The terms “counselling” and “psychotherapy” are often used interchangeably and have many similarities, but there are some important differences. In general, counselling is recommended for specific issues and situations, such as addiction or grief, and takes place over a period of weeks or months.
By contrast, psychotherapy tends to explore past issues that might be contributing to present day problems. It often takes place continuously or intermittently over a period of years. In actual practice, however, there is a great deal of overlap between the two types of therapies.
Understanding some more of the differences between counselling and psychotherapy may be helpful in choosing the type of therapy that will be most effective for you as an individual suffering from an addiction.
Counselling Vs. Psychotherapy
While the same therapist may provide both counselling and psychotherapy, psychotherapy generally requires more skill. It is conducted by a trained professional such as a psychiatrist or psychologist. While a psychotherapist is qualified to provide counselling, a counsellor may or may not possess the necessary training and skills to provide psychotherapy.
That said, a psychotherapist may provide counselling within certain situations and a counsellor may function in a psychotherapeutic manner. This includes addiction treatment. In recovery you will usually participate in both.
Counselling
The term “counselling” is generally used to describe a relatively brief treatment that is focused mostly upon a specific issue and discernment for dealing with it. Counselling tends to be wellness-based and provides increased insight and learning in order to overcome problems and challenges.
Technically speaking, “counsellor” means “advisor.” It involves two people working together to solve a problem. It is a term that is used in conjunction with many types of advice giving. For example, financial planning and spiritual guidance are both types of counselling.
Just about anyone may claim to be a counsellor if they are in the role of giving advice so you must be careful that the provider is qualified. The term “counselling” may also properly be used to refer to what occurs in a relationship with a psychotherapist. That is the case when treating addiction.
In the context of mental health, counselling is generally used to denote a treatment that is focused primarily on behaviour. It often targets a particular symptom or problematic situation and offers suggestions and advice for dealing with it.
In this setting, the counsellor offers guidance and support as the individual figures out ways to better manage life and adjust to change or adversity.
There are many types of counsellors, such as marriage and family counsellors, grief counsellors, and addiction counsellors.
Psychotherapy
Psychotherapy, on the other hand, is generally a longer-term treatment that focuses more on gaining insight into chronic psychological and emotional problems. Its focus is on the person’s thought processes, and how these may be influenced by past events. For example, psychotherapy might delve into how a past trauma has led to problems in the present, like addiction.
According to research, psychotherapy addresses the root cause and core issues of current problems so that lasting change and personal growth usually will occur during recovery. A psychotherapist will also provide strategies during addiction treatment.
There are several different types of therapy that fall under the general heading of psychotherapy, such as cognitive behavioural therapy (CBT), dialectical behaviour therapy (DBT), and psychoanalytic psychotherapy.
Psychotherapy is often treatment-based to address mental health issues such as mood disorders, anxiety disorders and eating disorders. It can be used in tandem with medication, but this isn’t always the case.
Psychotherapy is also known to go deep into a particular matter in order to reveal the root issue that causes the related, disturbed perspective of life. Ultimately, the client will find relief from inner turmoil by taking control of their life and developing self-awareness, rather than getting triggered by unconscious impulses.
Similarities and Differences
There are many similarities between counselling and psychotherapy, and even with the distinction, counselling often includes some psychotherapy and psychotherapy often includes some counselling. There are also some key differences.
Similarities
Similarities include:
- Development of a healing, safe, and therapeutic relationship between a provider and an individual – crucial for success in addiction recovery
- Both involve a conversation between client(s) and a therapist/counsellor that has the aim of helping people make changes within themselves and in their lives
- This process is not random; the therapist or counsellor, through questions, reflection, and feedback, acts as a facilitator to assist clients to help them find these answers within themselves. This is particularly helpful in recovery.
- Effectiveness for a wide range of people, both adults and children, including addiction treatment
- Understanding a person’s feelings and behaviours related to addiction, and addressing issues with the goal of improving a person’s life
- The provider has training and specific education
- The individual suffering from addiction learns strategies to manage it in recovery
- Psychotherapy and counselling both use psychological methods to help clients with a mental or emotional problem or disorder
- Both are used to treat addiction during recovery
Differences
While mental health professionals with more advanced degrees are more likely to provide psychotherapy, the same provider may only do both types of therapy if they are qualified. There are some key differences between the treatments, however.
- Counselling focuses on present problems and situations. Psychotherapy focuses on chronic or recurrent problems.
