Differences and similarities between counselling and Psychotherapy

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Introduction
This essay will critically consider the points of similarity and differences between counselling
and psychotherapy. After briefly considering what counselling and psychotherapy are, it will
firstly outline the broad arguments for the differences between the two and evaluate the validity
of these assertions. Then it will look at the points of similarity, again critically considering these
various points.
Psychotherapy can perhaps be defined as the process in which a therapist helps the client in the
process of re-organising their personality. The therapist also helps the client integrate insights
into everyday behaviour. Counselling may be seen as a process of helping clients overcome
obstacles to personal growth. According to the professional body for counselling and
psychotherapy in Scotland, COSCA: " Counselling and psychotherapy are ways of responding to
a wide range of human needs. Counselling and psychotherapy provide opportunities for those
seeking help to work towards ways of living in more satisfying and resourceful ways. " (2004:1).
Though this definition puts counselling and psychotherapy under the same umbrella it also goes
on to say that both are constantly changing fields of practice. Therefore that it is not possible to
have a definite fix on what they are.
The issue of similarity or difference is certainly one that attracts much debate. Some insist that
psychotherapy and counselling are very similar, even identical. Others think that they are very
different or at least differ fundamentally on certain points. So we have a situation that appears to
elude universal definition. Christine Webber (2005) points out one very practical source of
confusion: " Sometimes therapists advertise in both the counselling and psychotherapy sections.
And if they also have a qualification in hypnosis they often put themselves into the hypnosis
section, too. So one therapist can be listed under all three headings i. "
Also to make matters even more complicated is the problem that psychotherapy as a word may
be off putting to some people. Therefore, regardless of what they actually do in practice, a
therapist may simply call himself or herself a counsellor as it is a more neutral term. James
Chriss has noted: " If people feel that "psychotherapy" is too pretentious a word to apply to what
they do, they describe what they do as counselling, and so we have student counsellors, marriage
guidance counsellors, Samaritan counsellors, alcohol counsellors, drug counsellors " (1999).
But this problem of labelling reflects the uncertainty at the heart of the debate. If there was no
uncertainty then there would be no need for multiple labels. We do not see general practitioner
doctors also under multiple listing do we? (Such as magician' or quack' perhaps?).

Differences
Perhaps we should begin with looking at the historical differences between counselling and
psychotherapy. Psychotherapy has roots in Freudian psychodynamics, so that a medical aspect to
the training was involved in the past, which lends it an air of respectability. The training period
was also normally long, and involved working with real clients under supervision. Also of a long
period of self-analysis was required. Both in working with clients and the analysis of the
psychotherapist themselves focused mostly on in-depth consideration of past issues. Petrushka
Clarkson notes: " The psychodynamic past to psychotherapy still exerts an influence on the
debate, and consequently on perceptions ii. "
Therefore these characteristics from psychodynamics still affect the way psychotherapy is
viewed. Of course it can be said that nowadays courses of counselling also require a long period
of analysis on the part of the therapist in order to qualify and these too often involve working
with clients under supervision for a certain initial period. Never the less it is still imagined of
counselling as something that you can begin to do after a shorter period of training and less indepth self-analysis.
The training courses for counselling and psychotherapy often seem to reinforce this as
psychotherapy courses are normally at a postgraduate level, so that an individual needs to have a
degree already. And the level on counselling courses is often a little less academic than on
psychotherapy courses. This difference is sometimes reflected in counsellors receiving less pay
than the psychotherapists that they work along side in such places as hospitals. According to the
charity Counselling this all adds up to a situation where: " Counselling tends to be seen as the
poorer relation to psychotherapy iii " .
In addition the academic and professional standing of counselling has recently increased, as
Rowan Bayne, Jenny Bimrose and Ian Horton note: " There has been a massive increase in the
number of students on counsellor training courses, the numbers of courses available, and interest
in BAC Course Recognition, as well as the establishment of undergraduate and postgraduate
courses in counselling and psychotherapy, and the establishment of Chartered status for
Counselling Psychologists. " (1996).
However Bayne et al go on to mention that not everyone thinks this move is a positive
development. They cite Illich et al. (1977) regarding more professional prestige for counselling
who thought: " that such a move fosters restrictive practice, stifles initiative and is motivated
by money, status seeking and bargaining power, which in turn are out of line with the values of
counselling " (In Bayne et al, 1996). In addition greater academic requirements also mean
greater cost to the person training, and therefore people from poorer sections of society may have
less chance to become a counsellor. One of the advantages of the situation of having counselling
courses as short, cheaper and more accessible courses is that they are very inclusive. Working
mothers, part time workers, the unemployed etc can normally find some way to take some form
of counselling course. But the move towards respectability' and professionalisation is likely to
make such courses longer, more expensive and harder to get into.
The degree of training which psychotherapists and counsellors receive is another area of note.
The UKCP system is that an individual must have completed postgraduate level course in

