Why these words get confusing
In Surat, as across most of India, "therapist" and "counsellor" are used almost interchangeably — sometimes for someone with a full postgraduate degree in clinical psychology, sometimes for someone with a short certificate course, and sometimes loosely for anyone offering supportive conversation. There's no single regulatory body controlling who can call themselves a "counsellor" the way there is for doctors, which makes it genuinely hard to know what you're getting when you search for one.
This isn't written to discourage you from seeking therapy or counselling — both can be genuinely valuable. It's written so you can ask the right questions before you start, and understand where a psychiatric consultation fits alongside, or before, that decision.
What therapy and counselling typically involve
Supportive counselling
Regular conversations focused on a specific difficulty — a relationship issue, a stressful life transition, everyday overwhelm — aimed at helping you process what's happening and build coping strategies. Usually the right starting point for milder, more situational concerns.
Structured psychotherapy
A more formal, evidence-based approach — such as Cognitive Behavioural Therapy (CBT) — usually delivered by a trained psychologist or psychiatrist, following a defined structure across a set number of sessions, aimed at specific, measurable changes in thought patterns or behaviour.
Psychiatric care
Assessment and treatment by a medical doctor, which can include diagnosis, medication where appropriate, and therapy delivered directly or coordinated alongside a psychologist or counsellor — particularly useful when symptoms are more persistent, severe, or unclear in origin.
Psychiatrist vs psychologist vs counsellor/therapist
Here's a plain comparison of training and scope, so you can judge for yourself who you're speaking to and what they can offer:
| Area | Psychiatrist | Psychologist | Counsellor / Therapist |
|---|---|---|---|
| Base qualification | MBBS + MD/DNB Psychiatry | MA/MSc Psychology + MPhil Clinical Psychology (typical) | Varies widely — diploma to postgraduate; the term itself isn't regulated in India |
| Can prescribe medication | Yes | No | No |
| Can give a clinical diagnosis | Yes | Assessment & formulation; medical diagnosis needs a doctor | No |
| Primary focus | Diagnosis, medication where needed, and/or therapy | Structured psychotherapy & psychological testing | Supportive conversation, coping skills |
| A good fit when… | Symptoms are moderate-to-severe, medication may help, or you're unsure what's going on | You want structured, evidence-based talk therapy for a clear concern | You want a supportive space to talk through a specific, milder difficulty |
For a longer explainer, see psychiatrist vs psychologist: who should you see, and when.
How to know which one you actually need
There's no perfect formula, but a few honest questions help:
- Is this a specific, recent situation (a difficult conversation to prepare for, a relationship rough patch)? Counselling alone may be enough.
- Has this been going on for weeks or months, and is it affecting your sleep, appetite, work, or relationships? A psychiatric assessment is worth having.
- Are you not sure what's actually going on, or whether what you're feeling has a name? Starting with a psychiatrist can help map the territory and point you in the right direction.
- Do you already suspect medication might help, or want to at least understand if it's an option? That conversation needs a psychiatrist.
- Would you feel supported by a combination — regular counselling alongside psychiatric monitoring? Many people do best this way, and Dr. Heena can help coordinate that.
Called it something else? That still counts.
Many people describe wanting to talk to someone without using clinical vocabulary at all — "koi maansik tanaav ke baare mein baat kar sake" (someone I can talk to about mental stress), or simply "मुझे किसी से बात करनी है" (I need to talk to someone). In Gujarati, "માનસિક તણાવ" describes mental stress broadly, and "કોઈ સાથે વાત કરવી છે" — wanting someone to talk to — is exactly where a first conversation, whether counselling or psychiatric, usually begins.
About Dr. Heena Khanna
Dr. Heena Khanna, MBBS, MD (Psychiatry)
Dr. Heena Khanna is a Consultant Psychiatrist practising at Mahavir Health Campus, Ring Rd, Athwa Gate, Surat. She holds an MBBS and an MD in Psychiatry, and is a member of the Indian Psychiatric Society and the Indian Medical Association. Her practice includes therapy delivered directly (including CBT) as well as psychiatric assessment, medication management where appropriate, and coordination with psychologists or counsellors when that's the better combination for a particular situation. No referral is required to book a first session.