COUNSELLING AND PSYCHOTHERAPY: IS THERE ANY DIFFERENCE?

Osagu, Judith & Benjamin Omolayo

Department Of Psychology
Ekiti State University, Ado-Ekiti

ABSTRACT

Counselling and psychotherapy are two fields that are often viewed to be the same
and used interchangeably. The different definitions on both counselling and psychotherapy
are evidences to this fact. Efforts will be made in this paper to highlight the different
definitions, show the differences and similarities between the two. Examine briefly the
various types and approaches of counselling and psychotherapy and their historical
background

INTRODUCTION

So often people ask or assume counselling and psychotherapy to be the same. It is

very difficult to define counselling and psychotherapy because there is little agreement on the
definitions and also on whether there exists any difference between the two. Counselling is a
process by which a counsellor provides information and education about a situation and helps
the client to an informed choice of what is best to do in their situation. It is a helping process
that involves a one to one communication that is aimed at meeting specific needs of the
individual (FMHN, 2010). Psychotherapy on the other hand is a process focussed on helping
an individual or individuals to heal and learn constructive ways to deal with the problems or
issues with the individual’s life (Grohel, 2012). It is generally recommended when an
individual is grappling with life, relationship or work issue or a specific mental health
concern and these issues or concerns are causing the individual a great deal of pain or upset
for longer than a few days. Psychotherapy is a frequently used general term in describing the
process of treating psychological disorders and mental distress.

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 Many attempts have been made to differentiate counselling from psychotherapy.
Some writers have suggested that counselling is used with normal individuals and
psychotherapy with those who are severely disturbed (Sharf, 2008). According to Corsini
(2005), counselling is informative and educational while psychotherapy is facilitative. There
is yet another distinction based on work setting. Counsellors work in work settings such as
the school or guidance clinic while psychotherapists work in hospitals. These differentiations
have some flaws. For instance, concluding that counselling is used for normal individuals and
psychotherapy for the severely disturbed has the problem of differentiating severity of
disturbance since often times than not practitioners use the same set of technique for clients
of varying severity levels. Also differentiating them based on work setting is not helpful
because the overlap in patient’s problem is great regardless of work setting.

PSYCHOTHERAPY

Psychotherapy is a general term that refers to therapeutic interaction or treatment

contracted between a trained professional and a client, patient, family, couple, or group.
Often the problems addressed are dependent on the specialty of the practitioner involved and
are mostly psychological in nature and of no specific kind or degree. It is a process that is
aimed at increasing an individual’s sense of his or her own well-being. It refers to the various
therapeutic techniques employed to improve psychological functioning and promote
adjustment to life (Ofovwe, 2011).

There are various techniques or approaches to psychotherapy that a therapist can

employ. These approaches notwithstanding require a therapeutic relationship, communicating
and creating a dialogue and working to overcome problematic thoughts or behaviors or to
improve group relationships (such as in a family). Many different types of professionals with
different qualifications engage in psychotherapy regularly despite the fact that it is a separate
discipline. These individuals include clinical psychologists, psychiatrists, counselors,
marriage and family therapists, social workers, mental health counselors, occupational
therapists and psychiatric nurses.

COUNSELLING

The word ‘counselling’ covers a broad spectrum, from someone who is highly trained
to someone who uses counselling skills (listening, reflecting back what you say, or clarifying)

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as part of another role, such as nursing. Counselling is included in the broad family of helping
services. It is a helping strategy that requires a set of intervention. It is a process of
integration which facilitates meaningful understanding of self and environment resulting in
the establishment and/or classification of goals and values for future behaviour. Counseling is
a process in which clients learn to make better decisions and formulate new ways of
behaving, feeling and thinking. Some subspecialties are: school counseling, marriage and
family counseling and career counseling.

A BRIEF HISTORY OF PSYCHOTHERAPY AND COUNSELLING

The treatment of emotional and psychological problems can be trace to antiquity.

