One of us paid for the training. The other one paid for the noun.
Somewhere on Facebook this afternoon, between a mattress sale and a man doing pull-ups on a beach, there is an advertisement offering a Certificate in Counselling for roughly the price of a sandwich. It takes a weekend. It arrives as a PDF. It has a border, and somewhere on it, in a serif that came free with the template, sits a word arranged to look like an institution.
Buy it and you may lawfully describe yourself as a psychotherapist in Australia.
That is not a loophole, an oversight, or a scandal waiting for a journalist. It is simply how the vocabulary works, and almost nobody outside the professions knows it.
Not the same animal
People tell me, warmly and often, that a psychologist and a psychotherapist are the same thing. Same job, different word, no harm done. They say it on my Substack, in emails, and at parties where somebody is generously explaining me to somebody else.
We are not the same animal. We are not reliably the same species. And the difference is not intelligence, warmth or talent, because those are distributed by God rather than by invoice, and God has never shown the slightest interest in our paperwork.
The comparison I keep reaching for is accounting. A management accountant, a bookkeeper and an accounts clerk all handle your money, and nobody sane treats them as one profession in three moods. You would not hand the accounts clerk your tax position. The words describe different training, different scope and different liability, and the public somehow manages to keep them apart without assistance.
Do the same trick with the human interior and everyone goes vague.
What the two sides cost
My own route ran from 1994 to 2018, which is not a boast so much as an admission of pace. An honours degree in applied psychology and sociology. Twenty years of related work. Then a Master of Counselling Practice at Tabor College in Adelaide, with placements, supervision, examiners, and a great deal of money that no longer exists.
Where that money went matters more than how much of it there was. It went into an education system. Buildings, a library, the wages of people who had read more than I had, a placement coordinator ringing round for host sites, and a supervisor whose job included telling me I was wrong.
Now consider the economics on the other side, which are frankly superior.
A certificate mill has a marginal cost of approximately nothing. The PDF costs whatever the electricity costs. There is no library. No faculty. No placement coordinator, no host sites, no examiner, no academic misconduct process, no accreditation renewal, no annual audit, and nobody in a cardigan explaining that your reflective journal is not, in the strict sense, reflective. Sell a few thousand certificates at seven dollars a pop and you have out-earned the entire cost of my Master’s without once being in a room with a distressed human being.
My fees went into an institution. His seven dollars went into a Stripe account.
Calling it what it is
So the seven-dollar certificate should not be discussed as a smaller, cheaper version of education, because it is not a version of education at all. It is a receipt.
You are not buying training. You are buying a noun, from a man with no authority to sell nouns, in order to display it to people who have no way of discovering that. The transaction has three parties and only one of them knows what is being sold.
Two people sitting down so that one can tell the other what is wrong is probably the oldest technology our species has. It predates money, and it comfortably predates writing, and it worked for a very long time without documentation of any kind. We have now reached the stage where the certificate costs seven dollars and the sitting down costs whatever the market will bear, which is either progress or its precise opposite depending on which end of it you are standing.
The bit the research makes funny
Here is where the literature turns the knife, and it does not turn it in the direction anybody expects.
In 2012 Steven Walfish and colleagues asked mental health professionals to rate their own clinical skill against their peers. A quarter placed themselves in the top ten per cent. Not one placed themselves below average, which is a statistical achievement in a sample that necessarily contains its own worst member, holding a pen, concluding that they are probably ‘fine’.
A decade later, Michael Constantino’s team stopped asking and started checking. Fifty therapists, outcome data on 1,363 patients, each clinician classified from that data as effective, neutral or ineffective across twelve domains, then invited to guess their own classification. On eleven of the twelve they did no better than chance.
Now hold that beside the confidence of a man with a weekend PDF. People with six years of training, a supervisor, and outcome data on more than a thousand patients cannot reliably tell whether they are any good. The seven-dollar graduate is not merely overconfident. He is holding an opinion that the best-resourced people in the field have been demonstrated to be incapable of forming.
And the one thing that did predict effectiveness, in Daryl Chow’s data, was not a qualification at all. It was time spent deliberately working at improvement, in particular the effort of sitting alone with recordings of your own sessions. Years of experience predicted nothing. Highest qualification predicted nothing. Profession predicted nothing. A weekend course predicts, by construction, rather less than that.
