Is counselling the same thing as psychotherapy?

Whilst some people feel strongly about these words, they are now often used interchangeably. A commonly cited distinction is that psychotherapy may go on for longer and may go deeper. They both cost about the same though and it is more important that you feel comfortable with the person than what they call themselves. Both counsellors and psychotherapists offer ‘talking therapy’ to their clients; I think the term is self-explanatory.

A couple of years ago I did a bit of informal inquiry into several different approaches to understand if the particular way of working had more success or produced greater satisfaction. I took a specific issue (the importance of goal setting in therapy) and I asked peers of mine working with different models of counselling/therapy (Gestalt therapy, Person Centred Counselling, Mindfulness Based Therapy, Transactional Analysis, Cognitive Behavioural Therapy, Psychoanalyst) about the way they work and what it feels like to be a client in this work. I included myself as a respondent: I’d experienced Transaction Analysis, Psychoanalysis and Mindfulness Based Therapy.

Whilst my respondents were indeed my peers, not necessarily current clients, they had also experienced their own modality as a client – some of them for many years so I felt satisfied that I could draw informal conclusions.   Of course, the limited size and lack of formal measurement of this ‘study’ means it has no inherent validity, but it offers a good enough starting point for a hypothesis.

What I found was that the particular modality and the title (counsellor, analyst or therapist) had little bearing on the individual’s experience, progress and satisfaction as a client. The biggest differentiator was the quality of the relationship, the safety that the practitioner offered and the trust that emerged between client and practitioner over time.

In mindfulness based psychotherapy the underpinning intent is to be deeply attuned to what is happening for both therapist and client, to work with how things are in the present moment and to offer clients deep respect, warmth and safety. There are times within my practice where a cognitive behavioural therapeutic approach slips into a session, or a nod to transaction analysis. I concluded that other modalities use my approach just as I used theirs. Moreover, although I think the mindfulness based therapeutic approach is very particular, I found that there were person centred counsellors and psychoanalysts who would describe their own process in very similar terms. In short, I found it was the practitioner themselves, not their named working model, that resulted in client satisfaction and progress.

So, how does this help you, if you are a client, looking for a counsellor or therapist? Well, it means you might wish to take some time over your decision about who you want to work with. Ask around for referrals. Take time to have a look at websites and get a bit of a feel for the practitioner. Test out two or three; many will offer a free/low cost first session for this reason. Ask how they work and explore for yourself whether you feel safe enough in their practice room. Don’t be afraid to say no if it doesn’t feel right.

All that said, it is worth knowing that whoever you are working with is a member of a certifying institution, like the UK Council for Psychotherapy (UKCP), which is my governing body, or the British Association for Counselling and Psychotherapy (BACP). This means that, at the very least, you know they have had a solid training, work within a recognised ethical framework and are appropriately insured to work with clients. After that, it is all about the relationship.