Choosing a Therapist

5 Nov

One in five adults in the USA see a therapist, and it’s estimated that one in five Australian adults experience a mental health disorder, but finding and choosing a therapist in Australia is not an easy task!

In terms of efficacy, it is well documented that the most important factor for therapeutic success is the relationship between the client and the therapist. So when you are researching who to choose, always bear in mind that connecting with the right person for you, is what matters most.

Here’s an explanation of who does what…

The mental healthcare system

In Australia, there are a number of helplines available 24/7 if you need assistance with mental health issues (as listed below). However, in general, the starting point for mental health care is the medical system, as outlined by the Australian Institute of Health and Welfare. The government offers support through Medicare, which requires a diagnosis by a doctor (a GP, psychiatrist or paediatrician). When you visit your GP for mental health issues, they will generally take you through an assessment process, usually in questionnaire format, to diagnose a mental health condition like anxiety or depression. Depending on your symptoms and situation, they will provide you with a mental health treatment plan, or a referral to a psychiatrist or psychologist for a more specialised diagnosis. If you are eligible, you can claim a Medicare rebate for 10 individual and 10 group sessions with a mental health professional each calendar year.

Mental health professionals

Mental health professionals in Australia include GPs, psychiatrists, mental health nurses, psychologists, counsellors, occupational therapists (OTs), Aboriginal and Torres Strait Islander mental health workers and social workers.

Psychiatrists, psychologists, counsellors and psychotherapists are all trained in psychological development and human behaviour and may use different forms of counselling and psychotherapy to help.

While counselling and psychotherapy are recognised as mental health professions by the Australian government, they are not currently eligible for Medicare rebates. However, if you read on, you may find that they are a more cost-effective option for your needs.

What’s the difference between a psychiatrist, psychologist, psychotherapist and counsellor?

Psychiatrist

Psychiatrists train for 11 years. A psychiatrist is a qualified medical doctor who has trained as a psychiatrist. Psychiatrists train for four-six years to complete a medical degree, a year of hospital training and then complete five years of psychiatric training with the RANZCP – The Royal Australian and New Zealand College of Psychiatrists.

Psychiatrists treat the whole range of mental illnesses and undertake a comprehensive psychiatric assessment for diagnosis, and they can prescribe medications to help you to manage symptoms. Psychiatric care can be short-term for example for diagnosis and prescription of medication to long-term treatment which might include psychotherapy.

You should see your doctor for a referral to a psychiatrist if you have a severe mental health issue like schizophrenia, panic attacks or phobias; mood disorders like bipolar disorder or major depressive disorder (MDD); personality disorders like borderline personality disorder (BPD) or obsessive compulsive disorder (OCD); eating disorders such as anorexia or bulimia; attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or post-traumatic stress disorder (PTSD).

Fees vary from practice to practice, but range from about $500 for an hour initial consultation to upwards of $650 for an assessment and report. Medicare will cover some of the fee, however there is usually a gap payment of around $200 or more. You may also be eligible for some of the fee through private health insurance.

If you have seen a psychiatrist for a diagnosis and you are happy with your medication, working with a counsellor may be a low-cost solution for regular and on-going talk therapy support.

Psychologist

Psychologists train for six years. This includes three-four years at degree level focusing on scientific research and two years post-graduate training, which may include a year or more of supervised practice. Psychologists are accredited by the Australian Psychology Accreditation Council through the Psychology Board of Australia. Practicing psychologists must be registered with the Australian Health Practitioner Regulation Agency (AHPRA).

Psychologists may have an area of specialization such as exercise psychology or clinical psychology. Descriptions of the different areas of specialization can be found at the Australian Psychological Society (APS) website.

Psychologists can help you with anxiety, depression and stressful life events and other mental health issues. Psychologists are especially trained in assessment, so it’s wise to see a psychologist if you require a diagnosis, however psychologists are not medical doctors so are not able to prescribe medication.

Psychologists set their own fees, and are currently in high demand in some areas of the country. The APS recommends an hourly standard fee of $318, however practitioners are at liberty to charge what they think is fair. Medicare rebates are available for children with ASD or disabilities and people who have been diagnosed with a mental health disorder. At the time of writing, the Medicare rebate is approximately $98 for a registered psychologist, and you will have to pay the gap. Each practitioner’s pricing will vary, so it’s wise to do your research to find out what your out-of-pocket expenses will be.