- Counselling looks at specific situations or behaviours, psychotherapy is a big-picture approach that looks at overall patterns.
- Counselling is a short-term therapy lasting for several weeks or months. Psychotherapy is usually continuous or intermittent over many years.
- Counselling is focused on actions and behaviour; psychotherapy is focused on feelings and experiences.
- Counselling usually takes the form of “talk therapy”. Psychotherapy may include personality, intelligence, and other testing, talk therapy, and other treatments such as cognitive behavioural therapy.
- Counselling focuses on support and education to help people identify and find their own solutions to current problems. Psychotherapy has an in-depth focus on internal thoughts and feelings leading to personal growth.
- Counselling focuses on specific issues and is designed to help a person address a particular problem, such as addiction or stress management. The focus of psychotherapy is the underlying cause of the problem.
- Counselling addresses behaviour; psychotherapy addresses how patterns of thinking and behaviour affect interactions with the world.
How to Choose a Counsellor or a Psychotherapist
When choosing a provider, it’s helpful to learn about the differences noted above, as well as the background of specific healthcare professionals and the approaches they use. Sometimes the choice will come down to personal preferences, access, or insurance coverage.
The most important step, however, is to find a provider you can trust. In fact, the level of trust a person has in their mental health care practitioner plays the greatest role in whether the therapy will be successful or not. This will make addiction recovery more likely to lead to long-term sobriety.
You may need to talk with a provider or visit for a few appointments before you know which type of treatment is best for you. For example, it may be difficult to know if you are facing a short term, limited problem that would best be treated with counselling, or if there are events or situations in your past that are leading to the current problem.
When to See a Counsellor
Counselling may be a better option than psychotherapy if:
- You have specific issues or short-term problems you wish to address
- You wish to learn coping skills to help better manage stress and improve relationships
- You are coping with life transitions and adjustments, such as divorce or grief
- You are coping with addiction issues that are newer and less advanced
- You are looking for someone who is essentially a “coach” who can guide and support you as you learn to recognize problems and formulate healthy solutions yourself
When to See a Psychotherapist
A psychotherapist may be a better option if:
- You have problems that are significantly impacting your life and relationships
- You are coping with past trauma, or if you believe situations in the past may be playing a role in your current issues
- Your present issues are chronic or recurring concerns
- You have a chronic medical condition (such as autoimmune disease or cancer) that is affecting your emotional well-being
- You are struggling with severe recurrent addiction
- You have a diagnosed mental health condition such as bipolar disorder or a major anxiety disorder
- You have seen a counsellor and your issues aren’t improving even though you’ve been actively working on solutions
Counselling Vs. Psychotherapy for Addiction Treatment
Both counselling and psychotherapy are used in addiction treatment, and the choice can depend on the severity of the problem, whether it is a new issue or an ongoing or recurrent problem.
As far as the effectiveness of the two approaches, a recent study found that counselling was just as effective for the treatment of previously untreated mild to moderate addiction diagnosed in primary care.
Another study, however, found that interpersonal psychotherapy was somewhat more beneficial than counselling with people suffering from addiction, with respect to both symptoms and overall functioning over the short-term. That said, a recent study looking at the same group found that long- term, the effects of counselling were more beneficial.
People with chronic, severe addiction might benefit most from psychotherapy, whereas people with mild to moderate addiction may benefit most from developing a good relationship with a provider based on mutual trust, and then talking with them about which approach would be most helpful.
Preparing for a Visit with a Counsellor or Psychotherapist
Whether you choose to see a counsellor or a psychotherapist, your initial appointment will likely be more rewarding if you do a little homework ahead of time. Doing so will not only help you clarify why you are seeking professional help for your addiction but will help the provider know whether they believe they will be able to help you or not.
Before your appointment, make a list of:
- Any issues, concerns, or symptoms you are coping with, even if they seem to be unrelated or are not the reason why you are seeking therapy
- Key personal information, including any major stresses or recent life changes
- All medications, vitamins, or other supplements that you’re taking, including frequency and doses
- Questions to ask your healthcare provider, including recovery options for addiction treatment
Getting Help
There are some reasons why you may wish to choose a counsellor instead of a psychotherapist, or vice versa, but the most important step is getting started. At Addiction Rehab Toronto, we will match you with a provider you can fully trust, who has expertise in helping clients with issues similar to yours. Personalities differ, and the best provider for someone else may not be the right person for you. That is why all elements of our addiction treatment programs, including counselling and psychotherapy, are tailored to your unique needs and circumstances.
