What is the difference between counselling and psychotherapy?

In the UK, the terms “psychotherapeutic counsellor”, “counsellor”, and “psychotherapist” are often used interchangeably, and there is no legal distinction between the three. However, that does not mean that there aren’t valuable differences for you to consider.

When seeking therapy, it can feel a bit bewildering looking at all the different types of therapies, and the different kinds of clinicians and practitioners that are available. In this blog, I’m going to talk about the difference between a counsellor, a psychotherapist, and also a role that sits in the middle called a psychotherapeutic counsellor.

What is counselling?

Counselling is generally recommended for specific issues and situations, such as addiction or grief. It is generally used to denote a relatively brief treatment that is focused primarily on behaviour, particular symptom or problematic situation and offers suggestions and advice for dealing with it.

The history of counselling, however, can be traced back to ancient civilisations such as Egypt, Greece, and Rome, where individuals sought guidance and advice from religious figures, philosophers, and healers. Counselling was often viewed as a form of spiritual or moral guidance and was primarily focused on helping individuals find meaning and purpose in their lives. 

Today, counselling has a key role in helping people overcome mental health issues.

What is psychotherapy?

Psychotherapy can be short-term intensive or a longer-term in-depth treatment that focuses more on gaining insight into chronic physical and emotional problems. In other words, psychotherapy addresses the root cause and core issues of current problems so that lasting change and personal growth may occur.

The history of psychotherapy can be traced back to the late 19th and early 20th centuries with the emergence of psychoanalysis, developed by Sigmund Freud. Psychoanalysis was focused on exploring the unconscious mind and understanding the origins of psychological problems. 

This has remained much the same today as psychotherapy enables a deep exploration of ourselves and our past issues that might be contributing to present-day problems. 

Other forms of psychotherapy emerged in the mid-20th century, such as behaviour therapy, cognitive therapy, and humanistic therapy. All of those types of therapy have different philosophical underpinnings (i.e. a theory or attitude that acts as a guiding principle for behaviour) which is what makes each of them a different type of psychotherapy.

What is psychotherapeutic counselling?

Psychotherapeutic counselling isn’t as simple to define or differentiate as psychotherapy or counselling. Though there is no particular qualification with that title, Psychotherapeutic counselling is a form of counselling that essentially bridges the gap between counselling and psychotherapy. As such, it can help people to address the issues that they are struggling with, and also begin to explore why these issues have come about and figure out ways of preventing these issues from reoccurring.

With the appropriate level of training and experience, a counsellor may function in a psychotherapeutic manner, which is where the role of “psychotherapeutic counsellor” resides. This role is held by a clinician who holds a qualification between that of a counsellor and a psychotherapist. 

Therefore, while the same therapist may provide both counselling and psychotherapy, psychotherapy generally requires more skill and specialist training than counselling. 

Psychotherapy is conducted by professionals trained to practise psychotherapy such as a psychotherapist, psychiatrist or psychologist. While a psychotherapist is also qualified to provide counselling in specific situations, a counsellor may or may not possess the necessary training and skills to provide psychotherapy. 

Keep reading to find out how some of those considerations differ between these roles.

Training and Qualifications for psychotherapists, counsellors and psychotherapeutic counsellors

Counselling training can vary in length and intensity. Some counsellors have completed an undergraduate degree that awards them a mid-level qualification of a level 5, while others have completed courses ranging down to the lower levels around 3, which of course impacts the complexity of issues that they are able to work with.  Importantly, it is also necessary to be aware that it is possible to be a counsellor without any formal qualifications as it is not a legal requirement and the title of “counsellor” is not legally protected.

Psychotherapeutic counsellors typically have more training than a counsellor, but less than a psychotherapist. This tends to be around a level 6 such as a post-graduate certificate.

Psychotherapists typically have more extensive and formal training than counsellors. Psychotherapy training usually involves a graduate degree in psychology or a related field, followed by a master’s qualification in psychotherapy, which awards them a higher level of around a level 7 qualification. Those with doctoral degrees or with additional training and experience may reach up to level 10 as consultants.

Psychotherapists tend to work with clients who have more complex, deep and long-standing issues, while counsellors often work with clients who are experiencing more immediate problems such as grief or addiction. 

Psychotherapeutic counsellors may have some additional training to work with clients who have more long-standing issues but may not work with the complexity that a psychotherapist does.

What does your therapist believe in? 

Psychotherapists may be trained in a range of theoretical orientations that aim to work with long-standing, deep and complex issues. They often have a specific way of working that is underpinned by their personal philosophy and aims to meet their clients’ needs in a comprehensive way such as the therapeutic relationship, looking back at childhood needs, or through somatic (body) work for example. 

Psychotherapists are also more likely to have engaged in personal therapy themselves as a compulsory part of their training, which greatly informs how they work with their clients. 

