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Counselling, IAPT therapist, psychotherapist, counselling psychologist?

These job titles all seem to overlap in their focus quite substantially so I'm struggling to understand the difference between them outside of educational requirements.

Please could someone explain to me the differences in the practices each of these job roles undertake? How does a day as a counselling psychologist differ to that offering High Intensity Therapy as part of an IAPT service etc.?
I would caution against honing in on high intensity therapist at IAPT.

There is a tendency for 2nd years/3rd years/people a year or two out of uni to want to do high intensity. The thought process tends to go along the lines of once I'm in IAPT, it won't be too hard to jump from low intensity to high intensity and I can have a cool and exciting job away from the drudgery of low intensity.

The reality is there's a massive bottleneck. Once you get into IAPT many people who are PWPs are cheesed off and disillusioned with IAPT low intensity and want to get on so everyone wants the same as you and few achieve it. After two/three years people leave being a PWP and go off to do other things in many cases. You should ask yourself why this is?
Original post by marinade
I would caution against honing in on high intensity therapist at IAPT.

There is a tendency for 2nd years/3rd years/people a year or two out of uni to want to do high intensity. The thought process tends to go along the lines of once I'm in IAPT, it won't be too hard to jump from low intensity to high intensity and I can have a cool and exciting job away from the drudgery of low intensity.

The reality is there's a massive bottleneck. Once you get into IAPT many people who are PWPs are cheesed off and disillusioned with IAPT low intensity and want to get on so everyone wants the same as you and few achieve it. After two/three years people leave being a PWP and go off to do other things in many cases. You should ask yourself why this is?

Hi Marinade,

I highlighted high intensity therapy as I felt it would be more on par with the demands of a counselling psychologist. I was questioning the difference between the responsibilities and role of each title rather than difficulty in getting there.

This is very interesting information to know, however. I understand you need at least 2 years experience as a fully trained PWP to even consider moving to High Intensity Therapy which did stand out I have to say as I've known of people who underwent PWP training and during their training applied to the DClinPsy and were offered a place.

I've heard PWP training is more intensive than an AP role but this varies from person to person. My understanding of a PWPs day-to-day is limited in comparison to other roles.
(edited 3 years ago)
It's confusing but you are conflating several things.

A High intensity IAPT therapist is anyone who is delivering a high intensity CBT intervention: This can be from several disciplinary backgrounds including Clinical Psychology, Counselling Psychology, CBT therapist, CPN/OT with CBT training etc. It's an umbrella term that describes the kind of work you are doing, not the profession you necessarily come from.

A psychotherapist may be either a) an umbrella term anyone practicing any kind of therapy (CBT, systemic, psychodynamic, psychoanalytic, CFT, Gestalt, CAT etc), b) sometimes specifically used as a shorthand for psychodynamic psychotherapist (depending on the context).

A counsellor is someone who is trained in counselling (and sometimes other approaches depending on their training). They may or may not practice using CBT with additional training.

A practitioner psychologist is an applied scientist who has training in theoretical psychology (via undergrad or equivalent) and has subsequent training (usually at doctorate level). For counselling and clinical requires significant training in psychological assessment, several therapy modalities (usually CBT and at least one other approach), research and academic theory. They have to be state registered through the HCPC as it is a protected title. Within IAPT these tend do be high intensity therapists, but in my experience usually go onto supervisory and management roles fairly quickly.

In terms of a typical day it will depend.This is why experience is required in all of these fields, and you are best off asking people in those roles those questions, and ideally getting experience working alongside them.
You are best asking people.

I can't comment on counselling or counselling psychologist, however for PWP it seems to vary a lot. Some PWPs have setups with high volumes of calls for example (pre covid) and others not so much.
Original post by ChangeDirection
I highlighted high intensity therapy as I felt it would be more on par with the demands of a counselling psychologist. I was questioning the difference between the responsibilities and role of each title rather than difficulty in getting there.



A Counselling Psychologist's training allows you to do a huge number of roles, and are often interchangable with clinical psycholgists in many posts. They can be found across the lifespan from CAMHS through to older adult mental health teams, working in management posts, Health Psychology teams and specialist services. Some are more involved with research or academic roles and the skillset is far, far broader than just therapy.

High intensity therapists in contrast is a purely IAPT focussed role (in a CMHT they would just be a Band 7/8 psychologist and would be doing "high intensity work" by virtue of their position). If you are talking about the PWP-> High Intensity route, where you don't have a core profession, (apart from possibly gaining BABCP accreditation), that pretty much limits you to working in IAPT, or possibly offering CBT privately. I can think of one High intensity CBT therapist who has gone into a more management role but it is extremely limited and there is little/no scope to go beyond an 8a.

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