psychotherapy that lasted at least 4 years (part time). The BCP is even more thorough. It requires
one year of personal training (5 days a week at 50 minutes each session). This is followed by
three years of theoretical and clinical seminars (three times a week), and this is done
simultaneously with up to two years of supervised psychoanalysis of two patients (again 50
minutes each, 5 times a week). Only on successful completion of this process can the person
apply for associate membership in the British Psychoanalytical Society. Full membership is not
granted until after completing the Institute's two-year post-qualification course. In addition, this
process is usually not even started until the applicant is already well qualified in a related
discipline.
Contrast this to certain courses in counselling where the training is shorter and less intensive.
The Diploma in Person Centred (Rogerian) Counselling & Psychotherapy at Warwick University
can be done after a one year introductory certificate. It is noted as being: " A higher qualification
for those wishing to enter the counselling profession iv. "
The diploma lasts for just 2 years in which the student is required to carry out only 15 hours of
personal therapy (the BCP requires more than 200 hours in just one year!). The diploma also
requires only 100 hours of supervised counselling practice (BCP is more than 500 hours). This
course is at a reputable University, and may be a very good one. However, many counselling
courses are run by smaller, private organisations, and some of these seem to put ease of
qualification before quality of work. A certain college advertises a course of only 3 to 6 months,
of home study, and claims: " This course qualifies you as a counsellor allowing you to set up in
practice v " .
This is a claim that on the face of it seems almost laughable when compared to the rigorous
process of qualification for the BCP psychoanalysts (this may explain why there are only just
over 400 of them compared to around 23,000 members of the BACP). So although the attributes
gained during training are universally seen as important, there is, according to Cosca (2004): "
no consensus about the most effective methods for fostering and assessing these attributes.
Consequently all training courses include elements that aim to develop self-awareness but the
amount and proportion of time devoted to this, as well as the format, vary. "
However, there are also plenty of psychotherapy' courses that are available as short, rather
inadequate looking efforts, not just ones for counselling. The same college offers a
Psychotherapy Diploma Course' that lasts for only 6 months home study. It claims: " This
course would greatly help those enormously who wish to set up in private practice vi "
Therefore it can not be clearly held that psychotherapy training always differs from counselling
in terms of length and depth.
Even within the world of psychotherapy there are points of disagreement. Ann Casement, the
Chair of the United Kingdom Council for Psychotherapy (UKCP) in 1997, indicated that she saw
little difference between that body and the other psychotherapy body in the UK, the British
Confederation of Psychotherapists (BCP) vii. However Joscelyn Richards, Chairman of the BCP
(1999) disagreed and insisted that there were considerable differences in terms of the level of
training and supervision acceptable in the two. In addition she noted that in her opinion: " the

