For help focusing on your intimate relationship, it is best to choose a specialist in couples counseling, with a balance of relevant life experience and post-graduate training in a variety of approaches specifically for treating couples.


Psychiatrists are medical doctors who specialize in mental illness, and that is not the situation for most couples. While some are also excellent counselors, modern psychiatry increasingly relies on medication as their sole intervention. Though talk therapy is often found to be very helpful for many mental health situations, it is not as cost-efficient or time-efficient for someone with medical training to provide, and it is not financially well-supported by our health care system.

Likewise, medical doctors of other sorts have some training in recognizing mental illness, but those in regular practice cannot be expected to have the time and training to counsel on non-medical interpersonal issues.

The medical system is based on a disease model, even though many mental health conditions still lack a clear physiological basis for diagnosis or treatment. Nevertheless, when there is a need to prescribe or manage prescription medication mental health, the help of a psychiatrist, either as a counselor or a member of a treatment team, can be very valuable — if you can access one.


In British Columbia, virtually all psychologists have a doctoral degree in the science of behavior and mental processes. While some psychologists are the ones to push forward the frontiers of understanding and treatment of mental health concerns, their extensive schooling or research work may concentrate on theoretical matters that do not directly contribute to skill in practice.

Clinical psychologists with specializations in diagnosable mental illness, complex comorbidities, or trauma may be particularly helpful in sorting out those issues and providing access to specific psychological treatment such as rehab, group programs, or clinical research initiatives. They may also be excellent counselors. However, the services of registered psychologists are normally substantially more expensive than those of counselors, and may be out of reach for many people with everyday “problems in living”.

Social workers and clinical counselors

These practitioners usually have master’s degrees in psychology, and often significant post-graduate training in various specialties. Some have doctorates in other fields, perhaps related. Even so, they do not necessarily have much or any specific training in couples therapy. They may be skilled and experienced in helping with a wide variety of problems, or they may have certain specialties that are quite narrow.


Relationship coaches, inexperienced or lay counselors without university training, all-purpose counsellors who mostly work with individuals, or pastoral or spiritually-based counselors are more likely to be limited in their techniques and perspectives. Keep in mind that prominence in the media is also no guarantee of skill, as the most well-known are often those with the loudest voices or most outrageous approaches.