What is the difference between counselling and psychotherapy?

Which do I need?

Which one would be best for me?

These are questions people often ask when they are looking to access therapy. 

In reality, there is a cross over between the two and many therapists, particularly integrative or pluralistic therapists, will draw on theories and skills from a range of models to tailor an approach which is likely to be most helpful for the person in front of them (the key consideration here being, ‘what does this person want to get out of therapy?’).

To keep things simple though, here are some of the differences as most therapists would see them.

Counselling tends to focus on ‘here and now’, ‘transient’ issues – these may be work-related stress, life stress, anxiety or depression. A counsellor will work with the person’s strengths and resources and does not tend to work on the deeper ways in which personality has been shaped or strategies for living have been developed. The client is seen as the expert on their experience and the counsellor facilitates, encourages, helps the person to explore and may offer suggestions or education on, for example, the origins and workings of anxiety.

Psychotherapy, on the other hand, tends to focus on long-standing and deep-rooted issues and patterns of relating and behaving. For example – recurring experiences of depression or anxiety, or ways of relating that appear problematic for the person and perhaps, for others.

The starting point is that the dynamics of these issues are shaped by formative childhood experiences and relationships which may sit some way beyond the person’s conscious awareness (and control). The psychotherapist uses their skills and expertise therefore, to create opportunities for the person to connect with these deep experiences and to ‘rework’ them or develop new, better ways of relating. Counselling often tends to be shorter term – with useful change and better strategies for living being achievable within a relatively small number of sessions whilst Psychotherapy tends to be longer term.

Both offer the client powerful opportunities for developing better, healthier and more balanced and hopeful ways of living.In practice, there is often some overlap and counsellors and psychotherapists are equally skilled in what they do. In some countries, ‘Psychotherapist’ is a protected title, for which specialist training, in a particular model, is required. But this is not the case in the UK.

However, all therapists are bound by the ethical principle that they must practise within their levels of competence and expertise and so a therapist will say whether what they offer is the right ‘fit’ for you or whether a different type of expertise is required. Having that conversation upfront with a therapist is therefore really important, so that they can understand what you are wanting to work on in therapy and what you are hoping to achieve. 

That way, you can be sure that you have found the right therapist for you, whatever model they work to.