Does going to therapy mean I’m crazy?

There is a common misconception that seeing therapist means you are crazy, unstable, weird, or maybe even broken. However, any of those adjectives could not be any more further from the truth.

Therapy is useful for different reasons for different people; but one thing that every client has in common, is that they are seeking help. Assistance from a therapist may be required to:

• Work through a specific current day issue

• Find better ways of coping

• Better understand unhealthy patterns/symptoms/distress

• Validation and support, or

• Help with healthy decision making

Although this may seem like a short list, there is nothing in that list that suggests ‘craziness’ is a reason. Sometimes distressing emotions can feel like loosing control and that can then lead to questioning of experience, capacity, and general sound-mindedness. However, there is no clinical definition of crazy (that I know of at least!).

I recently attended a two a two day seminar where the distinguished presenter put it quite eloquently: “we are all bozos travelling on the same bus”. So whatever your reason, there is nothing crazy about wanting or needing to speak to a therapist.

Not all therapists are one in the same; the difference between professions.

As a psychologist, the question about the difference between psychologists, psychiatrists, and counsellors is one I receive multiple times throughout the year from all different clients. Although the three professions can label themselves as therapists, they are all different in many ways; with variability even within each profession. However, in an attempt to keep things simple these are the main reasons (see below for elaboration):

1. Education

2. Registration

3. Supervised Practice

4. Medication, and

5. Function

EDUCATION

Psychiatrists and Psychologists must have completed university qualifications.

• Psychiatrists have medical degrees (they’re legit doctors) who then complete specialist training in psychiatry.

• Psychologists have (at minimum) a Bachelors Degree in Psychology, a fourth year qualification (Honours or Graduate Diploma), and a Masters Degree. Some psychologists will have Dr in their title, which means they have completed a Doctoral program (Clinical Doctorate or a PhD). All of that study equates to at least five years of university, but can be up to 10 if the psychologist has completed a Clinical Doctorate or PhD.

Counsellors do not need to achieve a minimum level of training to practice with that title.

REGISTRATION

• Psychiatrists and Psychologists must be registered with the Australian Health Practitioners Regulation Agency (AHPRA) in order to be recognised to practice within Australia. AHPRA oversee and protect the registration of all health professionals in the country. Psychiatrists and Psychologists can be searched via AHPRA’s register of practitioners.

• Counsellors can be registered with Psychotherapy and Counselling Federation of Australia (PACFA) but this is not mandatory.

INTERNSHIP AND SUPERVISED PRACTICE

Unlike Counsellors, Psychiatrists and Psychologists must complete a supervised internship (under supervision of various Senior Psychologists) at some point in their university training. Psychologists are also expected to complete 30 hours of continuing professional development each year in order to remain registered.

MEDICATION

Psychiatrists are the only profession who can prescribe pharmacological treatment (medications) as they are the only profession of the three that has a medical background.

PURPOSE/FUNCTION

• Psychiatrists are usually engaged with clients who require pharmacological intervention as part of their treatment plan. This could include (but not limited to) psychiatric conditions such as: Bipolar, Schizophrenia, Personality Disorders, and other Chronic conditions that significantly impact the fulfillment of basic functions in an individual’s life. It would be recommended that a psychiatrist is involved in your care if your psychiatric condition has an organic (physical) cause, or “talking therapy” does not seem to be working.

• Psychologists are trained in “talking therapies”, and there is great variability within the field itself. Different psychologists specialise in different styles depending on their training and interests. It is important to ask psychologists about their therapeutic orientation and experience to get a sense of fit. Similar to Psychiatrists, Psychologists aim at reducing the impact of mental health issues, however do so without the use of medication. That being said, a Psychologist may refer a client to a Psychiatrist if there is a need for secondary consultation, or symptom management through medication would assist in improving therapeutic outcomes.

• Counsellors also provide talk-based therapies however the level of training between counsellors is extremely varied and un-regulated. At a minimum, counsellors are training to provide non-judgemental support. It is important to consider the reasons you are seeking therapy and do a bit of research around what services are in your area to access. Speaking to your GP is a great place to start.