What is the difference?

There isn’t a clear or unanimous answer to this question because people (including psychologists and psychotherapists) often apply their own idiosyncratic definitions to these words. All psychotherapy is psychological work. All applied psychology (work with patients/clients as opposed to e.g. research or corporate work) is a form of psychotherapy. Hence the understandable and enduring confusion, especially amongst the general public. Here are a few facts that will help tease these two terms apart.

A psychologist is a legally-protected term. That is, only registered psychologists can legally claim to be psychologists. It is a profession which is regulated by the Australian Health Practitioners Regulation Agency (AHPRA). You can confirm that a psychologist is registered via the AHPRA website. It takes a minimum of 6 years full-time training to quality as a registered psychologist.

Psychotherapy is a broad term that can be used to refer to any type of psychological work between patient/client and therapist. The term is not protected by the law hence anyone can call themselves a psychotherapist. You can confirm that a psychotherapist is qualified by asking about their credentials and then checking with the relevant professional body. Many legitimate psychotherapy courses have a website where you can confirm that a psychotherapist is a member. There are many schools of psychotherapy e.g. Analytic, Gestalt, Transactional Analysis. Many practitioners have multiple qualifications.

Psychologists often continue to learn additional psychotherapeutic approaches following registration. They endeavour to convey this to their patients by using the two terms.

Some clinicians distinguish the terms psychology and psychotherapy based on the duration and frequency of sessions attended; Short-term work being referred to as psychology; long-term work as psychotherapy.  So a person who attends regularly over the course of many months or years would typically be described as a person in psychotherapy whether working with a psychologist or any other type of psychotherapist.

In my practice

Psychology

In these days of Medicare rebates it makes some sense to distinguish between psychology and psychotherapy. Medicare rebates are limited to a maximum of 20 sessions per calendar year. Such time-limited work, partially funded by Medicare, is technically referred to as psychological services by the Australian government. There are clear guidelines on what therapeutic approaches can and cannot be used when accessing Medicare rebates. In my practice I call this type of work psychology.

Psychotherapy

The type of long-term psychological work I practice is called analytic psychotherapy.  Patients have the option of sitting in a chair opposite me or lying on a couch facing away from me.  They are invited to say whatever comes to mind. One reason for this is that whatever comes to mind is by virtue of its existence seeking attention.  Things which “sit well” with us are mentally filed away or digested and therefore are no longer on our minds.

Use of the couch raises anxiety for some. The reason I use the couch is that it can help people get in touch with, and then say and expand upon, what is on their mind.  Maintaining eye contact can be quite inhibiting.  The couch can also be an advantage to the therapist in that their attention is free to solely concentrate on and think about what is being said.  However it is not for everyone. The choice of chair or couch lies with the client/patient.  The couch is not used for initial consultations or short-term work.

Short-term or long-term work

Some people want a limited number of sessions to help them work through a particular and circumscribed problem. The Medicare 20-session rebate has in some ways influenced peoples’ expectations of what can be accomplished in 20 sessions. Some people feel satisfied with 20 sessions, many decide to continue beyond the rebate allowance. You can decide as you progress.

Clearly, the longer the time spent in psychotherapy, the greater the amount of psychological terrain explored; the more self-understanding is gained.  Longer-term work gets more into long-held patterns which have become self-defeating and difficult to identify, understand and then transform. Shifting life-long patterns takes time: time to identify the pattern, to understand the pattern, to process the associated feelings which are released when a hitherto unconscious pattern is consciously recognized, and time to allow a new way of being to evolve.

A useful analogy is the cleaning-out of one’s house. Very short-term work can be compared to cleaning out a drawer or cupboard. Alternatively a whole room can be cleaned out, redecorated, or completely renovated. Further along the spectrum would be the decision to renovate a few key rooms of one’s house. On the far side would be the choice of a major renovation of the entire house or even a (slow and simultaneous) deconstruction and reconstruction. The more work we do on ourselves, the longer it takes.

Another useful analogy is the work involved in becoming an accomplished musician. It takes many years of practice and continually attending private lessons, at least once-weekly, to become an accomplished musician. In psychotherapy, we are not only endeavouring to evolve and assimilate new ways of being; there is the added task of identifying, unlearning and replacing old, unhelpful habits/patterns.