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Question 2: What are the differences between the words "counselor," "therapist", and "psychotherapist?"


A: They used to mean approximately the same thing. In Washington state the word "counseling " is a legally defined word.   The title one goes by--social worker, psychotherapist, mediator--makes no difference.  If what the person DOES falls within the legal definition of counseling, the person must be certified, or licensed by the Washington State Department of Health, Counselors Section, P.O. Box 1099, Olympia, Washington 98507-0199.

        Unchanged by the new 2008 counselor credentialing law: "Counseling" means employing any therapeutic techniques, including but not limited to social work, mental health counseling, marriage and family therapy, and hypnotherapy, for a fee that offer, assist or attempt to assist an individual or individuals in the amelioration or adjustment of mental, emotional, or behavioral problems, and includes therapeutic techniques to achieve sensitivity and awareness of self and others and the development of human potential. For the purposes of this chapter, nothing may be construed to imply that the practice of hypnotherapy is necessarily limited to counseling.

        "Counselor means an individual, practitioner,  therapist, or analyst who engages in the practice of counseling to the public for a fee, including for the purposes of this chapter, hypnotherapists."  [So apparently the terms "counselor" and "therapist" are interchangeable titles.]

        "Psychotherapy" (defined for the first time, effective July 1st, 2009) "means the practice of counseling using diagnosis of mental disorders according to the fourth edition of the diagnostic and statistical manual of mental disorders, published in 1994, and the development of treatment plans for counseling based on diagnosis of mental disorders in accordance with established practice standards." [See DSM IV.]

         The following is not a legal opinion but, based on the definitions above, I believe that a professional who identifies himself as a "psychotherapist" does psychiatric evaluations to identify any qualifying symptoms for a mental health diagnosis (unless clients had already been diagnosed) and treats "patients" (rather than "clients") using appropriate treatment plans based on their diagnosis.  In contrast,  it appears that a professional identifying himself as a "counselor" or "therapist" can counsel clients without regard to whether or not the clients have mental health disorder.  So while a "counselor" or "therapist" may be qualified to diagnose and treat mental health conditions, by definition they are free to work with wider scope of clients, from those "normal" clients with normal problems-of-living, to those with some degree of diagnosed mental health conditions using a wide variety of counseling techniques.

----Floyd Else, MA, LMHC


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