Clinical or Counselling psychology – unclear about the differences?

Unclear about the differences between the work of Counselling and Clinical psychologists? Not sure which route to being a professional psychologist is going to suite you best? If so, you’re not alone! Many students find it difficult to sort out the fundamental differences between these 2 similar, but distinct, areas of the psychology professions.

Happily for you, help is at hand! A very kind clinical psychologist has taken the time to try to explain the differences, which in turn can help you to decide which is the most appropriate role in the psychology professions for you.

Counselling Psychologists tend to work with people who have suffered a loss (death, job loss, relationship break up), trauma (sexual, physical, emotional, neglect), or are having relationship difficulties. They do work with some mental health problems, but their approach is more about helping the person make sense of what has happened, using the therapeutic relationship to help them feel secure and explore social relationships / attachments, and a more Humanistic approach.

Traditionally, Counselling psychologists worked a lot less with mental health problems, and more with healthy individuals experiencing difficult life events, although they increasingly work more with people with mental health problems. Due to the nature of their work, most of their work is with adults.

Clinical psychologists work mostly, if not exclusively, with people with mental health problems – everything from anxiety and depression to psychosis and personality disorders. They also work in specific therapeutic modalities – they may use Cognitive Behavioural Therapy, Dialectical Behaviour Therapy, Interpersonal Therapy, Schema Therapy, Cognitive Analytic Therapy, Systemic therapy etc. All clinical psychologists are trained in CBT, and at least one (if not several) other approaches. Additionally, they may be qualified in a couple of specific therapies but will know enough and be competent enough to ‘borrow’ bits from other models to fit the clients’ needs.

The focus of Clinical Psychologists is using evidence based therapy models to treat mental health problems. Clinical psychologists also use neuropsychological and cognitive assessments, which Counselling psychologists do not.

For example, in the treatment of someone who has experienced a physical attack:

  • a counselling psychologist might help the person to understand what happened to them, how it changed their world view, what it means to them, how it makes them feel, and what they are going to do next.
  • a clinical psychologist is likely to formulate this as a Trauma and use a Cognitive Behavioural approach that involves safety and stabilisation, imaginative exposure, real world exposure (going to the same place), and relapse prevention. They may also borrow from bits of Dialectical Behaviour Therapy to help the person find ways of managing their emotions when the trauma is triggered.

These are two different ways of thinking about the client and approaches to helping them. It is not the case that one way is right, and one is wrong.

The path to both professional areas looks similar, both require a 3 year doctorate.

  • Clinical psychology doctorate training course – harder to gain a place as it is funded (fees paid), you are paid a salary (band 6 on NHS Agenda for Change) while training, and your placements are organised for you.
  • Counselling Psychology doctorate training course – self funding (you pay the course fees), and there is no salary. You also have to find and organise your own placements.

The experience you’ll need to get onto either course is very similar. Job wise, increasing numbers of jobs in the NHS are advertised for either a Clinical or Counselling Psychologist. However, these tend to be either entry level (band 7 on Agenda for Change) or main grade (Band 8a). More senior positions  (senior (8b), consultant (8c), head of specialty (8d) or head of service (9)) are usually reserved for Clinical Psychologists.

For more information on these career paths in the psychology professions, and how to get into them, check out the information on your Psychology-specific pages on our website – particularly in the Career Options and Work Experience sections.

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