UKCP saw psychotherapy as a linear extension of advice, guidance and Counselling rather than
involving a different order of complexity and intention as understood by the BCP. " Therefore
there remains considerable disagreement within the world of psychotherapy as to levels of
training needed and the connection with counselling.
However, it should be said that perhaps sometimes short-term training might well be more useful
than it seems. Hypnotherapy is a case in point. The basic skill may be learned quickly by
someone sufficiently focused and suitable. Therefore long training may be unnecessary. The
London College of clinical hypnosis (LCCH) runs a Diploma in Clinical Hypnotherapy that runs
for a year of part time (but intensive) study. They claim that: " Properly taught, the ability to
induce hypnosis is easy to acquire. However, it takes a long time to learn how to use this skill
effectively within a therapeutic framework viii. " This indicates that the element that takes time is
the ability to use the skill well to help clients. So perhaps the main aspect that such short courses
fall down is not the skill, but the lack of a long period of supervised therapy of clients.
One of the differences often cited is that psychotherapy involves working in greater depth than
counselling, that clients see their therapist more frequently and for a long period of time. By
contrast counselling takes place over a shorter period of time. Counselling cites the opinion of
trainer Petrushka Clarkson who thinks that counselling can be short term or long term but:
" Psychotherapy is about 'deconstruction, and 'reconstruction' of the clients self-concept, a
process likely to be lengthy and at a greater depth than counselling might explore ix. "
Again this image of length in psychotherapy is derived partly from the techniques of
psychodynamic therapy, so that the process can last months, even years, and take place more
than once a week. As with the training process the BCP indicates that the frequency can be very
high: " Psychoanalysts work with patients intensively (fifty-minutes a day, five days a week) and
less intensively (fifty-minutes a day, one, two, three, or four days a week) x. "
In contrast someone may go to see a counsellor for just a few sessions, perhaps even just once if
the issue is successfully addressed. This is because counselling is often carried out for more
situational' issues, such as the death of someone close, unexpected unemployment, relationship
problems etc. Where as Jo Ellen Grzyb (who advertises herself as both a counsellor and
psychotherapist) in an interview for the BBC noted: " Psychotherapy is a lot more like
archaeology - I'm looking at the causes and the roots for what's known in the jargon as
psychopathology - the behaviours that you keep repeating over and over and over again that
actually get in the way. xi "
Therefore counselling is seen to be about short-term help, and psychotherapy about longer term.
Connected to this is that the focus is on the past causes of the issues in the case of psychotherapy,
and the on the present issues in counselling. Also that psychotherapy is concerned with some
type of deeper personality change; but counselling is concerned with helping individuals develop
their full coping potential in regards to some particular issue. However, this too is not as clear cut
as it once may have been. Cosca indicates that some argue: " that the intensity and depth of
therapeutic work can be just as great in counselling as in psychotherapy. " (2004:4). In addition
some psychotherapists may offer brief therapy and some counsellors may work with the same
client for years.

The setting of the treatment is also thought to be different between counselling and
psychotherapy. A counselling session often takes place in a number of non-medical settings such
as an office or small therapy centre, or even in the therapists flat. Where as Psychotherapy is
often thought of as taking place in a more medical setting, perhaps a clinic or hospital. Again this
is not so clear cut, as counselling increases in respectability it can also be found in hospital
settings, and psychotherapy can also take place in settings like the therapist home.
Professor Paul S Morgan-Ayres makes the further point that, for him at least, counselling is more
suited to clients that are open to speaking. Psychotherapy is better for those who find it difficult
to open up, so that the therapists take more of an active role in guiding them. He notes: " As the
client becomes more able and used to talking, the process may change in to a more client centred
approach xii. " Counselling, according to Morgan-Ayers, is a process in which the therapist is
there as a tour guide' for the client, refocusing them in a process that they are otherwise quite
good at exploring themselves. Therefore: " The counsellor speaks very little and gives the client
plenty of space to offload and talk themselves into self-knowledge xiii. " . It could be said in
contradiction to this that Freudian psychoanalysis often places great emphasis on the therapist
not interrupting the client. So therefore this difference may not always be the case.
Similarities
Despite the assertions above there are many that maintain an opposite opinion. Donald Arbuckle
argues that: " counselling and psychotherapy are in all essential respects identical " (1967).
One of the most obvious things that need to be considered regarding the similarities between
counselling and psychotherapy is that the kinds of issues that draw people to use counselling and
psychotherapy are often very similar. Also that the aims of both are similar: both can be seen as
an attempt to allow the person to build up resources to live in more healthy, meaningful and
satisfying ways, and to develop self awareness. Also a high degree of respect for the autonomy of
the client is a basic principle in both counselling and Psychotherapy. With an understanding that
the clients bring with them the potential needed to successfully achieve their aims. (COSCA,
2004)
However, contrary points can be found for all of these. If, as stated, psychotherapy deals more
with deeper, long term problems and counselling with more situational and shorter term issues,
then clients do not go to these differing fields for exactly the same specific reasons, only because
of the same general motivation. Also it is perhaps only at the very general levels that the aims of
differing elements of counselling and psychotherapy are the same. Taking it a step further we can
see that different varieties have often quite different aims. Gestalt therapy for instance: " seeks to
promote a person's awareness, support creative choice and encourage responsibility in a person's
effort to realise a meaningful and fulfilling life xiv. "
This appears to be a more wide ranging and deeper aim than that of counselling reported here:
" Help the person focus on ways to manage their difficulties a little or a lot better xv. " This relates
to the point considered before that counselling is more focused on situational problems, and
therefore its aims are likely to be more limited than psychotherapy.
Psychoanalysis in particular has sometimes been criticised for concentrating to much on the
process and not enough on the aims. Molnos (1998) notes concerning goals in psychoanalysis:

