Hey there you!
Ok, so this is not actually a very easy question to answer, because the lines between the two can be pretty blurry at times, and the terms are often used interchangeably. That said, there is a difference and I am going to try and describe that difference, and perhaps it might help you decide if either are of relevance to you.
Counselling
Counselling is typically short-term (e.g. just a handful of sessions), and focused on identifying and implementing potential solutions to a current issue or problem.
Whilst the idea of counselling might fill you with dreaded images of lying on the couch, telling your whole family history, counselling sessions are typically much more focused on the present, and the issues or problems that have you stuck, rather than delving too deeply into the past (except for where relevant information is required). The counsellor’s job is not to get a complete psychological and historical profile of you, but rather to assist you in developing solutions to a current roadblock.
Counsellors use a core set of skills to do this, which include:
– Being a nice person – non judgemental, respectful and empathetic
– Listening closely to what you are saying without judgement
– Asking questions where necessary and encouraging you to explore the issue/problem in more depth
– Reflecting and summarising what it is you are saying and feeling
– Clarifying the key issues or problems that you are facing
– Observing and noting your body language for additional clues about how you are feeling
– Interpreting or reframing some of your experiences in order to help you take different perspectives or understand better the meaning of the issue/problem
– Where appropriate, offering suggestions, feedback or information in relation to the problem or potential solutions
– Where appropriate (and where trust has been developed), using confrontation or challenging to shift your perspective on an issue
A useful way to think about counselling is like getting an impartial 3rd party to help you solve a difficult problem. Commonly, people visit counsellors because they are not comfortable (for whatever reason) discussing the issue with family, friends, or colleagues.
At Flinders University, we offer a counselling service for students. This session-limited service helps students identify solutions to problems that are affecting their studies, such as procrastination, personal issues, stress management or relationships with lecturers/tutors. Similarly, staff at Flinders can access a small number of counselling sessions, through the EAP program, to assist them in resolving issues that are affecting their work.
There is sometimes the misconception that counsellors and counselling just deals with simple problems, but, in fact it is common for people to bring quite complex issues initially to the attention of a counsellor: high levels of distress, breakdown in personal or professional relationships, significant changes in living circumstances, or exposure to traumatic events. Counselling differs from therapy, not so much in the complexity of the presenting problems, but in the focus on short-term solutions.
In many cases, including some challenging cases, a few sessions with a counsellor is enough to both develop and implement some solutions to the problem(s) you face. For example, a counsellor might teach an individual strategies to handle episodes of high distress
However, in some cases, your time with a counsellor might identify that the issues you are struggling with, have been around (in different forms) for a long time, or are the result of entrenched patterns of behaviour, thoughts or feelings. In this scenario, the counsellor might suggest that you need therapy.
Therapy/psychotherapy
Therapy or psychotherapy is a medium to longer-term process focused on long-standing attitudes, thoughts, behaviours and feelings that have significantly impacted on an individual’s quality of life, relationships and/or work.
In this regard, therapy is often considered ‘deeper’ than counselling as it seeks to uncover and modify the root or historical causes of your problems. Outcomes in therapy are often more dramatic, as they may represent significant shifts in your perspective, beliefs, personality or feelings.
Therapy is also commonly focused on giving you the skills you need for ongoing self-reflection and self-knowledge. Such skills can be hugely valuable post-therapy in understanding your unconscious triggers and impulses and how your mind works.
In practice, counselling and therapy can look very similar from the outside. For example, both counselling and therapy sessions are typically 50-60 minutes. Therapists also use many of the same core skills as counsellors.
Where therapy differs is that it is usually considerably longer (10+ sessions) and therapists use additional techniques and processes that have been shown (in psychological research) to help people in similar situations or with similar presentations.
Whilst it is beyond the scope of this article to cover the many types of therapy, a couple deserve mentioning.
Cognitive behavioural therapy (CBT) is a style of therapy focused on how your beliefs shape you feelings, thoughts and behaviour. CBT uses a lot of practical exercises to help uncover and challenge these beliefs. CBT is a popular and well-researched type of therapy and has been shown to be effective in a range of mental disorders such as depression, anxiety and PTSD.
Psychodynamic psychotherapy (PDP) is a style of therapy that focuses on uncovering the unconscious forces shaping an individual’s feelings, thoughts and behaviour. PDP uses the relationship and interactions between the client and therapist to help illuminate some of these forces and develop alternative responses.
The type of therapy you end up receiving is a function of a) the nature of your problems (including any formal diagnoses you receive), b) the styles of therapy that your therapist is familiar with, c) what the psychological research says is helpful for people with issues like yours, and d) where you receive support (e.g. private psychology versus community mental health).
Regardless, as a consumer of a therapy service, you have the right to ask about whether the type of therapy you are receiving has been shown in research to be useful for people with similar issues to your own. This is because entering into therapy (including both attending and paying) is a significant investment on your part.
Which is right for you?
Honestly, if you are struggling (whatever the issue), the first step is just to reach out. Decisions about counselling or type of therapy can be sorted out down the track. It’s not a decision you need to make straight away. Where should you reach out?
Talk to your GP
Talk to one of our GPs
Talk to one of our counsellors
Contact an online or telephone service like Lifeline, Beyondblue, eHeadspace, 7cups
or reach out to a trusted friend, colleague or family member
It sounds trite, but it is true – reaching out is the first and most important step.
Want to comment on this article, or ask me a question about the health and well-being services available to you as a student? Feel free to comment below, abuse me on Twitter (@Dr_Furber), contact me on Skype (search for ‘eMental Health Project Officer Gareth’), or email me (gareth.furber@flinders.edu.au)