Clinical psychologist/Counselling psychologist/Psychiatrist: Whom to consult and for what?
Most people often struggle with understanding the difference between Clinical psychology, Counselling psychology and Psychiatry. The three areas of study share in common many functions, but they differ in origin, theory and career paths. The differences between the first two can be noted by observing the roots of the two words: The term “clinical” is derived from the Greek word “kline,” which means bed, which may reference clinical treatment provided at a patient’s bedside. The term “counseling” is derived from the Latin word “consulere,” which means to advise or consul. Psychiatry refers to a field of medicine focused on the study, prevention and treatment of mental disorders in humans. Additional details about the differences are presented below
Clinical psychologists tend to work more with serious mental illness. The work of a clinical psychologist often overlaps with that of a psychiatrist. After World War II, clinical psychologists began to treat soldiers returning from war for issues such as post-traumatic stress disorder – work that would previously have been reserved for a psychiatrist. Clinical psychologists today focus on a variety of serious mental illnesses, including bipolar disorder, schizophrenia and major depressive disorders, among others.
In terms of the theories that underlay their work, clinical psychologists focus on psychoanalytical and behavioral persuasions when treating their clients; their training tends to emphasize psychopathology. Clinical psychologists are often employed in more clinical “bedside” settings such as hospitals and medical schools, though many also work in private practice. Clinical psychologists are allowed to prescribe medication in certain countries.
Counselling psychologists, on the other hand, tend to work more with healthy patients who have fewer serious psychological problems. Their work focuses more on emotional, social and physical issues that arise from typical life stresses or more serious issues associated with school, work or family settings. Thus, their work is more client-centric, focusing on wellness and prevention rather than pathology. Counseling psychologists might see patients for relationship issues, substance abuse counseling, career advice, difficulty adapting to life changes and other related issues.
In addition to following humanistic traditions, training for counseling psychologists tends to emphasize multiculturalism and offers a more holistic education. Counseling psychologists are often employed at universities, especially in university counseling centers, but also as teachers, supervisors and researchers. Many counseling psychologist are also employed in human service settings such as mental health, family services and rehabilitation centers.
Psychiatrists are medical doctors and must evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments, or strictly psychiatric. Psychiatrists prescribe medicine, and may also use psychotherapy. Though a vast majority of psychiatrists do medical management only, a few of them refer the patient to a psychologist or other specialized therapist for weekly to bi-monthly psychotherapy.
Can psychologists (Clinical or counseling) and psychiatrists work together?
Although there are differences in their fields, psychologists and psychiatrists can and must work together in the treatment of patients. Psychologists (Clinical or counseling) usually do not prescribe medication, but may refer the patient to a psychiatrist in order to receive medications. Psychiatrists shall refer patients/clients to counselors for counseling and/or psychometric assessment and help them adhere to the treatment regimen. In this manner, the three health care providers can supplement each others’ services. Though a psychiatrist is concerned with the patients’ well-being, however, the focus is primarily towards disorders such as a chemical imbalance. On the other hand, a psychologist primarily focuses on the patient’s thoughts, feelings and general mental health.
Can counseling be done by other professionals?
There are many people active in ‘human service’ professions (for instance, the nursing, teaching, and the police) who consider counseling to be part of their work role. However, they are providing only non-professional counseling. There are also many instances where counseling is offered in the context of a relationship that is primarily focused on other, non-counseling concerns. For example, a student may use a teacher as a person with whom it is safe to share worries and anxieties. A nurse visiting a home to give medical care to a terminally ill patient may also be providing emotional support to the patient’s spouse. In these situations it seems appropriate to see what is happening as being a teacher or nurse using counseling skills rather than engaging in an actual counseling relationship. They are counseling, but not being counselors. This is a useful distinction to make, because it reserves ‘counseling’ for situations where there is a formal counseling contract and the counselor has no other role in relation to the client.
Prof. K. Madhu
Wellness Hub, Visakhapatnam
I have completed 30 years of teaching and research in psychology at the Department of Psychology and Parapsychology, Andhra University, Visakhapatnam, India.