Clinical Psychologist

According to the Australian Clinical Psychology Association (ACPA), a clinical psychologist is an expert in assessment, diagnosis, formulation, and psychological treatment of mental health, behavioural, and emotional disorders across the lifespan. Training to become a clinical psychologist takes eight years. It requires a four-year honours degree in psychology, which covers the scientific foundations of psychology, followed by a two-three year post-graduate degree and a one-two year registrar program overseen by the Psychology Board of Australia. When a clinical psychologist has completed accredited post-graduate training, they receive an Area of Practice Endorsement (AoPE), which is recognised under National Law.

A clinical psychologist is particularly suitable for when conditions are complex, or difficult to diagnose; if a person is at risk for suicide and when a client does not respond to standard treatment through a GP or other mental health professional. Clinical psychologists do not prescribe medication, but provide psychological therapy (psychotherapy or talking therapy), and psychological testing to gain an understanding of your condition.

At July 2025, the Medicare rebate for a clinical psychologist was $141.85.

Counselling and Psychotherapy

The Psychotherapy and Counselling Federation of Australia (PACFA) describes counselling as more likely to help with specific problems whereas psychotherapy is concerned with developing insight and restructuring the personality or recreating a sense of ‘self’.

In Australia, counselling and psychotherapy are self-regulated professions, so it’s important to review the credentials of the professional you are engaging with. There are two peak bodies for accreditation of counselling, PACFA and the Australian Counselling Association (ACA), which both require minimum qualifications from accredited universities and colleges, clinical experience and strict ethical standards to be met. Counsellors and Psychotherapists also have to meet requirements for professional supervision.

To become a registered and accredited counsellor with PACFA, you must at least complete a Bachelor’s degree of three-four years in a discipline specific to counselling and psychotherapy. Life experience and an affinity for working with people may also be required for eligibility. Accredited training is rigorous and typically requires in-depth study of the theory and practice of psychology and counselling modalities, trauma and grief.

In contrast to the study of psychology which has a heavy focus on research, accredited counselling training focuses on developing the clinical skills required to build a therapeutic relationship. Accredited counsellors are required to undertake supervised placement, ensuring a high level of competency before graduation.

You may see counsellors and psychologists listing their experience as Level 1, level 2 etc . For Counsellors, the ACA provides different levels of accreditation https://theaca.net.au/membership-categories/. As the levels increase in number, there are requirements for a minimum number of hours of clinical experience and workplace supervision. For registration to remain current, counsellors and psychotherapists are required to undertake continuing professional development, and supervision.

Counsellor

Counselling is a collaboration between client and therapist in a safe and confidential space for the exploration of a client’s mental health and life concerns. Counsellors use evidence-based interventions to help clients overcome life’s difficulties. Counsellors may also be trained in different modalities such as cognitive behavioural therapy (CBT), dialectical behavioural therapy (DBT), acceptance and commitment therapy (ACT), narrative therapy, expressive arts therapy and so on. There are hundreds of evidence-based manualised and non-manualised treatment modalities and your therapist will draw on those which are best for you.

Psychotherapist

Psychotherapy is generally used to describe ‘talk therapy’. However, in Australia, a professional psychotherapist has undergone rigorous training to work with people in a holistic and relational manner.

According to the College of Psychotherapy which is administered by PACFA, the primary difference between a psychotherapist and a psychologist is that a psychotherapist will endeavour to address the underlying causes of a mental health condition to facilitate lifelong change. As with other mental health professionals, a psychotherapist will provide information and tools for symptom reduction, but will also work to bring the unconscious conscious. Key to the therapy is that psychopathology and mental illness are regarded as disruptions to the development of ‘self’ which has been caused by relational or attachment issues, trauma or sustained interpersonal trauma.

As an easy way to remember the difference is that a counsellor generally helps you to move forward and a psychotherapist helps you to look backward in order to move forward.

Clinical psychotherapist

A clinical psychotherapist has had specific post-graduate training in psychotherapy, years of clinical experience and supervision and has also undergone their own personal psychotherapy. PACFA’s college of Psychotherapy has recently published its Professional Competencies for Certification as a Registered Clinical Psychotherapist., which outlines the details for professional competency required for registration.

Despite the rigorous academic and practical training most practitioners undertake, counselling and psychotherapy are regarded as non-medical services, so there are no Medicare rebates but some private health funds may offer rebates to clinical practitioners.