Psychotherapist, Counsellor, or Psychologist? What's the Difference in Ontario

Short answer: In Ontario, “psychotherapist” is a protected title. Registered Psychotherapists (RPs) are regulated by the College of Registered Psychotherapists of Ontario (CRPO) and provide psychotherapy but are not authorized to give you a diagnosis; psychologists belong to a different college and can diagnose certain mental health conditions, and psychiatrists are medical doctors who can diagnose and prescribe. “Counsellor” is not a restricted title, so on its own it does not tell you whether someone is regulated at all.

If you are looking for help in Kanata or elsewhere in Ottawa, here is what each title means under Ontario law and the regulators’ own guidance.

Registered Psychotherapist (RP)

A Registered Psychotherapist is a member of CRPO, which regulates the profession under the Psychotherapy Act, 2007. The Act describes psychotherapy as assessing and treating cognitive, emotional or behavioural disturbances through a therapeutic relationship built mainly on verbal or non-verbal communication. In everyday terms, it is talk therapy from a regulated professional; our guide to how psychotherapy works explains what it involves.

Only CRPO registrants can use the title “Registered Psychotherapist” or “RP.” The shorter title “psychotherapist” is restricted too: apart from CRPO registrants, only authorized members of five other colleges (for nurses, occupational therapists, physicians, psychologists and social workers) can use it, and only together with their own college or professional title.

What “RP (Qualifying)” means

RP (Qualifying) is a CRPO registration category, not a separate profession. Qualifying registrants have met CRPO’s entry requirements, such as completing a psychotherapy education program, and are finishing the steps to become a full RP: passing CRPO’s registration exam and completing at least 450 hours of direct client contact and 100 hours of clinical supervision. Until then, they must practise with clinical supervision, and CRPO allows up to five years to finish.

At Life Seasons Counselling, both of our therapists are registered with CRPO: Isaac Davis is a Registered Psychotherapist, and Arden Sabourin is a Registered Psychotherapist (Qualifying) who, like all Qualifying registrants, practises with clinical supervision.

Psychologist and Psychological Associate

Psychologists are regulated by the College of Psychologists and Behaviour Analysts of Ontario (CPBAO), which was called the College of Psychologists of Ontario until July 2024. The titles “psychologist” and “psychological associate” are restricted to its members. According to CPBAO, psychologists typically hold a doctoral degree in psychology, while psychological associates hold a master’s degree in psychology plus four years of work experience; both share one scope of practice.

The key difference is diagnosis. When practising psychology, CPBAO members are authorized to communicate a diagnosis of neuropsychological disorders and psychologically based psychotic, neurotic or personality disorders, and they can also provide psychotherapy. That makes a psychologist one option for a formal assessment, such as for adult ADHD (see our guide to getting an adult ADHD assessment in Ontario). Psychologists in Ontario are not authorized to prescribe medication.

Psychiatrist

A psychiatrist is a medical doctor who has gone on to specialize in psychiatry; Royal College of Physicians and Surgeons of Canada certification in psychiatry requires a five-year accredited residency and a certification exam. Psychiatrists are regulated by the College of Physicians and Surgeons of Ontario (CPSO) and are authorized to communicate a diagnosis, prescribe medication and provide psychotherapy.

Medically necessary physician services, including psychiatry, are covered by OHIP. If you think a psychiatric assessment or medication could help, raise it with your family doctor or nurse practitioner.

Registered Social Worker (RSW)

Social workers are regulated by the Ontario College of Social Workers and Social Service Workers (OCSWSSW), and “social worker” and “registered social worker” are protected titles. Their scope covers individual, interpersonal and societal problems, so a social worker may combine therapy with help addressing practical or systemic barriers.

OCSWSSW members are authorized to perform the controlled act of psychotherapy and may call themselves a psychotherapist if their college or social work title comes first, as in “Registered Social Worker, Psychotherapist.” OCSWSSW has said psychotherapy is the only controlled act its members may perform, so social workers are not authorized to communicate a mental health diagnosis.

What “Counsellor” and “Therapist” Mean in Ontario

“Counsellor” is not one of the titles restricted by the Psychotherapy Act, 2007, and CRPO states that it does not regulate counsellors or counselling. “Therapist” on its own is not restricted by the Act either; the Act restricts “psychotherapist,” “registered psychotherapist” and “registered mental health therapist.”

That does not make someone who uses these words unqualified; regulated professionals describe their work as counselling too, and our own practice has the word in its name. The word alone simply does not tell you whether a person answers to a regulatory college, so ask which one.

CRPO also distinguishes the activities. Counselling generally focuses on information, advice, encouragement and instruction, while psychotherapy works through an ongoing therapeutic relationship to change how a person thinks, feels, behaves and functions. The two overlap, but an unregulated counsellor cannot use the title “psychotherapist” or, outside a few narrow exceptions, perform the controlled act of psychotherapy.

The Controlled Act of Psychotherapy: Who Can Perform It

Ontario’s Regulated Health Professions Act, 1991 lists 14 controlled acts, activities risky enough to be restricted to authorized professionals. Psychotherapy became one of them on December 30, 2017. It is narrower than talk therapy in general: it covers treating a serious disorder of thought, cognition, mood, emotional regulation, perception or memory, using psychotherapy technique within a therapeutic relationship, when that disorder may seriously impair a person’s judgement, insight, behaviour, communication or social functioning.