" At one extreme of this continuum there are those psychoanalysts and psychotherapists who
consider goals to be an arbitrary matter and see goallessness as technically essential to analytic
work. At the other end of this spectrum those practising forms of Brief Dynamic Psycho-therapy
tend to be concerned with setting specific and explicit therapeutic aims to be attained at the end
of the therapy xvi.
One other area of similarity is that both counselling and psychotherapy involve clear contracts
between the therapist and the client as to what the aims are and the roles involved. These have
been summarised by Professor Paul S Morgan-Ayres as:
1. " An Assessment to ascertain whether the therapist can help you / have a good chance of
helping you.
2. That the therapist does not lead you to believe in some sort of magic cure and that you
realise that they are there to help you change yourself.
3. That you have explained to you what is proposed before the therapy commences so that
you are giving informed consent to the therapy.
4. That any person under 16 years has a parent's permission and signature.
5. That confidentiality is discussed and the therapist's position is made clear.
6. That the therapist is registered, insured and monitored xvii. "
Another point of similarity mentioned by COSCA is that both counselling and psychotherapy
require the therapist to have highly developed skills. Their paper on the subject mentions:
" Consequently, counsellors and psychotherapists undergo lengthy training, often lasting several
years. Their work is always supervised by another practitioner who helps them to process and
reflect on the issues of concern to their clients. " (2004: 2). However it has already been
considered that different routes involve considerably different levels of difficulty and length of
training and supervision.
Counselling notes that: " The BACP tend to see both disciplines as so similar that debate about
differences becomes rather redundant. It is undeniable that many similarities do exist between
the two xviii. "
It does appear that the argument for similarity is winning the debate. A survey in 1993 indicated
that over 50 per cent of the members of the then BAC used psychotherapeutic models of
counselling. Membership of the BAC and UKCP often overlaps, as does that between the BAC
and the British Psychological Society (BPS). Bayne et al note a growing tendency: these
bodies might not fight but might confederate through a process of rapprochement, in what
appears to be an unstoppable momentum towards the professionalisation of the disciplines "
(Bayne et al, 1996). This process can be seen already. Jo Ellen Grzyb noted that when she began
as a therapist her organisation was called the British Association' but that later the name was
extended to the British Association for Counselling and Psychotherapy'. Grzyb reflected: " So
magically suddenly we're all psychotherapists xix. "

Perhaps then, in conclusion, as the BACP they insist: " It is not possible to make a generally
accepted distinction between counselling and psychotherapy xx. " The BACP go on to say that
perhaps the differences can only really be found at the level of the individual therapists daily
practice, not at the wider level of definable principles. In practice a professional calling
themselves a psychotherapist my deal with deeper psychological problems in one setting, such as
a hospital; but may in their own private practice see clients with more situational' issues. The
work in that setting may be far more similar to that often seen as the domain of counselling. The
BACP also insist that although counsellors may work on very specific everyday issues in setting
like work or school, that in private practice they may offer: " therapeutic work which in any
other context would be called psychotherapy xxi " .
It appears that the trend, despite noticeable dissenters such as the BCP, is for recognising the
similarities between counselling and psychotherapy. This trend is reflected in the increasing
pressure towards joint bodies representing both fields of practice.
BIBLIOGRAPHY
Arbuckle, D. S. (1967). Counselling and Psychotherapy: An Overview. New York: McGraw Hill.
Bayne,R., Bimrose, J. and Horton, I. (eds) (1996). New Directions in Counselling. New York:
Routledge.
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Chriss,J. (1999) Counseling and the Therapeutic State. New York: Aldine De Gruyter
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COSCA (2004) Counselling and Psychotherapy: COSCA's Description Stirling: Cosca
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http://www.ganz.org.au/pages/whatis.html Accessed: 23/2/2005
Feltham, C. (Editor) (1999) Controversies in Psychotherapy and Counselling. Sage, London
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http://www.lcch.co.uk/prospectus.htm Accessed: 9/3/2005

Molnos, A (1998) found at Internet URL:

http://fox.klte.hu/~keresofi/psyth/guide/aims_of_analytic_psychotherapies.html Accessed:
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