Choosing a therapist: What’s the difference between a social worker and a psychotherapist?
A social worker or psychotherapist - what’s the difference?
Mental health awareness and the normalization of therapy have increased over the last few years - that’s a great thing. But with the increase in interest, there has also been an increase in options, and that can be confusing. I’m a therapist myself and sometimes struggle to find the right match when I’m looking to make a referral. One thing that people get tripped up on is what “type” of therapist they need. There are a lot of factors that go into finding the right match, but a good place to start is understanding the difference between 2 of the common professions - social workers and psychotherapists.
I am a social worker and am absolutely biased toward social work. Declaring that upfront.
That being said I do have some amazing psychotherapists on my team (say hi to Tarni!) who I absolutely recommend and who possess all the qualities I would want in addition to technical training, like understanding of systems, power, privilege, oppression, trauma, context, and nuance. Lots of words.
Start with knowing this: in Ontario, all social workers are psychotherapists, but all psychotherapists are not social workers.
Make sense? Of course not. Let me explain more.
An interesting phenomenon has happened recently in the field of therapy and mental health, and that’s the use of the term “psychotherapist”. Fun fact, the regulation around “the controlled act of psychotherapy” didn’t come into effect until December 2017. Before that most people would call themselves social workers, psychologists, counselors, or therapists.
The use of the term comes down to legislation. There are actually a lot of providers that are legally allowed to use the term “psychotherapist”. They include members of:
College of Registered Psychotherapists of Ontario
College of Nurses of Ontario
College of Occupational Therapists of Ontario
College of Physicians and Surgeons of Ontario
College of Psychologists of Ontario
Ontario College of Social Workers and Social Service Workers.
Yep. Nurses and doctors can call themselves psychotherapists too.
So while all social workers are psychotherapists, not all psychotherapists are social workers.
Let me break it down for you some more. I’ll talk about everything at the Master’s level, because that’s who you should be working with for therapeutic work (I said what I said).
What kind of education do social workers and psychotherapists have?
A Registered Social Worker who is practicing psychotherapy has a Master’s in Social Work. The end.
Most MSW programs will require a BSW for admission, and if not a related undergraduate degree (psychology, sociology, etc.) that will then require additional courses at the Master’s level.
A Registered Psychotherapist could have a Master’s in Psychology, Counselling Psychology, Expressive Arts, Psychotherapy, Gestalt Psychotherapy, Education, Art Therapy, Pastoral Studies… and a lot more. The prerequisites vary widely for these types of programs. Some require a related undergraduate degree, for others, you can have a completely unrelated undergraduate degree but a few hours of volunteer experience.
Here’s a sample of courses in a Master of Social Work program:
Comprehensive Social Policy Analysis
Communication Skills in Social Work Practice
Social Work Practice with Individuals
Social Work Practice with Groups
Social Work Practice with Families
Social Work Practice with Organizations and Communities
Social Work Values, Ethics & Anti-Oppressive Practice
Challenges in Human Behaviour
Advanced Social Work Research: Practice Evaluation
Advanced Direct Social Work Practice
Advanced Indirect Social Work Practice
Social Justice and Social Change
Advanced Social Policy Analysis and Development
Program Design and Evaluation
And here’s a sample of courses in a Master of Counselling Psychology program:
A Biopsychosocial Approach to Counselling
Assessment in Counselling
Counselling Methodology – Humanistic & Psychodynamic Modalities
Counselling Methodologies – Behavioural and Cognitive Modalities
Ethical Standards for Mental Health Service Providers
Research Methodology
Group Counselling
Counselling Skills and Competencies
Applying Interventions
Couples & Family Systems
Cultural Diversity in Counselling
Psychopathology for Counsellors
Addiction Counselling
Counselling in School Environments
Crisis and Trauma Counselling
We are all trained to treat common experiences like anxiety and depression.
The biggest difference you will find is that all social workers are trained in what we call the person-in-environment perspective. This means that we look at you as a whole person AND at the environment, you’re in and how it contributes to what you’re experiencing.
There are some approaches to therapy that look at everything residing within the individual and we’re just not down with that. We exist in relation to each other, we live in a world that has spoken and unspoken rules, and those things affect us and our mental health.
This one is huge for me. I’ve worked with other therapists who don’t take into account things like poverty, race, or gender and it does a disservice to the client at best and causes harm at worst.
How are social workers and psychotherapists regulated?
Social Workers are regulated by the Ontario College of Social Workers and Social Service Workers (OCSWSSW). Psychotherapists are regulated by the College of Registered Psychotherapists of Ontario (CRPO).
I give the college some money, they give me permission to practice and keep their eyes open for if I’m being bad along with providing some resources for making sure I am practicing ethically. That’s pretty much the relationship. When you enter this relationship you can use the title Registered Social Worker (RSW).
CRPO members have 2 different titles. Registered Psychotherapist (Qualifying), and Registered Psychotherapist.
A qualifying psychotherapist - RP(Q) - is a recent grad or someone who is just starting their supervision requirements. I’ll talk more about supervision next.
Does your therapist have a supervisor?
In our field supervision is when a therapist hires another more experienced therapist to consult with them on the work that they’re doing. A supervisor helps a therapist with their clinical practice, making sure they understand their theories and interventions and looking out for things like transference and counter-transference to make sure the therapist is providing quality and ethical service. A supervisor is also a helpful place of support for all of the heavy stuff a therapist hears throughout their work.
Interestingly, there is NO requirement for social workers to be under supervision. I (and many other social workers) pay out of pocket for supervision because I see it as helpful and necessary for me to make sure I’m doing the best work possible and taking care of myself at the same time. Even though it’s not mandatory, I would be less inclined to work with someone who doesn’t use supervision, and talked about why in this Instagram post.
Psychotherapists have supervision requirements in order to use the title of Registered Psychotherapist. Psychotherapists, who are registered only with CRPO, start as RP(Q)s. An RP(Q) must complete 100 hours of supervision before they can move to the next category which requires them to complete 1,000 direct client contact hours along with 150 hours of supervision. Once these requirements are met they are able to move to “independent practice”.
Taxes on Therapy Services
In Ontario, social workers are exempt from HST when providing professional services. When I provide therapy, there is no HST. If I am doing a speaking gig or consulting, the tax man wants a piece.
Psychotherapists are NOT tax-exempt. It comes down once again to words and legislation. A profession is eligible to be GST/HST exempt nationally if it is regulated as a health profession “by at least five provinces or territories”, the government says it’s not. It’s a whole thing.
What really matters when choosing the right therapist?
Choosing the right therapist comes down to choosing the right therapist FOR YOU.
The bare minimum is the appropriate education, registration with a regulatory body, and practice insurance. We all get trained in CBT - it’s what the individual brings beyond their training that matters.
Whether someone is a social worker or a psychotherapist might not matter as much. Start with the bare minimum and then explore these 5 questions when choosing the right therapist for you:
Has your therapist done their own work?
Can they speak to your pain with knowledge and compassion?
Do they understand your lived experience and the realities of what you’re going through?
Do they demonstrate a commitment to staying on top of their practice with continuing education?
Are they serious about practising with ethics and integrity?
Do you LIKE them? Is the vibe right?
All of our therapists are people who are passionate about this work because they’re dealt with their own stuff and want to use their skills and expertise to help others. At The Relationship Agency we live our values of Courage, Curiosity, Connection, and Integrity. If you’re ready to make a change book a free consult to see if we might be the right fit for you.
