What is the Difference Between Psychotherapy and Counselling?

by Andrea M. Darcy

A counsellor or a psychotherapist – which one do you need? It’s one of the most popular questions asked when people decide to seek therapy.

*Note that this article pertains to the definitions of counselling and psychotherapy in the United Kingdom. If you are reading this article from outside of the UK refer to your country’s version of these two qualifications.

Counselling or psychotherapy?

The truth is that it’s rather a grey area when it comes to counselling and psychotherapy in the UK. Whereas in some countries like the United States there is a definite difference between psychotherapy and counselling? In Britain there is a definite overlap in both training and practice.

The professional accrediting bodies for therapists in the UK show how closely related these professions are. One is even called the British Association for Counsellors and Psychotherapists (BACP). The other professional body, the UK Council for Psychotherapy (UKCP), is welcoming of “psychotherapeutic counsellors” as members.

Therapists themselves can have varying ideas on what the difference is, and there are therapists who are qualified as and see themselves as both. Some therapists with a psychotherapy degree might even choose to call themselves counsellors as they feel it’s a less intimidating term.

What is counselling?

Counselling is a term that can be used to describe any sort of talking therapy. And what is talk therapy? Sharing what is troubling you in a safe, supportive environment to a person who is trained to listen and respond in a way that helps you to understand yourself and others better. Talking therapies help you find more effective ways to live a satisfying life.

All forms of talk therapy are a sort of counselling. But the term is most often used to describe the talk therapies which focus on your behaviour patterns. These are the choices and actions you are presently taking that are causing your life to be as it is.

Counselling might reference your past. But in general counselling’s focus is on helping you with what you are experiencing right now.

Counselling is often what is called ‘time-limited’ or ‘short-term’. In other words, you decide with your therapist during the first meeting how many sessions you will work together, which can be anywhere from 12 to 24 weeks or more. Because it’s shorter term, counselling can be quite structured, with an agenda laid out in advance.

What issues does counselling deal with?

The issues that counselling most often deals with are the things a client is currently feeling stressed by, whether that is the challenges they are facing on a daily basis at home or work or its a traumatic circumstance such as a breakup, divorce, or bereavement. Counselling can also help with things like confidence issues and addictions.

Counselling can be done not just as an individual but also as a couple, family, or group.

The different kinds of counselling in the UK

The forms of talk therapy that are usually referred to as ‘counselling’ in the UK include:

• Cognitive behavioural therapy (CBT)
• Person-centred therapy (also called humanistic therapy)
• Couples counselling
• Integrative counselling (a blend of various approaches)

What is psychotherapy?

Like counselling, psychotherapy describes different talking therapies where you share what is troubling you and are listened to and supported in finding ways forward. Psychotherapy, too, looks at your behavioural patterns that are causing you distress in your daily life.

But psychotherapy also works to help you have a deep understanding of your emotions by looking at your past. It questions how what you experienced as a child and young adult affected you in ways that might still be causing you issues now.

Psychotherapy aims to find the very roots and beginnings of your issues and challenges, not just how to manage them now.

Some sorts of psychotherapy also dive very deeply into exploration of self, looking at questions of identity and beliefs.

While counselling might have you asking, what can I do and change to feel better, psychotherapy might also find you asking, who am I? How did I become this person? And who do I really want to be, deep down?

Psychotherapy tends to be long-term, which can mean anything from six months to several years.

That said, there are some newer offshoots in psychotherapy which are shorter versions of longer psychotherapy models. The short-term forms of psychotherapy can be quite structured, like certain forms of counselling. Long-term forms of psychotherapy tend to work with what comes up each session without any imposed format or overall plan for the direction of your therapy.

The issues that psychotherapy deals with

The issues that psychotherapy deals with runs a very wide gamut. Like counselling, it can help with present issues like stress, relationship issues, bereavement, sexual problems, and addictions. It also deals with mental health challenges like depression, bipolar disorder, anxiety disorders and PTSD, personality disorders like OCD and avoidant personality disorder. And psychotherapy doesn’t just focus on present issues but also on past issues, such as childhood traumas like abuse and neglect.

