What’s the difference between psychotherapy and counselling?

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Psychotherapy and counselling have a lot in common and usually mean the same thing. Both are used to describe professionals who use talk-based approaches to help someone recover from a mental illness or mental health problem. Many different professionals may provide counselling or psychotherapy, including registered psychologists, registered clinical counsellors, psychiatrists, other therapists and counsellors, family doctors, psychiatric nurses, and faith leaders.

It’s useful to talk to someone about any problem—a lot of people find that simply talking with friends or family can help them feel better. A professional therapist or counsellor can offer more: they have training, experience, and emotional distance (since they don’t know you). They use different theories to listen to you, support you, and approach different problems or patterns. For example, a psychotherapy called cognitive-behavioural therapy is based on the theory that learning skills to change your thinking and actions can positively impact your emotions, well-being, and future thoughts and behaviours. A therapist could help you learn and practice these skills.

There are many psychotherapies with good evidence of being effective for different problems or illnesses. A few examples include cognitive-behavioural therapy, interpersonal therapy, dialectical behaviour therapy, solutions-focused brief psychotherapy, narrative therapy, and emotion-focused therapy.

In general, some aspects of therapy and counselling are the same, no matter which approach you choose: the expectations you bring to your counselling sessions, the match between your understanding of the problems and your therapist’s understanding of the problem, and the trust and rapport that you have with your therapist. In fact, one research review found that 50% of the improvement seen in clients who just received active listening and support from a counsellor (called non-directive supportive therapy) was due simply to the relationship between client and therapist.1 Psychotherapy can and does work, but the professional you choose, and their match with your values, is also very important.

When you’re looking for a professional, it’s always a good idea to ask if they are a member of a professional organization (like those listed in the next section).

Where can I learn more?
Footnotes:
  1. Cuijpers, P., Driessen, E, Hollon, S.D. et al. (2012.) The efficacy of non-directive supportive therapy for adult depression: a meta-analysis. Clinical Psychology Review, 32(4), 280-291.
 
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