When people consider going to therapy, they often discover a whole landscape of different mental health professionals. You might come across psychotherapists, counsellors, psychologists, and psychiatrists. Each profession brings something unique, and sometimes people work with more than one type of practitioner at different points in their journey.

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A guide for anyone seeking therapeutic mental health support in the UK or Portugal

As a psychotherapist and counsellor, I’m often asked about the differences between psychotherapists, counsellors, psychologists, and psychiatrists. It can feel confusing to know who does what, and how each type of professional can help. I’ve created this guide to help you understand who’s who, what they do, and how they’re regulated in both the UK and Portugal.

What Is a Psychotherapist?

Psychotherapists offer a deeply relational form of therapy. Working with a psychotherapist involves exploring the patterns, emotions, and experiences that shape a person’s life.

Because of this depth, psychotherapy is often longer-term, allowing space for meaningful and lasting psychological change to unfold through the therapeutic relationship. Clients usually have autonomy around when to begin and end their therapy.

Psychotherapy is a distinct, scientifically grounded profession and clinical practice within the mental health field (Hunt, 2021). The practice of psychotherapy is typically grounded in a specific modality, which encompasses a particular approach and set of philosophies. Evidence-based modalities include psychodynamic psychotherapy and person-centred psychotherapy.

Psychotherapy often includes:

Exploring emotional patterns and relational dynamics
Supporting long-term psychological growth
Providing a consistent, reflective therapeutic space

Training

Psychotherapists complete postgraduate or master’s level (Level 7) psychotherapy training, which includes advanced clinical training, supervised practice, and ongoing professional development.

Regulation

In the UK, psychotherapist is not a protected title, and the practice of psychotherapy is not regulated (Stevens, 2016). In Portugal, psicoterapeuta is not a protected title, and the practice of psicoterapia is not regulated (Vasco, 2008). There is no single national register in either country. Many qualified psychotherapists register with voluntary associations which set high standards for training, ethics, and supervision.

Professional registers in the UK: United Kingdom Council for Psychotherapy (UKCP), British Psychoanalytic Council (BPC), and other voluntary registers
Professional registers in Portugal: Federação Portuguesa de Psicoterapia (FEPPSI) and other voluntary registers

What Is a Counsellor?

Counsellors offer a supportive, non-judgmental space to explore emotional difficulties, life challenges, and personal concerns. Counselling is often short-term or medium-term, though some counsellors work long-term depending on their training and approach.

The process tends to be more structured and present-focused than psychotherapy, though there is overlap between the two professions.

Counselling often includes:

Providing emotional support during difficult life events
Helping clients develop coping strategies
Offering a safe space to explore feelings and experiences

Training

Counselling training varies, but many counsellors complete a Level 4 or Level 5 diploma, with some going on to advanced or specialist training.

Regulation

In the UK, counsellor is not a protected title, and the practice of counselling is not regulated (BACP, 2018). Similarly, in Portugal, the title terapeuta is not protected, and the practice of counselling is not regulated. There is no single national register in either country. Many practitioners belong to voluntary associations.

Professional registers in the UK: British Association for Counselling and Psychotherapy (BACP), National Counselling and Psychotherapy Society (NCPS), and others
Professional registers in Portugal: Voluntary registers based on therapeutic approach

What Is a Psychologist?

Psychologists study how people think, feel and behave. Support with a psychologist is often medium-term and focused on specific psychological difficulties or diagnoses. There are many types of psychologists, including educational and forensic. Those seeking treatment would typically meet with a clinical or counselling psychologist.

Clinical and counselling psychology often includes:

Psychological assessment
Evidence-based treatments
Structured therapeutic approaches

Training

Clinical psychologists typically complete a doctoral degree in clinical psychology. Counselling psychologists typically complete a master’s degree in counselling psychology.

Regulation

In the UK, specialist titles such as clinical psychologist and counselling psychologist are legally protected. In Portugal, psicólogo/a is a protected title, and all practising psychologists must be registered with the Ordem dos Psicólogos Portugueses (OPP).

Professional register in the UK: Health and Care Professions Council (HCPC)
Professional register in Portugal: Ordem dos Psicólogos Portugueses (OPP)

What Is a Psychiatrist?

Psychiatrists are medical doctors who specialise in mental health. Appointments with psychiatrists are often brief and focused on diagnosis and medication management.

A psychiatrist can:

Diagnose mental-health conditions
Prescribe medication
Manage complex mental-health needs

Training

Training in psychiatry includes a medical degree followed by specialist psychiatric training.

Regulation

In the UK and Portugal, the practice of psychiatry is regulated as a medical profession, and the titles psychiatrist (in the UK) and psiquiatra (in Portugal) are protected.

Professional register in the UK: General Medical Council (GMC)
Professional register in Portugal: Ordem dos Médicos (OM)

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How These Professionals Work Together

Psychotherapists, counsellors, psychologists and psychiatrists each bring different areas of expertise to mental health care. Because of this, people may sometimes work with more than one professional.

For example, someone may:

be referred to a psychologist for a psychological assessment
be referred to a psychiatrist for a psychiatric evaluation when medical input is needed
be referred to a counsellor while receiving medical care
self-refer or continue psychotherapy alongside other mental-health services

This collaborative approach relies on communication and mutual professional respect, and it can be incredibly supportive for clients who need a combination of relational, psychological, and medical care.

Which Professional Is Right for You?

There’s no one best option. It depends on your needs and what you’re looking for:

If you want to explore your inner world, patterns, relationships, and long-term emotional well-being, psychotherapy may be the right fit.
If you’re seeking emotional support around life events or short-term challenges, counselling may be helpful.
If you’re seeking structured assessment or interventions for specific difficulties, a psychologist may be helpful.
If you need medication or medical oversight, a psychiatrist is the appropriate professional.

Many people start with one and move between them as their needs evolve.

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Beginning Therapy

I am a psychotherapist and counsellor working with individuals and couples. Initial consultations are 20 minutes and take place by Zoom or phone. They offer a contained space to explore whether this way of working is appropriate for your situation and whether there is a mutual fit.

The consultation is not a therapeutic session, but an opportunity to clarify what you are seeking and to discuss how the work would be structured.

Book a consultation

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Understanding the Differences Between Psychotherapists, Counsellors, Psychologists, and Psychiatrists

A guide for anyone seeking therapeutic mental health support in the UK or Portugal