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Should I See a Perinatal Psychologist or a Counsellor?

There is so much confusion about different types of ‘talking therapy’ that it can be hard to tell what sort of professional you actually want to speak to. You might assume that both a perinatal psychologist and perinatal counsellor would work in similar ways to help you resolve emotional distress, and whilst there is a little overlap between the two, there are also profound differences between these professions and the therapeutic experience you would have with each. I wrote this guide to help you work out whether a psychologist or counsellor would be right for you, to help you achieve your therapy goals.

Starting with a small disclaimer, speaking as a psychologist myself many of the statements here are general in nature, as there will be variability within both professions. Every therapist has a different style and level of training, so this article is just a guide. Also, the information is coloured by my specialism as a perinatal psychologist – working with women who are hoping to be mothers, preparing to be mothers or are mothers already, and the specific problems I see in my work. I write this to provide insight to the differences between the different professional approaches to help you decide what sort of help you need.

What types of approach do psychologists and counsellors use?

Good psychologists and counsellors should both have core skills in ‘counselling techniques’ – for example reflecting and paraphrasing, clarifying and empathising. These are the building blocks necessary for a strong therapeutic relationship, which is well-known to be a significant factor in positive change for you as a client seeking help.

Psychological therapy is not ‘just talking’. Storytelling can be helpful, but speaking for myself here, psychologists tend to be more directive in approach: not simply making space but also directing the therapeutic process. Psychologists’ training extends beyond core counselling skills to include at least three specific types of psychological approach to treat problems, giving psychologists a diverse toolkit that can be applied to whatever situation you may be in. Examples might include working with your nervous system, neural (memory) networks or the unconscious using approaches such as poly-vagal therapy, EMDR therapy or psychoanalytic therapy.

One fundamental component of psychological therapy is a psychological formulation. A formulation is something that is co-created between you and your psychologist to summarise your difficulties and make sense of them, looking at triggers, past experiences, and your strengths to understand your unique story. This is crucial to understanding how to help you feel better and recover. Psychologists ask; ‘What has happened to you?’ ‘How did it affect you?’ ‘What sense did you make of it?’ ’What did you have to do to survive?’ ‘What are your strengths?’

Perinatal psychologists are interested in how this applies to your journey to motherhood, your relationship with your baby, partner, wider community and broader ideas about motherhood.

As a perinatal psychologist specialising in reproductive trauma (including miscarriage therapy, birth trauma therapy and infertility counselling) my clients benefit from ‘top- down’ approaches (such as ACT or CBT), to help you develop skills and regulate your emotions. These are then in turn used as the basis for ‘bottom-up’ approaches which focus more on the healing process of therapy (such as EMDR Therapy, where we can process the stuck memories/experiences which lead to the problem itself).

Psychologists also use the therapeutic relationship very consciously as a tool. We are not only listening to the content of a therapy session but also paying attention to what is happening underneath it, including the relationship with your psychologist as valuable information to help you move forward. This is a complex and core element of psychological therapy.

What problems do psychologists and counsellors treat?

Counselling generally works at an immediate level, focusing on a current issue. It is best suited for people going through a difficult life event, but one in which the level of distress is low, and you want a non-judgemental space to talk about current events in your life. If you believe that your issue is an isolated experience and not something that relates to the past or is a repeating pattern in your life, then a period of counselling may be sufficient for you.

If, however, you are experiencing more moderate levels of emotional distress or problems which might meet criteria for a diagnosis such as perinatal anxiety, postnatal depression, or PTSD (for example) then therapy with a psychologist might be more appropriate for your case. Equally if you are concerned about how your past experience affects your present life, or you want to address the deeper roots of how you think and behave, or how you relate to yourself and others, then psychological therapy would most likely be better suited to you.

What differences exist in the training between a psychologist and a counsellor?

Clinical Psychologists complete a doctorate training and integrate clinical knowledge, science and theory to understand and treat emotional distress. Psychologists look at all the factors which might be contributing to the problem you present with, which inform your personalised psychological formation. For example, as a perinatal psychologist, when understanding someone who is struggling with postnatal depression, I would be considering childhood experiences, past and present relationships, physical health, cultural factors, sexuality, current thoughts, feelings, behaviours…and more, in order to form as complete a picture of the client as possible and find the best way to help them.

Psychologists have often furthered their training and specialist in a particular line of work. Following my Clinical Psychologist training I developed specialist knowledge in perinatal psychology, using psychological therapy to treat women experiencing distress with issues around conception, pregnancy, birth and early parenthood.

Counsellors do not have this broad training, but guidelines recommend that, in order to practice, counsellors should have completed at least an appropriate diploma. Psychologist’s fees are higher than counsellors, which reflects their level of training, the depth of understanding, and ability to adjust the therapeutic approach taken.

Are psychologists and counsellors both regulated professions?

Unfortunately, in the UK, ‘counselling’ and ‘psychotherapy’ are not regulated professions. ‘Clinical Psychologist’ is however a protected term, regulated by the HCPC as a ‘Practitioner Psychologist’.

Conclusion

In summary, I might say both psychologists and counsellors have core skills in positive regard, empathy and the building blocks of a good therapeutic relationship. But a psychologist’s training extends beyond these foundations with doctorate level training integrating clinical knowledge, science and theory, helping to formulate and treat your emotional distress and drawing from at least three types of evidence-based psychological therapies to create a solution that is most likely to help you.

I hope this article has helped you better understand the differences between a psychologist and a counsellor in considering your own therapy needs right now.

One final point – no matter who you choose, feeling comfortable with your counsellor or psychologist is key to a successful outcome. Contact the professional you are considering, to see if they feel like a good fit for you. They should also help you work out if your needs fall within their skill set and level of competence, or signpost you to a professional more appropriate for your needs.

I can help

If you would like to arrange an introduction call, you can do so on my Contact Page. I would be happy to help! You can also find a free guide on that page which may help with anxiety after a miscarriage.