I am sometimes asked how counselling and therapy differ from one another.  It’s a confusing thing; they’re similar and the terms are often used interchangeably, even by me, but there are some subtle differences too.

Who

If you do a Google search on therapy in Vancouver, or any other city for that mater, you’ll come up with a range of results including psychotherapists, chiropractors, physiotherapists, occupational therapists, naturopaths, massage therapists and other healing practitioners.  As if finding a counsellor or therapist in Vancouver wasn’t hard enough already!

The search for counsellors is more targeted; there seems to be an understanding that counselor is referring to a mental health-related practitioner.

What

Both counselling and therapy are unregulated terms; anyone can say that they practice counselling or therapy with no legal ramifications.  It’s buyer beware!  I cover this topic and a host of other issues pertaining to finding a mental health professional who is right for you, in my article Finding a Therapist. I also developed a checklist to help this process along.

The terminology can sometimes be a stumbling block too.  The term therapy is short for psychotherapy and just spelling the word counselling can trip us up. If you’re Canadian, from the UK, Australia, New Zealand or other Commonwealth countries you spell it “counselling.” Americans spell it “counseling,” with one L.  And some of us struggle every time we want to write the word, making guesses like “counsiling,” “counceling,” “counciling”, “councelling” and the like.

Similarities

What the two share in common is that both involve a conversation between client(s) and a therapist/counsellor that has the the aim of helping people make changes within themselves and in their lives.

This process is not random; the therapist or counsellor, through questions, reflection and feedback acts as a facilitator to assist clients to help them find these answers within themselves. Any mental health practitioner who claims to have “all the answers” or convinces you that you can not survive without their expertise should be subject to your scrutiny.  Therapy and counselling is a mutually influential process; the therapist affects the client and the client the therapist, and together a therapeutic path is formed and traversed.

Differences

When I was trained in counselling and psychotherapy, I was taught that psychotherapy could be understood as “a journey for understanding the self”, while counselling related to assisting clients in resolving problems in the here and now and mobilizing clients’ strengths to assist in this process.

The Psychotherapy and Counselling Federation of Australia puts it this way:

Although Counselling and Psychotherapy overlap considerably, there are also recognised differences. While the work of Counsellors and Psychotherapists with clients may be of considerable depth, the focus of Counselling is more likely to be on specific problems, changes in life adjustments and fostering clients’ wellbeing. Psychotherapy is more concerned with the restructuring of the personality or self and the development of insight. 

Decision Time

Sometimes it’s tempting to make a judgement between what is “better”: counselling or psychotherapy.  They’re similar and different at the same time.  Counselling may be more appropriate at one stage of your life and psychotherapy at another; sometimes a blend of both works well and for others, it’s one or the other.

The choice between counselling and psychotherapy is not necessarily an overt conversation between client and therapist.  Most of the time the therapist makes a clinical decision about what general approach might work best but there can be a “clash” when there’s a mismatch in the way the client and therapist see the situation.  For example, a client might say, “I came in to talk about my financial problems and all the therapist wanted to do is discuss my growing up!

If you feel that your therapist is using an approach that you feel is not right for you, be it a counselling vs. psychotherapy difference, or even in the choice of a specific therapy method, bring it up!  All therapists should be receptive to open dialogue with their clients.  If they’re not, find someone else.

Clients sometimes continue with therapy approaches that are not working for them out of fear of offending the therapist, or because they’re wanting the counsellor’s approval, or maybe they’re struggling with the assertiveness skills necessary to raise the issue.  More commonly, clients drop out of treatment rather than have this conversation.  This can be unfortunate because if you have a responsive and willing therapist on board, the course of the counselling or therapy can be greatly enriched with even a little feedback from the client.

Why

I am a huge (admittedly biased) advocate about the benefits of counselling and psychotherapy to help us get through life’s rough spots or to help us, on a deeper level, when it comes to unresolved losses, trauma or issues from long ago that are affecting the way we see the world today.

If the therapist you’re interested in hiring has a free initial consult or phone call, don’t hesitate to take advantage of this, asking about his or her approach and sharing your needs too.  It can be a journey well worth taking!