Counselling or Psychotherapy?

Tuesday July 27, 2021

I am well placed to answer this question. I have completed training to qualify as a counsellor. I am also roughly halfway through my training to become a psychotherapist. I have also been a client of both so will try to answer this question with what is useful for a client in mind.  One caveat, this piece is my opinion. I am not here to denigrate one modality or glorify another. 

Similarities

Counselling and psychotherapy share some important similarities. Both modalities:

  • Aim to help people who are struggling get through difficulties in their lives. 
  • Have meetings on a regular basis, typically weekly. 
  • Work to build meaningful relationships with their clients. This allows clients to feel safe enough to share what troubles them. 

When Counselling may be helpful.

I know that counselling can be very effective in the right circumstances. I have worked with clients as a counsellor and done significant work within a short time frame. I have seen huge changes in people in less than 3 months.

Counselling is particularly effective where the client has a level of self-awareness. These clients have a level of understanding about why they are suffering.

A good example of this would be bereavement counselling. Someone who is grieving can already understand the cause of their pain. Other examples include depression following the loss of a relationship or workplace stress.

When Psychotherapy may be helpful.

I believe counselling is less effective for certain client presentations. For example, people with long term mental health/illness problems or trauma. Issues where a person cannot immediately establish a link with what may have caused them. This is where psychotherapy can have much more of an impact. 

There are some quite fundamental differences between the two.

Counselling is…

  • Often short term (12-16 sessions)
  • Non directive (meaning the counsellor won’t lead you in certain directions)
  • The BACP accredits Counsellors with a Level 4 Diploma

Psychotherapy is…

  • Usually longer term (Clients may be in therapy for years)
  • Directive (meaning the therapist will ask you specific ‘leading’ questions)
  • The UKCP accredits therapists with a Masters Degree or similar.

Another big difference is that psychotherapists formulate.

What is formulation?

Formulation is constructing a picture of what is going on in a client’s life. How they feel and how they have come to be where they are? Their history and many other elements. From this, the therapist can come up with a plan of what may be beneficial to the client going forwards in the work. 

In my chosen field of psychotherapy, I would do this by employing a range of theories. One of these could be ‘drivers’. Drivers are powerful behaviour patterns that we learn in childhood. They become our default behaviour when we are under stress.

Understanding a client’s driver behaviour can help us understand repetitive life patterns. From this, we would figure out a direction for the work in therapy to take. 

Working with parts of self.

I heard this phrase in training and it stuck with me.  It helps me to understand the difference between the two.

Counsellors help you identify the resources that lie within. This helps you to find your own answers to the questions that may have brought you to therapy. But what happens when these answers are unavailable? 

Have you ever had an argument with yourself in your own head? Hearing two conflicting voices that both have compelling viewpoints. Voices that collide in a stress-inducing lack of resolution? Psychotherapy can help you make sense of these conflicting parts of self. 

This is the realm of psychotherapy. Helping clients identify deep long term issues and employing active strategies for change.

Psychotherapists are much more likely to work with your past experiences. This can help you understand the person you are today. The aim is to understand why these issues are there and identify options for change in the present. 

Both counselling and psychotherapy can be life-changing. Ultimately it is up to you, the client, to decide which you think could be more helpful. At UKCN we offer both counselling and psychotherapy. If you would like to find out more or to make a referral contact us. 

Jamie Jeffreys

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