Psychiatrists, Psychologists, Counselors, and Social Workers can all become psychotherapists. But a more important question is do they all operate the same? The quick answer is no, each has their own paradigm.

The distinctions between Counselor, Psychologist, Psychiatrist, and Social worker have slowly become clearer to me over a period of years. I have a solid understanding of counseling and not counseling because I spent four years in class rooms, practicum, and internship acquiring my Professional Counselor license. I still remember the confusion over what we did and where we fit when I took my first professional orientation class. Even further back when I was working with my own counselor and decided to become one I couldn’t understand where all of the other professions fit. I expect the distinctions are still very fuzzy to the public.

My personal, and simple understanding now, is that we all start in different places, have varying levels of college degrees that we have or can earn, and then by choice a bunch of us arrive at the same place. The place we arrive at is psychotherapy, our common ground. The following professions commonly practice psychotherapy (I have listed only the most common college degrees):

· Psychiatrist with an M.D. (Medical Doctor)

· Psychologist with a PhD or PsyD (We call them Dr. too)

· Professional Counselor with an MA (that’s me)

· Social Worker with an MA

The difference between these professions as therapist lie in what else they are trained in, and ultimately in their orientation toward clients. Psychiatrists are Medical Doctors, typically look for illness of the mental sort, and many focus on prescribing medication. Of course they can also do “talk therapy” if they choose. Psychologists are the academic type of doctor, do research, teach at the college level, work with people who are intensely “mentally ill”, and of course can do “talk therapy.” Counselors typically work with an agency or in a school, work with vocational issues, help people solve personal problems, and of course can do “talk therapy.” Social Workers I am less familiar with but seem to work within an agency and help people gain the social services that they need to resolve complex situations, and of course can do “talk therapy.”

The main point of all of this is that each profession operates from a basic paradigm. The paradigm will tend to influence how they do their “talk therapy.” Psychiatrists and Psychologists are more likely to identify with the medical model and look for illness. Counselors lean toward a human growth and development model. They, or at least I, tend to look for how people grow and adapt. Social Workers, I presume, lean toward a social support system model and may tend to look to how people are connected to social services. However, individuals within each profession have a lot of latitude on how they operate within the profession so any one professional can land almost anywhere they choose. So, let the buyers (client) beware. A therapist, is not a therapist, is not a therapist.

Maybe all therapists should have a blog (or not), then after a few months or years the potential client may get a sense of the paradigm that each operates from. I will continue to represent both a counselor paradigm and my personal proclivities in this blog.