Psychotherapist vs. Counselor?


New Member
Morning everyone,

Well, the agency where I took difficult child to see the psychiatrist has recommended he see a psychotherapist. She called yesterday to make the appointment and we're going tonight.

Are there any differences between this and a counselor? My difficult child did see a counselor at one time, he was younger and it didn't seem to do any good. The counselor played games with difficult child, talked about feelings, etc, but difficult child really isn't vocal with anyone else other than family, and after a year, I felt like we were getting nowhere.

I'm hoping this psychotherapist can help difficult child with things like his compulsive lying, his mean, hateful way he is to everyone, his anger, etc. Anyone else have an experience with someone like this?

Thank you,




Years ago there was a distinction between "psychotherapist" (who may be psychiatrists, Ph.D. level psychologists, or psychiatric social workers) who dealt with "abnormal" behavior also called psychopathology. In contrast, "counselors" (usually trained at the Master's level) dealt with "normal" developmental problems that most people experience. Other names of this earlier era included "child guidance counselor" and of course, the "school counselor" who helped us all get through school -LOL--most kids never knew they had one. Also "camp counselor" suggests this role--I can't imagine a camp therapist--or if I can, it conjures up a very special type of camp.

Fast forward to the present: with the advent of Ph.D. Counseling Psychology programs, the above distinctions have been lost. To name a few, "counselors" at egbs and Residential Treatment Center (RTC) certainly deal with psychopathology as do "drug counselors" in rehab.

So the bottom line to me in choosign a therpist is:
1) How well qualified is the individual?--education isn't everything but it is a starting place.
2) Does the person have the appropriate licensure for the state? (this is controlled at the state not the national level)

Beyond these factors there are practical matters: if you have insurance, it may not pay for master's level couseling but will pay for psychotherapy or it may pay for neither and pay for medication only.

Lastly, the most important consideation after the person being skilled is how your difficult child reacts to a given person. Sometimes gender is an issue, sometimes it's race, other times it's style. Even the most resistant kid will do better with a therapist who is a good "match".

Next question: how does one find a good match? Trial and error seems to be the only way.

I have an ex-difficult child who has been to and through lots of therapists. He is now able to articulate why a therapist is helpful or not, who has countertransference issues with him, whose style he likes or not etc. etc. However, when he was younger, of course, he could not do this. All I can say is when he was young, I forced him to go to therapists I thought were well qualified. If he continued to resist, or the therapist gave me information I thought wasn't on-target, I would find another therapist. Often the resistence ended telling me there was something "off" about the prior relationship. Now, it would be up to him if he needed to go back into therapy to choose an appropriate person--I doubt he would be as concerned about credentials as "match."

Hope the above helps you see which way you want to go.



New Member
For me it's a no brainer between psychotherapist and counsellor. If you have access to, and can afford/cover the cost of the p/therapist, then that's what I would choose.

There are a gazillion counsellors out there and some may be good, some not good, most in-between; and they often don't have a lot of training. I have never seen any of them do any good for any kid, though they do no harm.

The p/therapist may be right or wrong for your child, but he/she has a LOT more training than a counsellor. Even if not right for your kid, they can do an assessment, so YOU know what you are dealing with .... it's not a diagnosis as such, though may include a diagnosis. But it's an ASSESSMENT. I do not think counsellors are qualified to do that.

I stand to be corrected - just MHO and experience.

Really, agreeing with Martie - but giving it my own slant. Which is that before you decide if the p/therapist is right for your child, you decide between p/therapist and counsellor, and I would choose a p/therapist every time, if I could afford it or it is covered.