Mental illness as a medical condition rather than a sign of malevolent deities was first
identified by the ancient Greeks however their understanding of the nature of mental illness
was not correct. So also was the treatment for it. For instance, bloodletting was used for
psychosis while bathing was used to treat depression. The history of psychotherapy dates
back formally to when Sigmund Freud began using talk therapy to work with patients. Freud
techniques included transference, dream analysis and free association. Later in the twentieth
century when behaviorism became a more prominent school of thought, techniques such as
conditioning and association began to play an important role in psychotherapy. Many of its
methods are still very popular today despite the fact that behaviorism is not be as dominant as
it once was.

In the 1950s, humanistic psychology began to have a major influence on

psychotherapy. Carl Rogers developed an approach known as client-centered therapy, which
focused on the therapist showing unconditional positive regard to the client. Today, this
approach remains one of the most widely used models in psychotherapy. In the 1960s, the
cognitive revolution began and has ever since had a major impact on psychotherapy and
counselling.

TYPES OF COUNSELLING AND PSYCHOTHERAPY

Counselling and psychotherapy can be grouped using the number of individuals
involved in the session. Thus, one talks about group counselling and psychotherapy and
individual counselling and psychotherapy.

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Group Counselling and Psychotherapy

Group counselling involves a single counsellor or therapist working with multiple

patients in order to help them resolve issues. It can be effective for people who are not
comfortable in a one-on-one setting, who have social anxiety issues, or who do not find it
financially feasible to pursue individual counselling or psychotherapy. They are different
forms of group counselling or psychotherapy. It may involve related persons, [family
counselling/therapy (focused on modifying family relations to achieve harmony), couple
counselling/therapy,( focused on marital relationships and between unmarried partners)], or
unrelated persons, (Alcoholics Anonymous, Gamblers Anonymous). The focus maybe
preventive or curative and it could also be formed on the bases of shared personal
characteristics or similar psychological disturbances (Ofowve, 2011)

Individual Counselling and Psychotherapy

Individual counselling involves a single therapist or counsellor and a single client or

patient. It is a direct, active and personal approach that focuses on increasing an individual’s
self-awareness, understanding, and adjustment.

Counselling and psychotherapy can also be grouped using the approach employed by the
therapist or counsellor. That is whether the approach is directive or non-directive. Examples
of directive approach include,

APPROACHES TO COUNSELLING AND PSYCHOTHERAPY

There are actually a wide variety of techniques and practices used in psychotherapy and
counselling. The exact approach used in each situation can vary based upon a variety of
factors, including the training and background of the therapist, the preferences of the client
and the exact nature of problem the client is experiencing. Some of the major approaches to
psychotherapy include:

Psychoanalytic: An approach to therapy that involves delving into patients thoughts and past
experiences to seek out unconscious desires or fantasies.

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Behavioural: this approach focuses on helping individuals understand how changing their
behaviour can lead to changes in how they feel. Behavioral therapy often uses classical
conditioning, operant conditioning and social learning to help clients alter problematic
behaviors.

Cognitive: this approach focuses on helping individuals to understand how their maladaptive
thinking might affect their feelings and actions.

Humanistic: A form of therapy that focuses on helping people maximize their potential.

Existential: This helps people to clarify, think about and understand life, so that they can live
it well. The counselling focuses the client on how much they already take charge of their life,
and not on what they are doing wrong. At the same time, it takes note of any real limitations,
so that they can make choices based on a true view of the options available.

Gestalt: This is a directive type of counselling, focusing on encouraging people to have an

active awareness of their present situation, and also incorporates communication that goes
beyond words.

Personal construct: This is based on the idea that nobody can know absolute truth. Instead,
each person constructs their idea of the truth from their own experiences, and this affects the
way they see the world. The problem is that people can get stuck with a view of things that
prevents them from living life to the full, because they can’t find any alternative ways of
seeing things. Personal construct counselling helps people to look at different ways of
behaving that may be useful in changing the way they see the world.

Cognitive-Behavioral: A type of psychotherapy that involves cognitive and behavioural

techniques to change negative thoughts and maladaptive behaviors. This is concerned with
the way people’s beliefs about themselves shape how they interpret experiences. The
objective is to change self-defeating or irrational beliefs and behaviours by altering negative
ways of thinking.

