Finding the right therapist can feel overwhelming, especially if you’re already struggling with your mental health. Terms like counsellor, psychotherapist and psychologist are often used interchangeably, making it easy to feel confused. This guide will explain the key differences to help you choose the right mental health professional – whether it’s support for trauma, anxiety, depression, or general wellbeing.
Psychotherapy
Psychotherapy is an evidence-based practice that addresses underlying causes of distress. It uses a holistic approach encompassing the emotional, psychological, relational, cultural, and spiritual aspects of mental health and wellbeing. Psychotherapists work with a range of concerns including trauma, anxiety, anger, depression, abuse, relationship issues, suicidality and self-harm. Psychotherapy is long-term and focuses on deep-seated psychological patterns and self-structure.
Many mental health professionals may train as a psychotherapist, including psychologists, psychiatrists, and mental health social workers. It requires an advanced level of knowledge and practice, with ongoing professional development and supervision. Unless they are allied health, a psychotherapist cannot provide Medicare rebates.
Counselling
Counselling focuses on mental health and wellbeing through deep listening, non-judgement, and empathy. Counsellors use a range of evidence-based interventions to address problems similar to psychotherapy, including trauma, anxiety, and depression. Whilst counselling has overlap with psychotherapy, it is generally shorter-term and goal-oriented. It has a larger focus on problem-solving and is deeply concerned with clients feeling safe, respected, and accepted. It helps clients develop self-understanding and feel more empowered when facing problems.
Like psychotherapy, many mental health professionals can be trained in counselling including psychologists, mental health nurses, and occupational therapists. It is less in-depth than psychotherapy but still requires a high degree of practice and ongoing professional development. Unless they are allied health, a counsellor cannot provide Medicare rebates.
Psychology
There are many different types of psychologists, though we will focus on psychologists who provide counselling and psychotherapy. Counselling psychologists and clinical psychologists have training in counselling and/or psychotherapy. Whilst both work with complex mental health problems, clinical psychologists undertake continued education in assessment, diagnosis, and treatment. Clinical psychologists are also qualified to provide medical diagnosis for mental illnesses.
Psychology is considered an allied health profession. Only allied health professions are able to work in hospitals to provide mental health treatment, and to provide Medicare rebates in the community.
Mental Health Social Work (MHSWs)
Like psychologists, MHSWs are allied health professionals and may be trained in counselling and/or psychotherapy. As an allied health profession that specialises in mental health, MHSWs are approved to provide ‘Focused Psychological Strategies’ under Medicare. Whilst psychologists have more focus on mental illness diagnosis, MHSWs have more emphasis on social justice and broader conditions that affect mental health. For example, a MHSW may be better at providing therapy alongside providing support for legal matters, domestic violence, discrimination, or adversity.
Whilst there are differences between mental health allied health professionals, there is also considerable overlap. They all subscribe to the biopsychosocial model of mental health and may receive significant training in other allied health professions.
Mental Health Occupational Therapists (MHOTs)
MHOTs are another allied health professional that specialise in mental health. They may also be trained in counselling and/or psychotherapy, and can provide Medicare rebates for Focused Psychological Strategies. Whilst there is overlap with MHSWs and psychologists, MHOTs have more of a focus on mobility, functional assessment, structured skill development, and environmental modifications. This is particularly important for people facing impairment due to mental illness and disability.
MHOTs have a unique skill set in disability and impairment. However, MHOTs, psychologists and MHSWs often job share general therapy roles in mental health organisations. Each profession achieves positive therapeutic outcomes for clients, but from different standpoints.
Psychiatry
Psychiatrists may also have training in counselling and/or psychotherapy; however, they are quite different to the above professions. Psychiatrists are qualified medical doctors that undergo additional training to specialise in medicine that diagnoses and treats mental illness. People with serious mental health conditions will need to see a psychiatrist if they’re seeking diagnosis and medication for complex mental illness. Psychiatrists often lead allied health teams in mental health departments in hospitals.
Comparison of Mental Health Professionals in Australia
| Therapist Type | Focus | Can Diagnose | Medicare Eligible? | Commonly Helps With |
| Psychotherapist | Deep psychological patterns | No | No | Trauma, long-term issues |
| Counsellor | Short-term issues, support | No | No | Stress, relationships |
| Psychologist | Clinical diagnosis + therapy | Yes | Yes | Anxiety, depression |
| MHSW | Social context + therapy | No | Yes | Trauma, injustice |
| MHOT | Functionality + therapy | Yes | Yes | Disability, daily living |
| Psychiatrist | Medical diagnosis + medication | Yes | Yes | Severe mental illness |
How to Choose the Right Therapist
- Consider whether you want short-term or long-term therapy
- Consider whether you want to claim under Medicare or health insurance
- Ensure the therapist has qualifications and experience in your key concerns
- Use your head but go with your gut – trust in your sense of comfort and connection
Final note
Choosing the right mental health professional isn’t just about their qualifications – it’s also about connection. The quality of the therapeutic relationship is one of the strongest predictors of successful outcomes. Trust your gut, ask questions, and don’t be afraid to try another therapist if it doesn’t feel like the right fit.
About the author
Blake Johns is a trauma-informed counsellor and psychotherapist with accreditation as a Mental Health Social Worker. If you’re looking for Medicare-funded counselling and psychotherapy in Margaret River or online, book a consultation.
