Do I Need a Counsellor or a Psychologist?

Thinking about starting therapy but unsure whether to see a counsellor or a psychologist? For many people, the world of mental health support can feel confusing and full of jargon, and when you're already feeling overwhelmed, the last thing you need is more uncertainty. Here’s the good news: counselling is one of the most accessible and impactful ways to get support.

This question comes up all the time in my counselling practice: What’s the difference? Who should I see? Will I get a rebate? Will they help with what I’m going through? Do I need to go to a doctor first?

Read on as I break it down so you can find the right support, without the confusion.

What’s the difference between a counsellor and a psychologist?

The biggest differences come down to training, treatment focus, and how sessions are structured.

Counsellors (like me) take a warm, collaborative, person-centred approach. We’re trained to work with a wide range of life challenges such as relationship difficulties, identity issues, emotional stress, grief, anxiety, life transitions and more. Counselling tends to be less medicalised and more focused on helping you understand yourself and your relationships, develop coping strategies, and move forward with clarity. It can be short-term or longer-term, depending on your needs. Counsellors who are registered with either of the two Australian professional bodies, ACA or PACFA, are required to meet rigorous training standards, ethical guidelines, and ongoing professional development.

My clients come to counselling not because they have a diagnosis, but because something in their life or relationship isn’t working, and they want to talk it through with someone skilled, empathic and non-judgemental. They don’t want to spend their sessions completing clinical scales to diagnose an “illness” and then work on a recovery program for this diagnosis. Unlike this medical lens, which tends to ask “What’s wrong with you?”, counselling often begins with a different, more compassionate question: “What’s happened in your life that’s brought you here?”

Psychologists, on the other hand, often focus more on assessment, diagnosis and treatment of mental health disorders like depression, PTSD, OCD or ADHD. They may use structured tools to measure symptoms, and work with you (and sometimes your GP) to create a treatment plan. Psychologists are also trained in how they think, learn and behave which can be helpful if you’re dealing with cognitive or developmental issues.

Both counsellors and psychologists use evidence-based techniques (treatment models that are scientfically proven and backed with extensive research) but our approaches and the frameworks we draw on can differ. What matters most is finding someone you trust and feel safe with.

What about couples / marriage counselling?

Here’s something many people don’t realise: counsellors often specialise in relationship therapy, while many psychologists focus more on individual work. If you and your partner are stuck in cycles of conflict, struggling with intimacy, recovering from betrayal, or simply feeling more like housemates than intimate partners, counselling can help you both feel heard, understood and supported in finding a way forward.

At Vanessa Wylie Counselling, I work with couples and individuals at all stages of life, especially those navigating midlife transitions, parenting pressures, ageing parents or simply wondering “Is this all there is?”

With a Master of Counselling (Postgraduate), extensive experience, and training in evidence-based approaches like EFT, the Gottman Method, EMDR, Acceptance and Commitment Therapy (ACT) and psychodynamic therapy (amongst others!), I help clients gently uncover patterns, shift stuck dynamics and reconnect with themselves and the people they care about.

Can I claim counselling on Medicare?

Can I claim counselling on Medicare?

At this stage, counsellors in Australia aren’t covered by the Medicare rebate system. Only psychologists, some social workers and occupational therapists are eligible under a Mental Health Care Plan (MHCP) from your GP.

To access a MHCP, you’ll need to book an appointment with your doctor and meet certain criteria, usually by completing a mental health questionnaire or rating scale that helps identify clinical symptoms such as anxiety or depression. If you qualify, your GP can refer you to a psychologist for a set number of rebated sessions.

It’s also important to know that MHCPs require a review appointment around the 6-session mark. This means heading back to your GP for an in-person check-in to continue accessing rebates. For some people, this process can feel medicalised or time-consuming, especially if your concerns are more relational, situational or emotional than diagnostic.

Couples counselling, however, is not covered by Medicare, regardless of whether you see a psychologist or a counsellor. Medicare only supports individual mental health treatment under a MHCP. So, if you’re seeking help for your relationship, you’ll be paying privately either way.

This is where counselling can offer a more straightforward, human-centred alternative. You don’t need a diagnosis, referral or GP paperwork to begin. You can start where you are, with whatever is going on in your relationship or your life, and be met with warmth, understanding and real support.

Is there a waitlist?

One of the benefits of seeing a counsellor is that we often have shorter wait times and more flexible availability. If you’ve ever tried to book a specialist only to be told it’s a three-month wait you’ll understand how important this can be.

At my practice, I do my best to offer timely support, especially during life’s trickier moments when waiting simply isn’t an option.

So, who should you see?

There’s no one-size-fits-all answer. Your choice may come down to:

• The type of support you’re looking for (relational, emotional, diagnostic)
• Your financial and health insurance situation
• Whether you’re seeking individual or couples work
• How soon you want to begin

Most importantly, it comes down to fit. A warm, attuned therapist who “gets” you can make all the difference, regardless of their title.

Both psychologists and counsellors are qualified professionals, and most of us offer an initial phone consult to help you decide if we’re a good match. So don’t be afraid to ask questions, read bios and trust your gut.

Final thoughts

Starting therapy is a big step. Whether you work with a counsellor or psychologist, what matters most is feeling safe, supported and seen.

If you’re curious about working together, I’d love to hear from you. I offer counselling for individuals and couples in Toorak, Melbourne, and online across Australia. No GP referral required, no long waitlists, just a down-to-earth, collaborative space to help you make sense of what’s going on and figure out what’s next.