Psychotherapy can also be done in a couple, as a family, or as a group.

Different types of psychotherapy

The forms of talk therapy that are usually referred to as ‘psychotherapy’ in the UK include:

• Psychodynamic psychotherapy
• Existential psychotherapy
• Psychoanalytic psychotherapy
• Jungian psychoanalysis
• Dialectical behaviour therapy
• Acceptance and commitment therapy
• Integrative psychotherapy (a blend of approaches)

Shorter forms of psychotherapy include:

• Cognitive analytical therapy (an offshoot of cognitive and psychoanalytic theory)
• Dynamic interpersonal therapy (an offshoot of psychodynamic and psychoanalytic theory)

Psychotherapy and counselling – the differences

Both psychotherapy and counselling:

• explore feelings, beliefs, and thoughts
• focus on creating a safe, supportive environment
• help you understand yourself better
• support you to understand others better
• help you make better choices and move forward in life
• involve working with a therapist with at least three years of training.

But counselling is more likely to:

• be action and behaviour focused
• and be short-term
• focus on your present issues over past issues.

And psychotherapy is more likely to:

• go on longer than a round of counselling sessions
• be more in-depth than counselling
• explore the past as well as the present
• look to childhood root issues instead of just behavioural patterns
• see your therapist has at least four years of training
• deal with deep mental health problems and disorders that have developed over a long period of time.

Psychotherapy and counselling – the conclusion

The above proposed similarities and differences aside, it’s still a murky world when it comes to comparing psychotherapy with counselling. A counsellor might work very deeply in a way that seems psychotherapeutic. A psychotherapist might offer counselling as part of a bigger treatment plan.

The only definite, watertight answer for what is the exact difference between a psychotherapist and a counsellor? Is that it depends on what training program and theoretical approach your therapist has chosen for themselves. Was their training program called counselling, or psychotherapy?

So do I need a counsellor, or a psychotherapist?

Although psychotherapy training is a year or two longer than counselling therapy in the UK, more years of training do not necessarily a better therapist make. Plus, most counsellors and psychotherapists take additional training on top of their original certification. They are also required in the UK to invest in a certain amount of hours of Continued Professional Development (CPD) each year.

The therapist that is right for you will be the one that suits your personality, needs, and issues.

The better question to ask?

So perhaps the question is less, do I need a counsellor or psychotherapist, and more, what sort of therapy and therapist works for me?

• Do I want a short term therapy that mostly focuses on my thoughts and actions (CBT)?
• A short term therapy that looks mostly at my relationships (dynamic interpersonal therapy or cognitive analytical therapy)?
• Therapy where I decide the agenda (Person-centred)?
• Or therapy that leads me to deeply explore all that I am (Existential psychotherapy)?
• Do I want a male or female therapist, someone who is very gentle or a bit firm, someone with a sense of humour or someone quiet and reserved?

Have you already tried psychotherapy or counselling?

What sort of therapy you need is also affected by whether you’ve already done other forms of therapy. If you have done years of psychotherapy in the past and have a strong understanding of yourself, you might just need a round of action-focussed counselling. Whereas if you have never tried therapy before and have troubles resolving problems, a more open-ended therapy that helps you understand yourself deeply and build self confidence might be life changing.

Don’t forget that you don’t marry your therapist! If you try a counsellor or psychotherapist and they aren’t right for you, you have every right to be honest with them and then try someone else.

Time to get the support you need? Book an appointment now with our renowned team at Harley Therapy’s London clinics. If you are based outside of London or would like online counselling, you can visit our sister site harleytherapy.com to find and book a registered, professional therapist in minutes. 

Something you’d like to say about the difference between psychotherapy and counselling? Comment below.

Photos by Shot By Susan, Department of Foreign Affairs Australia, Andes Survivor, and Torbak Hopper

Andrea M. Darcy is the editor and lead writer of this site. A popular mental health writer, you can also keep up with her on Medium.