“Understanding counselling… Counsellors, psychologists, social workers and psychiatrists – What’s the difference?”
Briefly, there are four basic philosophies underlying the counselling profession. Firstly, counsellors follow a wellness model. Secondly, counsellors see most problems in life as developmental. Thus, they are seen as natural and normal, and likely to be transitory. Counsellors emphasize the importance of prevention and early intervention, rather than just remediation. Lastly, the goals of counselling may vary with different counselling theoretical orientations. But generally, goals of counselling involve empowering individuals and to assist them in solving problems independently, and an increased ability to deal with similar problems in the future (Remley & Herlihy, 2014).
The Medical versus the Wellness Model
Generally, in the wellness model, mental health is a continuum, and contains many other aspects. They include relational aspects in different areas such as family, work, communities, religious affiliations, friendships; spirituality, leisure, physical health, sexuality, living environments, career and financial statuses. Counsellors assess clients’ functioning in the different areas and current life situations, and help them achieve their maximum potential, while keeping in mind societal and physical limitations etc. The medical or the illness model on the other hand, has been the primary model historically, and assumes that individuals are diseased. The goal is to return individuals to previous levels of functioning before the onset of the disease. It starts with diagnosis, and specific principles applied to cure the disease (Remley & Herlihy, 2014).
The main difference between the two models, is that the wellness model sees individuals with the potential and desire for autonomy and success, while the medical model sees individuals with diseases that needs to be cured. Having said that, it is important to consider various overlaps between the two (Remley & Herlihy, 2014). Counsellors are now trained to use the medical model of diagnosis mental disorders, such as the use of the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013). While other medical professionals are adopting parts of the wellness model such as preventive medicine etc.
Mental Health Professionals: Counsellors, Psychologists, Social Workers and Psychiatrists
Generally, individuals who provide services to individuals with mental health issues, are considered mental health professionals. They can include counsellors, psychologists, social workers and psychiatrists. To better understand the differences between the roles, generally, the key service provided by counsellors, is counselling. Although they may perform other services such as assessment, diagnosing, advocacy, case management and teaching. Psychologists, social workers and psychiatrists on the other hand, may also provide counselling, but only as a secondary service (Remley & Herlihy, 2014).
Briefly, counsellors apply principles of mental health, psychological and/or human development through the cognitive, affective and behavioural perspectives, to deliver interventions that addresses issues of wellness, pathology, personal and/or career development. Psychologists on the other hand, focus on the understanding of both normal and abnormal functioning in human behaviours. Their primary service is assessment, but they also treat clients with mental and emotional problems. Social workers emphasize on goals of promoting social justice, human rights and improved quality of life, and the primary service offered is the linking of clients to community resources. Psychiatry, is a field of specialty for physicians. Psychiatrists specialize in the diagnosis and medical treatment of mental disorders, and are the only group of mental health professionals who prescribe medications (Remley & Herlihy, 2014).
Additionally, you may also wonder, what is the difference between counselling and psychotherapy? While the terms have been used interchangeably at times, a simple way to understand, is to think of counselling as the process of treating symptoms. Psychotherapy focuses on the root of the issues. For example, if a client comes in with relational issues related to a spouse, counselling can impart communicative skills or focus on the expressing of emotions etc., depending on the counselling orientation. Psychotherapy can also assist the client in improving his/her relationship with the spouse, but with a focus on earlier factors that may have contributed to the interpersonal issues. E.g. the client may have been abandoned as a child, and now has trust issues, and is now causing friction in the relationship.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association Publishing.
Remley, Jr. T. P., & Herlihy. B. (2014). Ethical, legal and professional issues in counselling (4th ed.). New Jersey: Pearson.
Gratitude – Quek Wan Ting