Psychotherapy and counselling

The terms counselling and psychotherapy are often used interchangeably to cover a wide range of talking therapies with considerable overlap. In certain situations, counselling is offered as part of the process of psychotherapy; whereas a counsellor may take a psychodynamic approach to working with clients.

The key difference between counselling and psychotherapy lies in the practitioner's training and experience, and the depth to which the work is able to go. Generally, counselling refers to a briefer treatment focused on addressing a specific behavioural issue, while psychotherapy explores more of the emotional and psychological roots of long-held patterns. Although it is a crude generalisation, we might say that a counsellor will focus on 'doing' – practising techniques and methods of intervention to alleviate symptoms – whereas a therapist's primary concern is with the client's 'being'. 

A practitioner's capacity to go to depth is governed in large part by the extent to which they have worked through key issues in their own personal therapy. A psychotherapist is their own primary 'instrument', and so needs to address their own wounding to ensure they don't avoid what is evoked by their clients' suffering. They help the client rediscover their 'aliveness' and embodiment by meeting the client in the present moment—even in the exploration of past and future events—and offer healing through the spontaneous engagement of a co-created relationship.  

Key differences between counselling and psychotherapy

Counselling:

• Symptom orientated: good treatment for anyone wanting to look at an issue or address a specific problem
• Helps people identify problems and crises, encouraging them to take positive steps to resolve these issues
• A shorter to middle-term process that encourages changes of behaviour through exercises and the adoption of specific technques
• Works with conscious processes and thoughts
• More likely to involve first-order change

Psychotherapy:

• Insight orientated: helps people with enduring patterns and psychological issues that are discernible over time
• Invaluable for looking at challenges in relationshipr and comprehending feelings, thoughts and actions more clearly 
• A longer or middle-term process of treatment that is more about tool-making than tool-using.
• Explores the background to a client's difficulties and helps identifies new approaches to difficult emotional issues
• Works with unconscious, preconscious and unconscious processes and perceptions
• More concerned with second-order change

What is counselling?

Generally speaking, a counsellor will offer a targeted service providing a clear structure to the therapeutic experience. Often the work centres on a specific issue and the steps needed to address or remedy that issue, so for instance, treatment for addiction will be offered in progressive stages over a set period of time. 

Counselling can be directive, but rather than offering advice, a good counsellor will often guide the client to discover their own answers and support them through the actions they choose to take. In counselling, problems are largely discussed in the present-tense with less attention given to the role of past experiences and the unconscious. A counsellor will generally hold a recognised counselling qualification and be registered with a professional body such as the BACP and abide by their code of ethics. While most counselling trainings expect trainee counsellors to attend a set number of personal therapy sessions, some do not require a practitioner to do any personal work. 

What is psychotherapy?

Psychotherapy brings deeper awareness to the emotional background and psychological foundation of the issues in a person's life, rather than working with the specific behaviours they result in. Psychotherapists seek to resolve past experiences as part of laying the foundation for a satisfying future, hence the work may involve the client examining their past and considering how learned patterns continue to impact the present and future. 

A psychotherapist will often glean information from a variety of unconscious sources – such as the body, 'inner child', dreams and the imagination – and reflect on the therapeutic relationship itself, in order to bring long-standing patterns to light. A good pschotherapist works from an on-going enquiry into his or her own state of being, and is hence more able to tolerate traumatic memories or difficult emotions. Consequently, most psychotherapy trainings insist students attend personal therapy for at least the duration of their studies. A psychotherapist will often hold a recognised psychotherapy qualification, be registered with and/or accredited by a professional body such as the UKCP or BACP, and abide by their respective code of ethics. 

What is the difference between the BACP and UKCP?

The British Association for Counselling and Psychotherapy (BACP) registers and accredits counsellors, psychotherapists and their colleges while the United Kingdom Council for Psychotherapy (UKCP) registers and accredits psychotherapists, therapeutic counsellors and psychotherapy trainings. Broadly speaking, the BACP requires less formal training in terms of study time (2 years) whereas UKCP courses can take up to 4 years and require much more client contact hours and personal therapy hours.

Training and client issues

My clinical training includes a foundation year, a three and a half year counselling traning (equivalent to undergraduate degree level) plus a four and half year MA in psychotherapy (nine years in total). I am a registered and accredited UKCP psychotherapist who works with a variety of clients across a wide array of issues and concerns, including: 

• Addiction and substance abuse
• Anxiety and stress management
• Bullying and its consequences
• Change and transition
• Creative expression
• Depression
• Dissociation
• Eating disorders
• Gender issues
• Identity
• Loss and grief 
• Mindfulness and consciousness-raising
• Relationship counselling
• Sexuality and intimacy
• Step and blended families
• Trauma and abuse

I also pay attention to our human impact on the more-than-human world and 'climate trauma', the psychological distress caused by the realisation of our part in this ecological crisis.