Rational-emotive: This takes the view that people have two main goals in life: to stay alive
and to be happy. It aims to remove the obstacles that people place in their own way, and also
to achieve a healthy balance between short-term and long-term goals.
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DIFFERENCES BETWEEN COUNSELLING AND PSYCHOTHERAPY

1. Counselling is indicated for short-term and less-serious problems while

psychotherapy is indicated for long-term and much more chronic psychological and
emotional problems.
2. Counselling is generally giving advice while in psychotherapy there are more in-depth
interventions.
3. Counselling deals mainly with basic life problems that most people experience at one
time or another such as work stress, relationship problems or difficult life transitions
such as the loss of a loved one while psychotherapy suggests a greater focus on
improving problems with a person's underlying thoughts, beliefs or emotions.
4. Counselling is mostly directive while Psychotherapy is less directive.
5. Counselling deals with personal, social, vocational, and educational concerns while
psychotherapy focuses more on adjustment and psychological problems.
6. Counselling tends to be short-term ranging from 8-12 sessions over several months
while psychotherapy is a long term relationship, to range from 20 -40 sessions over a
period of 6 months to 2 years.
7. Counselling is most often provided in an out-patient setting while psychotherapy is
provided in both in-patient and out-patient setting.
8. Counselling lays more emphases on change while psychotherapy emphasises on
insight.
9. The training of counselling is less in-depth and more lengthy that that of
psychotherapy.
10. Historically, counselling differ from 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.
11. Traditionally, counselling is associated with education and to some extent, social-
work settings, while psychotherapy is associated with psychiatrists, clinical
psychologists and medical settings.

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SIMILARITIES BETWEEN COUNSELLING AND PSYCHOTHERAPY

Psychotherapy and counselling have similarities as well. They include the following:

1. The kinds of issues that draw people to use counselling and psychotherapy are often
very similar and the aims of both are also very similar.

2. Both can be seen as attempt to allow the patient/ client build up resources to live in
more healthy, meaningful and satisfying ways, and to develop self-awareness.

3. In both counselling and Psychotherapy, a high degree of respect for the autonomy of
the client is a basic principle. There is a basic understanding that the clients bring with
them the potential needed to successfully achieve their aims. (COSCA, 2004)

4. 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

5. And lastly, that both counselling and psychotherapy require the therapist to have
highly developed skills.

CONCLUSION

Attempts at differentiating between counselling and psychotherapy have not been

conclusive. Some view it to be same (eg. Arbuckle, 1967); others consider them to be wide
apart while some others believe that the difference is very little (Sharf, 2008). The basic issue
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is that both psychotherapy and counselling are interactions between a therapist/counsellor and
one or more clients or patients. The purpose being to help the patient or client overcome his
or her problems that may have some aspects related to some aspects of disorders of thinking,
emotional suffering or problems of behaviour. The therapist’s knowledge of personality,
psychotherapy and counselling will be used to improve clients/patients functioning. The
approach used must be legally and ethically acceptable.

REFERENCES
Arbuckle, D. S. (1967). Counselling and Psychotherapy: An Overview. New York: McGraw
Hill.

COSCA (2004) Counselling and Psychotherapy: COSCA's Description Stirling: Cosca

Federal Ministry of Health Nigeria (2010). National xxx for paediatric HIV and AIDS
treatment and care. 2nd edition. Federal Ministry of Health Nigeria.

Morgan-Ayres, P. (2005): URL: http://www.hypno-analysis.co.uk/psychotherapy-analysis-

counselling.htm) Accessed: 9/10/2005

Sharf, R. S (2008). Theories of psychotherapy and counselling: concepts and cases. 2nd
edition. Brooks/Cole Cengage Learning. Pp 3-7

Corsini, R. J. (2005). Introduction. In R. J. Corsini & D. Wedding (Eds), Current

psychotherapies 7th Ed. Belmont, CA: Thomson Brooks/Cole. Pp 1-14.

Ofovwe, C. (2011). Fundamentals of general and clinical psychology. First Edition. Mindex
Publishing Company Ltd, Benin-city. Pp 248