychotherapy. These individuals are trained to conduct assessments of an individual's functioning; including their biological, psychological, social, emotional and cultural needs. Unlike Psychologists and Psychiatrists, although they can assess for clinical need, they cannot provide a diagnosis. Their approach often takes into consideration the context of an individual’s system (family, workplace, school), or environment (country, climate), offering a perspective that alleviates individuals from being the root cause of their problems. They typically earn additional certifications in evidence-based therapeutic treatments such as CBT, DBT, EMDR, or ACT in addition to their Master’s Degree in Social Work (MSW).


Regulated by: Ontario College of Social Workers and Social Services Workers (OCSWSSW)
Education Level: Masters level degree (MSW)
Provide Diagnosis: No
Prescribe Medications: No
Conduct Assessment: Yes
Therapy Treatment: Yes
Session Fee in Greater Toronto: Typically ranges from $120-$180 with a median of approximately $150. Generally tax exempt
Coverage: Covered by most employer benefits plans
Waitlists: Generally short or none


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

Psychologists and Psychological Associates are trained to assess and diagnose challenges in thinking, feeling and behaviour and to help individuals overcome or manage such challenges. Psychologists rely on a variety of treatments or psychotherapies when working with their clients. Educational and training requirements for Psychologists vary by province.


Regulated by: College of Psychologists of Ontario (CPO)
Education Level: Psychological associates have completed a masters level degree in psychology (e.g. M.A., M.Sc., M.Ps., M.Ed.), which is then followed by four years of experience working in the scope of practice of psychology. Psychologists have completed a doctoral level degree in psychology (Ph.D., Psy.D., Ed.D., D.Psy.) which typically includes a one-year internship. Some Canadian jurisdictions award the title ‘Psychologist’ to individuals at the Masters, rather than Doctoral level and the CPO recognize this title for these individuals in Ontario.
Provide Diagnosis: Yes
Prescribe Medications: No
Conduct Assessment: Yes
Therapy Treatment: Yes
Price Per Session: In Greater Toronto, Psychologist prices typically range from $160-$250 with an average above $200. The recommended rate by the College of Psychologists of Ontario is $225. Generally tax exempt
Coverage: Covered by most employer benefits
Waitlist: Vary by provider. There can be no waitlist or up to several months

 

Registered Psychotherapists (RP or RP(Q))

A Registered Psychotherapist is an individual who is trained and licensed to provide psychotherapy in Ontario. They have completed the necessary training and supervision recognized by the College of Registered Psychotherapists of Ontario. These practitioners specialize in providing counselling on interpersonal, social, and psychological obstacles which have come as a result of mental health challenges. Each psychotherapist will have their own approach and areas of specialization as a result of their individual experience and training. 


Regulated by: College of Registered Psychotherapists of Ontario (CRPO)
Education Level: Master’s degree (M.Ed, M.A, M.Div, M.Sc, MPS) or diploma in counseling and psychotherapy  
Provide Diagnosis: No
Prescribe Medications: No
Conduct Assessment: Yes
Therapy Treatment: Yes
Session Fee in Greater Toronto: Typically ranges from $110-$180 with a median of approximately $135+HST (unlike RSWs and C.Psych, RPs are not currently tax exempt)
Coverage: Covered by some employer benefits plans. Currently covered less often than RSW and C.Psych given the CRPO is a relatively new professional college 
Waitlists: Generally short or none


Counsellor

Psychotherapy and counselling are interrelated. Both involve conversations between client and provider aimed at helping the client achieve changes within themselves and in their lives. Simplistically, one can think of psychotherapy as a subset of counselling that also incorporates treatment of mental illness. Unlike psychotherapy, counselling is not regulated in Ontario. “Counsellor” is a broad term that can include some of the professionals listed above. This term also includes providers who are not licensed/regulated. Some counsellors may seek certification with the Canadia Counselling and Psychotherapy Association obtaining the credential of Canadian Certified Counsellor (CCC). 

Additional regulation created in recent years in Ontario prohibits unlicensed providers from performing the controlled act within 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.

 

Finding the Right Therapist for You

As you can see, there are many types of providers which can assist with mental health challenges. Each type of professional has its own unique strengths, skills and scope of practice.

At Layla, we work with a clinically and culturally diverse team of licensed therapists who each bring a different set of skills and experiences. We understand that trying to find the right therapist can be confusing, stressful and debilitating, and we created Layla to simplify this process for our clients. We match clients with therapists based on the client’s mental health needs, the specialization of the therapist, convenience of time and location, setting (online versus in-person), and interpersonal fit. In everything we do, we pay close attention to relational factors - including client-therapist fit and collaboration -  which are known to account for as much as 75% of success in therapy.   


If you’re interested in finding out more about Layla and how to get started, click here.