Members of six colleges may perform it, each under their own college’s rules:

• CRPO (Registered Psychotherapists)
• CPBAO (psychologists and psychological associates)
• OCSWSSW (social workers and social service workers)
• CPSO (physicians, including psychiatrists)
• College of Nurses of Ontario
• College of Occupational Therapists of Ontario

Exceptions are narrow, such as students training under supervision and Indigenous healers providing traditional healing to Indigenous people or communities. CRPO also lists services outside the controlled act, including general counselling and advice, crisis intervention and single-session counselling.

Who Can Diagnose a Mental Health Condition in Ontario?

Communicating a diagnosis is also a controlled act when it is reasonably foreseeable that the person will rely on it. For mental health, the main professionals authorized to do it are:

• Physicians, including family doctors and psychiatrists
• Nurse practitioners
• Psychologists and psychological associates, for neuropsychological disorders and psychologically based psychotic, neurotic or personality disorders

RPs and social workers are not authorized to communicate a diagnosis. CRPO draws the line between assessment and diagnosis: an RP can summarize the symptoms you describe, propose a treatment plan, treat a condition that has already been diagnosed, and suggest you follow up with someone who can diagnose. You do not need a diagnosis to start therapy with an RP.

What’s Covered: OHIP vs. Extended Health Benefits

OHIP covers medically necessary services from doctors, including psychiatrists, but not health services delivered outside a hospital by providers who are not physicians or other prescribed practitioners. In practice, private sessions with RPs, psychologists and social workers are generally paid out of pocket or through extended health benefits.

Plans vary in which professions they list, so check your booklet or ask your insurer; our guide to whether insurance covers therapy in Ontario lists the questions to ask. At Life Seasons Counselling, sessions are $160 to $190 for 50 minutes depending on the therapist, with receipts you can submit to your plan (see our fees page).

There are publicly funded options too. The Ontario Structured Psychotherapy Program offers free cognitive behavioural therapy and related services to adults 18 and older, with a referral from a physician, nurse practitioner or other health care professional (self-referral is available in some areas). The Royal Ottawa Mental Health Centre is one of its regional lead organizations for eastern Ontario.

Side-by-Side Comparison

Extended health benefits apply only if your plan includes that profession, and coverage can also depend on where the professional works.

How to Choose, in Kanata or Ottawa

The same provincial rules apply in Kanata, Stittsville, Barrhaven or downtown Ottawa. A few questions can help narrow it down:

1. What do you need? For therapy with anxiety, stress, relationships or a life transition, RPs, psychologists and social workers can all provide psychotherapy. For a diagnosis or formal assessment, start with your family doctor, a nurse practitioner or a psychologist. If medication might help, talk to your family doctor, a nurse practitioner or a psychiatrist.
2. What does your plan cover? Check which professions your extended health benefits reimburse before you book.
3. Are they registered? Search the public register: CRPO for RPs, CPBAO for psychologists and psychological associates, OCSWSSW for social workers, and CPSO for physicians. CRPO’s register also shows each RP’s category and whether they practise with supervision.
4. Is it a good fit? Ask about their experience with your concern, and notice whether you feel comfortable with them.

To explore working with us, read about our services and our therapists, then book a free 20-minute consultation by phone or video. We see clients aged 14 and up in person at 99 Kakulu Road, Suite 208, in Kanata, and online anywhere in Ontario. If a diagnosis, medication or another kind of support would serve you better, we will tell you and talk through where to start.

If you are in crisis: Life Seasons Counselling is not a crisis service. If you are thinking about suicide, call or text 9-8-8, the Suicide Crisis Helpline, at any time. In an emergency, call 911 or go to your nearest emergency department.

Frequently Asked Questions

What is the difference between a psychotherapist and a counsellor in Ontario?

“Psychotherapist” is a protected title in Ontario: only members of the College of Registered Psychotherapists of Ontario (CRPO), and authorized members of five other regulatory colleges who use it with their own professional title, can use it. “Counsellor” is not restricted by the Psychotherapy Act, 2007, and CRPO does not regulate counsellors or counselling, so the word alone does not tell you whether someone is regulated.

Can a Registered Psychotherapist diagnose in Ontario?

No. Communicating a diagnosis is a controlled act that CRPO registrants are not authorized to perform, although they can assess your concerns and treat conditions another professional has diagnosed. Physicians (including family doctors and psychiatrists), nurse practitioners, and psychologists and psychological associates can communicate a diagnosis within their scope.

Should I see a psychologist or a psychotherapist?

It depends on what you need. Registered Psychotherapists, psychologists and social workers can all provide psychotherapy for concerns such as anxiety, stress or relationships. If you need a formal assessment or diagnosis, such as for adult ADHD, a psychologist, physician or nurse practitioner can provide one. What your benefits plan covers may also shape the choice.

What does RP (Qualifying) mean?

RP (Qualifying) is a CRPO registration category for psychotherapists who have met the College’s entry requirements and are completing the rest: passing CRPO’s registration exam and completing at least 450 hours of direct client contact and 100 hours of clinical supervision. Qualifying registrants are regulated by CRPO and must practise with clinical supervision.

Does OHIP cover therapy with a psychotherapist or psychologist?

Generally not in private practice. OHIP covers medically necessary services from doctors, including psychiatrists, but not health services delivered outside a hospital by providers who are not physicians or other prescribed practitioners. Private sessions with Registered Psychotherapists, psychologists and social workers are usually paid out of pocket or through extended health benefits. The Ontario Structured Psychotherapy Program offers free therapy to adults 18 and older.

Important note: This article is general information, not legal, medical or insurance advice. Rules can change, so check the relevant regulator’s website for current requirements.