Counsellors, however, may focus more on specific approaches person-centred or solution-focused. These approaches can be more manualised, with a focus more so on the therapy goals rather than the therapeutic relationship. Psychotherapeutic counsellors typically have a theoretical orientation that includes elements of both counselling and psychotherapy, that allows for the therapy to begin to build on a therapeutic relationship between therapist and client, whilst focusing on the specific issue at hand.

What are the regulatory bodies for psychotherapists, counsellors and psychotherapeutic counsellors?

While there is no legal distinction between psychotherapeutic counsellors, counsellors, and psychotherapists in the UK, there are professional bodies that regulate and accredit practitioners. 

There has been a debate in the therapy profession about how protected the titles and roles are, and how we can make sure that clinicians/practitioners are working to a framework that respects the varying levels of skills and qualifications. And new regulations appear to be coming into place that may make things easier to understand. 

Currently, the title of “psychotherapist” tends to be viewed as more protected as the qualifications needed typically will be accredited by a regulating body. 

Counsellors and psychotherapeutic counsellors can also be members of an association or be accredited by these regulating bodies providing their training and experience is of a standard that is recognised.

Be mindful that not all counsellors and psychotherapists will be a member of a professional body

Whilst counsellors and psychotherapists are under no legal obligation to become a member of a professional body, having a membership indicates that they have met certain requirements set by their professional body and must abide by a formal code of ethics and complaints procedure. 

Being registered/accredited with a professional body means an individual must have achieved a substantial level of training and experience approved by their member organisation. 

Counsellors and psychotherapists who are registered/accredited with their professional body will often advertise their membership numbers, so be sure to check this on the registers found on the websites of the professional bodies.

How do I choose between a psychotherapist, a counsellor or a psychotherapeutic counsellor?

When considering which kind of clinician/ practitioner you’d like to work with to support you with your mental well-being, it’s important to know:

  • If you would like to work on a particular issue such as grief or addiction, a counsellor might be enough for you
  • If you would like to gain insight into chronic physical and emotional problems addressing the root cause and core issues of current problems, you are better off looking for a psychotherapist or a psychotherapeutic counsellor
  • The professional’s level of training/qualifications 
  • Their experience working with the issues you would like support with 
  • Which registering or accrediting body they are with (if they are with one) – Notable regulating bodies for counselling and psychotherapy are the British Association for Counselling and Psychotherapy (BACP) and the United Kingdom Council for Psychotherapy (UKCP).
  • Costs
  • How they work in terms of their philosophical approach to therapy.

There isn’t a straightforward answer to this as it’s really a matter of personal preference of what you would like to focus on which is the best way to work for you. The best way to start is to first identify what issue you would like some help with. This can be as simple as identifying a bereavement, an unhelpful habit that impacts your life, or even naming a feeling that you frequently experience such as anger, loneliness or lack of motivation.

Then you can ask yourself the following: 

  • is this issue or concern a standalone situation that would benefit from a safe and non-judgmental place to air my thoughts before reaching a solution? 
  • Or is it more of a long-standing issue that keeps recurring throughout my life, perhaps in relationships, your workplace, in group settings, or in how you feel about myself?

Finding the answer to these questions can give you a good indication of which route to go down. 

If you feel your answer is “yes” to the first question, it may be that your issue can be aptly suited to short-term and solution-focused therapies that are available through counselling. 

If you feel your answer is “yes” to the second question, it is more likely that in-depth therapy from a psychotherapeutic counsellor or a psychotherapist would be more suited to your needs.

How much does counselling or psychotherapy cost?

Therapy can be quite expensive though there are free options available through the NHS or some charity organisations.

Of course, the higher the level of a professional’s qualification, training and experience, the more you can expect to pay for your therapy. 

This is also where knowledge of the clinicians mentioned would also be the right fit for you, as counsellors’ fees can range to as low as £20, and psychotherapists to over £100 per session depending on region and specialisms. 

As with anything worthwhile, therapy is often a commitment and investment in yourself and your growth. By looking at it this way, it can be helpful to see therapy as no different than going to the gym.

My personal advice to you if you were looking to start therapy, is to have a deep dive into the qualifications and memberships of the therapist you were interested in. 

I would then request an initial call where you can ask more about their training, philosophical underpinnings of therapy, their experience, and their preferred way of working. Most therapists will offer some time to discuss this for free. 

Notable regulating bodies for counselling and psychotherapy are the British Association for Counselling and Psychotherapy (BACP) and the United Kingdom Council for Psychotherapy (UKCP). But there are many more that are specific to being sufficiently trained in specific types of therapy. 

It’s worth noting that these differences are generalisations, and there is significant overlap between these professions. Ultimately, what matters most is finding a practitioner who is well-trained, experienced, and a good fit for your needs.

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What is the difference between counselling and psychotherapy?