Where the words actually part company
None of which makes me better in a room than a well-trained counsellor, and I am not making that claim. Chow’s data would embarrass me if I tried.
The difference is what happens when it goes wrong, and it goes wrong more often than the brochures suggest. Estimates of negative experience in therapy run from three to fifteen per cent of patients. A systematic review of adverse events in psychotherapy trials concluded they can be expected to affect more than one participant in ten. In a representative German sample, close to seventeen per cent of people who had been in therapy reported feeling violated by something their therapist said to them.
On one side of the vocabulary, a complaint has an address. There is a register, a body obliged to investigate, a code that can be found to have been breached, and the genuine prospect of a career ending. On the other side there may be nothing whatsoever to be struck from. Where no voluntary membership is held, your remedy is the courts, which is to say your remedy is money and years, and the man can be trading again by Monday under the identical word, with the same PDF certificate framed and hanging on their wall at your eyeline.
And the people this robs hardest are not psychologists like me. They are the counsellors who did it properly, who paid between fifteen hundred and twelve thousand dollars for a diploma with a hundred hours of supervised placement, who joined PACFA or the ACA voluntarily and submitted to a code nobody forced on them. They are legally indistinguishable from the bloke with the border and the free serif. The counsellor cannot prove the difference. The certificate holder is under no obligation to raise it.
My own position, which undercuts me
I once held registration in Australia. I do not hold it now. I live in Vietnam, which has no regulatory fence around the word at all, so at this longitude I stand in precisely the same legal position as the man with the PDF.
I am arguing for a mechanism I am currently outside of, and the honest feeling that produces is discomfort rather than righteousness. Nobody here can check me either. I have simply been in the trade long enough to know what that absence is worth, and it is worth a good deal less than my own opinion of myself, which the research says is worth nothing at all.
The question
So do not ask a practitioner whether they are any good. The literature says that answer is worthless whoever supplies it, and the more confidently it arrives the less it is worth.
Ask what happens to them if they get you wrong.
On one side of the word there is a body that can end a career. On the other there is a man who can delete a Facebook page before dinner and have a new one running by breakfast, with the same border, the same serif, and a fresh batch of certificates at seven dollars.
Sources and notes
The seven-dollar figure is my own observation of Facebook advertising rather than a published statistic, and is offered as such. For scale, legitimate Australian counselling diplomas run roughly $1,499 to $11,797 and include around a hundred hours of supervised placement.
Chow, D. L., Miller, S. D., Seidel, J. A., Kane, R. T., Thornton, J. A., & Andrews, W. P. (2015). The role of deliberate practice in the development of highly effective psychotherapists. Psychotherapy, 52(3), 337–345. https://doi.org/10.1037/pst0000015
Constantino, M. J., Boswell, J. F., Coyne, A. E., Muir, H. J., Gaines, A. N., & Kraus, D. R. (2023). Therapist perceptions of their own measurement-based, problem-specific effectiveness. Journal of Consulting and Clinical Psychology, 91(8), 474–484. https://doi.org/10.1037/ccp0000813
Hardy, G. E., Bishop-Edwards, L., Chambers, E., Connell, J., Dent-Brown, K., Kothari, G., O’Hara, R., & Parry, G. D. (2019). Risk factors for negative experiences during psychotherapy. Psychotherapy Research, 29(3), 403–414. https://doi.org/10.1080/10503307.2017.1393575
Klatte, R., Strauss, B., Flückiger, C., & Rosendahl, J. (2025). Adverse events in psychotherapy randomized controlled trials: A systematic review. Psychotherapy Research, 35(1), 84–99. https://doi.org/10.1080/10503307.2023.2286992 (Advance online publication 13 December 2023)
Strauss, B., Gawlytta, R., Schleu, A., & Frenzl, D. (2021). Negative effects of psychotherapy: Estimating the prevalence in a random national sample. BJPsych Open, 7(6), e186. https://doi.org/10.1192/bjo.2021.1025
Walfish, S., McAlister, B., O’Donnell, P., & Lambert, M. J. (2012). An investigation of self-assessment bias in mental health providers. Psychological Reports, 110(2), 639–644. https://doi.org/10.2466/02.07.17.PR0.110.2.639-644
Leave a Reply