I remember when I was at one of my first jobs in child and youth mental health after finishing my Masters of Social Work, my supervisor said with pride,
“We don’t provide counselling, we provide psychotherapy.”
I was kind of embarrassed and wondered how I hadn’t known the difference between counselling and psychotherapy until that time.
But then, when designing my website, I asked friends what they would prefer if they were seeking talk therapy – counselling or psychotherapy? Almost everyone chose counselling over psychotherapy. And most people saw counselling & psychotherapy as being the same thing.
How Counselling & Psychotherapy Are Similar
Imagine that talk therapy is represented by the ocean. If you receive counselling or psychotherapy, you have jumped into the ocean. All counselling and psychotherapy are forms of talk therapy. This is the only guaranteed similarity.
How Counselling & Psychotherapy Are Different
However, after this, the difference will change depending on your country and even the region you reside in that country. In some places counselling and psychotherapy are used interchangeably by talk therapists and clients. In other places psychotherapy connotates use of psychotherapeutic techniques such as Cognitive Behavior Therapy (CBT) or Emotion Focused Family Therapy (EFFT), whereas counselling is understood as talk therapy in a broader sense and may or may not include psychotherapeutic techniques.
The province I live in – Ontario, Canada – has made a decision to separate counselling and psychotherapy. Counselling could be seen as most of the ocean. Counselling can be understood as a broad term of providing talk therapy to an individual, couple, family or group.
Psychotherapy would be for those parts of the ocean where you start wondering if you, your passengers and your boat are going to be okay. The waves are choppier, perhaps you’ve entered a more dangerous storm. Imagine that you are a pretty good sailor, but you are no longer sure you can guarantee safety to the same degree you could in smoother waters. Psychotherapy, according to the Regulated Health Professions Act, 1991, is defined as:
“Treating, by means of psychotherapy technique, delivered through a therapeutic relationship, an individual’s serious disorder of thought, cognition, mood, emotional regulation, perception, or memory that may seriously impair the individual’s judgement, insight, behavior, communication or social functioning.”
Psychotherapy consists of (1) use of a psychotherapeutic technique and (2) the severity of an individual’s disorder. A person can offer counselling and use a psychotherapeutic technique, but they cannot use it with someone who fits the definition of having a serious disorder.
Another difference is that in Ontario, counselling can be offered by anyone, whether or not they have an education in counselling or any sort of certification. Anyone can take a boat and put it in the water. However, if a practitioner advertises that they provide psychotherapy, then the rules change. Someone who practices psychotherapy is a practiced sailor. Practitioners of psychotherapy need to be members of a college such as the Ontario College of Social Workers and Social Servicers Workers (OCSWSSW), the College of Psychologists’ of Ontario, and the College of Registered Psychotherapists among others.
What Is A Serious Disorder?
This is where the definition of psychotherapy enters shades of gray. If you’re working with someone who provides psychotherapy, the gray area is less important, because psychotherapy encompasses counselling. If you’re working with a someone who provides counselling, you will have to check with them to see if they are qualified to provide psychotherapy if needed.
Clear as mud? Here are a few examples.
If you have depression, but you are not suicidal, then you can see someone who provides either counselling or psychotherapy. Both counselling and psychotherapy can use evidence-based psychotherapeutic techniques and/or more general counselling techniques and possibly some complementary services such as energy healing or hypnosis, and others to help meet your needs.
If you have depression and you are regularly suicidal, then you have entered a more serious phase of depression and would need to be seen by someone who can provide psychotherapy. You can ask your practitioner if he/she is qualified to do so and your practitioner will be responsible to communicate his/her level of expertise. This person must (1) be a member of a professional college who can offer psychotherapy and (2) use psychotherapeutic techniques. In addition, they could also use more general counselling techniques and complementary services such as energy healing, hypnosis, naturopathy or others to enhance your care.
If you are looking for assistance in parenting one or more of your children, then the psychotherapeutic technique of using Emotion Focused Family Therapy can be a helpful therapeutic model to help you and your child. Engaging in Emotion Focused Family Therapy with a practitioner, in this case, could be considered under the umbrella of counselling, even though it is a psychotherapeutic technique. The reason this assistance would be considered counselling, is because it is being used in a less serious situation.
To contrast, if you are looking for assistance in parenting one or more of your children and they have mental health issues that are more serious, then the use of Emotion Focused Family Therapy would fall under the umbrella of psychotherapy. The reason this becomes psychotherapy is because the psychotherapeutic technique is being used in a more serious situation.
I hope this has helped you understand the difference between counselling and psychotherapy. If you’re not sure if you should look for psychotherapy or for counselling, don’t fret. The easiest way to understand is to talk to a psychotherapist or counsellor in your area. Give them an idea of what you’re hoping for from talk therapy, and they can help you navigate whether counselling or psychotherapy is a better fit for you.
If you know that you are seeking psychotherapy, ask your talk therapist what professional college they belong to and whether they are qualified to offer psychotherapy. Feel free to contact me if you have any further questions.