When South Africans look for a counsellor, they meet a small alphabet of professions — psychologists, social workers, registered counsellors — and very little plain information about how they differ. Since I am a social worker in private practice, people sometimes ask me directly: why should I see you rather than a psychologist?

It is a fair question, and it deserves a straight answer rather than a defensive one. Here is how the two professions actually compare in South Africa, and how to choose well.

Two professions, two training paths

A psychologist in South Africa typically completes an honours degree in psychology, then a competitive master's degree in a registered category — clinical or counselling psychology being the ones relevant here — followed by supervised internship work, and registers with the Health Professions Council of South Africa (HPCSA).

A social worker completes a four-year professional Bachelor of Social Work degree (in my generation, a BA Social Work — mine, with honours, is from Wits), which includes supervised practical placements throughout, and registers with the South African Council for Social Service Professions (SACSSP). Counselling is part of a social worker's core training and legally defined scope of practice — it is not an add-on.

So both are regulated professions with formal training, registration numbers, ethical codes and councils to answer to. They grow from different roots: psychology from the study of the mind and its measurement; social work from the person in the whole context of their life — family, community, history, circumstance.

What each may do

Psychologists are trained in psychometric assessment — formal testing of IQ, personality, neuropsychological functioning — and clinical psychologists in particular focus on diagnosing and treating mental illness. If you need a formal assessment for a court, a school placement, or a complex psychiatric diagnosis, a psychologist (or psychiatrist) is the right professional. Neither psychologists nor social workers prescribe medication; that is psychiatry.

Social workers in private practice offer counselling within their scope: relationships and couples, grief and loss, trauma, family difficulties, parenting, life transitions, support around illness and ageing. Many, like me, add years of further training in specific approaches — in my case emotionally focused, somatic and trauma-focused work, built on top of a long career across statutory work, a care home, and private practice.

Can you claim from medical aid for a social worker?

Often, yes — this surprises people. Registered social workers in private practice have practice numbers, and several South African medical aids pay benefits for their sessions, depending on your plan and available benefits. Sessions with a registered social worker can often be claimed back from aids including Bonitas, Discovery Health, Fedhealth, GEMS and Momentum, and I provide everything you need to submit the claim. The honest caveat: benefits differ by scheme and plan, so check yours. My fees and medical aid page sets out the details as they apply to my practice.

How to choose between them

Match the professional to the need:

  • Formal assessment, complex diagnosis, or serious psychiatric illness — a psychologist, usually alongside a psychiatrist.
  • Counselling for grief, relationships, trauma, family strain, ageing, life's hard passages — a psychologist, an experienced social worker, or another well-trained counsellor can all serve you well.

For counselling itself, decades of research — and my own long experience of watching it — point to the same conclusion: the strongest predictor of whether counselling helps is the quality of the relationship between you and the counsellor. Training matters, registration matters, experience matters; the letters after the name, on their own, predict less than people assume.

Why I practise as a social worker — and never pretend otherwise

I am not a psychologist, and you will never see me use that word for myself. I am a social worker in private practice, registered with the SACSSP, with a career that runs from community and family work through years in residential care for older people to a long counselling practice. Social work trained me to see people inside their whole lives, not as a set of symptoms — and I regard that as a strength of the route, not a compromise on it. If you want to know exactly whom you would be sitting with, my about page tells the fuller story.