Counselling or psychotherapy: What's the difference?
As you trawl through the directories and web pages, you may find yourself asking: What is the difference between counselling and psychotherapy? And, which is best for me?
The British Association for Counselling and Psychotherapy explains that “counselling and psychotherapy are umbrella terms that cover a range of talking therapies”. Because it is possible to offer counselling or psychotherapy and use the same therapeutic approaches, underpinned by the same theoretical models, these terms are often used interchangeably or "therapy/therapist” is used to represent both.
The purpose of this article is to highlight the similarities and some general differences between counselling and psychotherapy.
A focus on creating a non-judgemental, supportive and confidential space within which to explore personal difficulties.
The quality of the relationship between therapist and client is important for effective therapy.
The therapist is trained to listen and respond in a way that can help you to:
explore and process your feelings, thoughts and behaviours
better understand yourself, others, and your relationships with others
view situations from different perspectives
become aware of choices and make decisions
access your inner resources to cultivate self-support
find more effective ways to live a satisfying life
Neither counselling nor psychotherapy involve giving advice or opinions.
Both can be brief, medium term or long term.
Self-awareness (often facilitated by personal therapy) is an important part of the therapist’s training and ongoing development.
This is difficult because the term counselling is commonly used to refer to a range of psychotherapeutic practices and in this context is virtually indistinguishable from psychotherapy. For example, I am an integrative counsellor trained in Gestalt Therapy and Transactional Analysis among other psychotherapeutic approaches. However, if we consider some common settings and contexts for counselling services (e.g. educational settings, employee assistance programmes, bereavement services, relationship counselling) where the counselling provided is often short-term and focused on the present, we have the basis for a contrast with psychotherapy:
Counselling is more likely to provide support in dealing with present day experiences. This may involve empathic, emotional support in dealing with a traumatic event or a more active exploration of the thoughts and behaviours that are causing your life to be as it is. By contrast, psychotherapy, in addition to this attention to the present, strives to foster a deeper understanding of your psyche by exploring your early life experiences and how these may have influenced your emotional, cognitive and behavioural development. This approach can help you to develop a much better understanding of yourself as a person.
Psychotherapy is also more likely to help you uncover unconscious influences. For example, you may struggle to communicate with certain people in your current life (e.g. bosses) because they represent, unconsciously, a person from your past (e.g. an angry school teacher).
The issues that counselling most often deals with are the things you might currently be feeling stressed by including difficulties at home or work, a relationship break-up, job loss, health issue or bereavement. By comparison, psychotherapy doesn’t just focus on present issues but also on past issues including childhood abuse and neglect, other difficult or abusive relationships and other past traumatic experiences e.g. accidents, bereavements.
Choosing a therapist:
Perhaps the ultimate question, rather than getting hung up on the differences between counselling and psychotherapy, is what sort of therapy best suits your needs?
Questions you might ask yourself include:
Do I want support to help me cope with current difficulties or do I also want to explore the links between my past and who/how I am today?
Do I prefer a pragmatic approach (e.g. understanding and challenging current problematic thoughts and behaviours) or a more philosophical approach (e.g. why do I think and behave in this way? have I felt like this before?, why does this pattern keep repeating in my life?, how can I find meaning and purpose in my life?).
As an integrative therapist I am able to draw from several approaches in counselling and psychotherapy so that we can find the kind of therapy that feels most helpful to you.
Arguably most important, however, is your relationship with your therapist. That’s why many of us offer free introductory sessions so that you can get a feel for not only our therapeutic approaches but our way of relating. Do you prefer a therapist who is very gentle or a bit firm? Do you prefer to set the agenda or do you prefer a more directive approach? What is your preferred balance between being supported and challenged? Do you prefer someone with a sense of humour or a therapist who is more reserved?
I hope this helps you to find the therapy and therapist that works best for you.