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December 14th, 2021

Therapist vs Counsellor: Which Is Right for You?

By Dr Rumina Taylor (Chief Clinical Officer)

  • Therapy
  • Anxiety
  • Depression

When you’re feeling low and need to seek help, it can be hard to know where to start. Not only are there a myriad of options in terms of organisations, both public and private, but there are also lots of different roles involved in mental health and wellbeing - many of which sound similar.

Therapists and counsellors are often confused with one another. For people suffering from depression or anxiety, it can be challenging to see which is the appropriate professional for their needs. So while you might be wondering what the difference between a counsellor and therapist is, the better question is actually: how do I choose between them?

In the UK, the British Association for Counsellors and Psychotherapists (BACP) states that “counselling and psychotherapy are umbrella terms that cover a range of talking therapies.” Counselling is a type of therapy, but it is only one approach. Psychotherapy is a wider discipline that requires different qualifications to those a counsellor holds.

While therapy and counselling may be confused, there’s a far clearer distinction between psychotherapy and counselling - which are heavily differentiated due to approach, outcome and qualifications.

Let’s take a closer look.

Are counselling and therapy the same thing?

Before we answer, let’s start with the similarities. Both practices can help you if you’re struggling with depression, anxiety or other conditions. Even BACP, the main accrediting body for mental health professionals, considers the two as part of an umbrella term. However, in HelloSelf’s view, counselling is a type of therapy but psychotherapy is distinct from counselling.

So no, the two are not the same thing. In the UK, we’d split them due to their approach, goal outcomes and seniority/professional requirements.

Counselling is a long-term commitment, a process that generally involves patient-led treatment where you’ll have a confidential chat with a professional. You’ll ‘lead’ the session because you’ll discuss the problem or problems you want to deal with, and then the counsellor can then ask questions and make suggestions. It is a therapeutic approach in that it can provide relief and alleviate many of the issues you’re currently experiencing. However, counselling is usually focused on the ‘right now’ - the challenges you currently face.

Psychotherapy is a more strategic process and is a term to encapsulate various approaches such as Cognitive Behaviour Therapy (CBT). Therapy follows a defined treatment programme, can be shorter than counselling, and it is focused on outcomes rather than inputs. Essentially, it is designed to help equip you with the tools needed to manage or overcome your mental health conditions. Unlike counselling, the sessions are therapist-led although collaborative. Therapy focuses on your experiences, habits and behaviours, identifying the triggers that now contribute to your current mental wellbeing.

Psychotherapy usually requires far more education and qualification to practice - with many professionals, either psychiatrists or psychologists. While most qualified psychotherapists can perform counselling, many counsellors do not hold the necessary qualifications for psychotherapy.

Therapist qualifications

To become a professional therapist, everyone must train for a number of years and seek qualifications from accredited bodies. A psychotherapist needs an undergraduate degree in a relevant subject and/or be qualified as a psychiatrist, psychologist, mental health nurse or social worker.

Guidelines indicate that counsellors must complete at least 400 hours of therapy training - but the route they take can vary. From BA (Hons) to MA and then PhD, the qualification level can indicate a therapist’s knowledge - but their experience is crucial, too. For example, to become accredited with the BACP, you need to show 450 hours of formal training on a BACP diploma or counselling course.

To become a psychotherapist with the UKCP, you need to have successful completion of a Masters degree level training with a mental health component and 450 hours of supervised clinical practice.

Crucially, while the more senior positions such as clinical psychologists and psychiatrists can provide counselling, counsellors and therapists cannot provide many forms of clinical psychotherapy.

One key reminder: a therapist’s qualifications are not a deciding factor. They are there to help show their seniority and education, but they do not necessarily represent the time spent delivering therapy or specialising in key problem areas such as depression, anxiety, OCD, ADHD etc. As long as your therapist holds the qualification or accreditation needed to make them capable of delivering your counselling or therapy sessions, you should choose them based on how their personality and approach meets your needs.

What are the different types of mental health professionals?

So now we’ve established that there are many types of ‘therapist’, which is the right one for you? So let’s take a quick rundown of the main titles you might see and how they can help - as well as whether they can offer psychotherapy or just counselling.

  • Psychiatrist: requires a medical degree (MBBS or MBChB) and then further training in psychiatry. Can perform psychotherapy and counselling.
  • Clinical psychologist: a legally protected term that requires doctorate level training and registration with the Health and Care professionals network. Can perform psychotherapy and counselling.
  • Counsellor: a varied term where the employer stipulates qualifications. The NHS, for example, requires a counsellor to be registered with a Professional Standards Authority accredited counselling or psychotherapy register. Therefore, they can only perform counselling unless they hold specific qualifications.
  • Mental health nurse: The main route is through a degree in Mental Health Nursing. Can sometimes deliver evidence-based therapeutic practices such as CBT with additional training , but the focus is on building a therapeutic relationship to aid in recovery.

How to decide between counselling or therapy?

Both counselling and therapy can be effective approaches. Many professionals will be able to offer a blend of both - whereas some will instead recommend their choice based on your requirements. Remember: counsellors cannot offer psychotherapy.

For depression

For those suffering from low mood or depression, counselling can provide an outlet and help deal with feelings of loneliness and despair. You’ll talk with your counsellor and discuss your current issues to help alleviate the burden.

On the other hand, therapy will likely take a more solution-orientated approach through a practice like CBT. Here you’ll be trying to determine the triggers or factors that have led to depression and work to overcome them.

For anxiety

Anxiety sufferers can benefit heavily from CBT practices. In many cases, CBT is an effective first-line treatment for anxiety sufferers. While counselling will help you explore current anxious situations and behaviours, a psychotherapy treatment will work to manage the triggers that cause anxiety.

Which is right for you?

Remember: there’s no clear ‘right’ or ‘wrong’. Not only are there a range of different approaches, but there are also different circumstances and factors that will affect how effective the treatments can be. So, counselling might not work most effectively for you right now, but it may prove useful in a year once you’ve undergone CBT.

It is worth noting that in HelloSelf’s experience, many patients who have had counselling in the past and found it to be effective will return to seek more long-lasting help. On the other hand, psychotherapy tends to have a more permanent impact due to its outcome-focused approach and its ability to equip you with coping strategies.

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