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The Difference Between Psychotherapy vs Counselling

Written by Sarah Norman

Tagged in

  • wellbeing
  • wellness
  • anxiety
  • depression


Mar 20, 2024, 12 min read

When it comes to therapy, there are so many different variations to choose from, making it difficult to decide what the appropriate type of therapy is for you, and which one is likely to make a real difference for your specific situation. 

The terms ‘therapy’ and ‘counselling’ are frequently used interchangeably, but there is a difference, so here, we are demystifying what each of these are and how they can be differentiated. We will also share the qualifications a counsellor or psychotherapist requires, which is the best choice for conditions such as depression, autism, ADHD and more, and how to choose and access psychotherapy or counselling. 

Psychotherapy vs Counselling

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about different therapy options, we’re here to help. 

What is psychotherapy? 

Psychotherapy is a treatment option for anyone looking to address physical or emotional symptoms causing them distress in life. There are many variations under the larger psychotherapy umbrella – such as cognitive behavioural therapy (CBT), dialectical behaviour therapy (DBT), and more – but regardless of the branch of psychotherapy being used, the focus is on an individual’s thought processes. 

Psychotherapy focuses on how a person’s thoughts have been influenced so far, and how and why they continue to cause issues in daily life. While other therapies may look at what’s going on right now, psychotherapy attempts to get to the root cause of the issues in order to rebuild the foundation of a person’s thought processes and habits. 

This type of therapy is thought to be highly beneficial, and according to research, around 75% of people who receive psychotherapy experience at least some benefits. 

What is psychotherapy used for?

A person might choose to pursue psychotherapy to address difficult symptoms like depression, excessive worrying or feelings of hopelessness or disinterest in life. In a more general sense, they may also choose psychotherapy as a way to make daily life easier, or improve their overall quality of life. 

Psychotherapy can be beneficial for a number of situations, including things like extreme work stress, grieving a loss, relationship issues, unexplained physical symptoms, or a diagnosed mental health disorder. This type of therapy should always be tailored to the individual, their mental health needs, and their specific life circumstances. For example, someone who visits a psychotherapist to deal with their grief will require a bespoke type of psychotherapy that is very different to what someone with obsessive compulsive disorder (OCD) might need.

What is psychotherapy?

For each person, the psychotherapist may use the foundational therapy approach they are trained in while bringing in elements of therapy modalities to help shape the experience for the individual. 

Psychotherapy will look unique for different people. Below are some examples of the types of psychotherapy that may be used depending on the person’s needs:

  • Cognitive Behavioural Therapy (CBT) – One of the most popular forms of therapy is CBT, which is focused on helping people better understand how their thoughts and feelings can influence their behaviours. This is an extremely versatile form of therapy regularly used as part of treatment for conditions like depression, anxiety, addiction issues and more. You can find further helpful information in our article: The Differences Between CBT vs Counselling
  • Cognitive Therapy – Cognitive behavioural therapy is the combination of two different types of therapy, one being cognitive therapy. This type of therapy is similar to CBT, but focuses more on how negative thoughts can build and create a pessimistic outlook on life, which influences a person’s mood. By working to identify these cognitive distortions, cognitive therapy aims to reframe these in a more positive light. 
  • Behaviour Therapy – In a similar way, behaviour therapy is focused more on the behavioural element of CBT. By using therapy techniques such as classical conditioning and social learning, a therapist can help their client address behaviours causing them harm or long-term damage. 
  • Humanistic Therapy – This client-centred approach to therapy focuses on validating the client’s experiences and feelings, and helping them to reach their potential through learning more about themselves and how they think. 
  • Psychoanalytic Therapy – This type of therapy aims to figure out how an individual’s memories and past experiences have shaped who they are now, and influenced their current thoughts and feelings. 

Within each of these types of psychotherapy there are further formats available depending on the person’s needs. These include things like couples therapy and family therapy, and each can be tailored to help with a number of conditions, including things like bipolar disorder, eating disorders, phobias, post-traumatic stress disorder (PTSD), and more. 

What are the pros of psychotherapy?

There are many benefits to seeking psychotherapy. For example:

  • It is often more affordable than other therapy variations, and according to Verywell Mind's Cost of Therapy Survey, 8 in 10 American respondents undertaking therapy said psychotherapy was a good investment despite the cost.
  • It can cultivate healthier thought patterns in order to achieve a more positive outlook.
  • It can improve a person’s communication skills.
  • It can help people to learn more about their life and mind.
  • It can be beneficial for both those with a diagnosed condition and anyone who simply wants to improve their life in a more general sense. In the same Cost of Therapy Survey mentioned above, 78% of respondents said psychotherapy played a significant role in the progress made towards their mental health goals.
  • It can help anyone who is struggling to make a big life choice.
  • It can teach a range of coping strategies (such as mindfulness techniques) to make life easier or help deal with stress.
  • It can help to heal strained relationships with others.
  • It can help to improve symptoms of anxiety and depression. According to NHS data, 50.8% of people undertaking treatment for anxiety and depression with psychotherapy in 2017/18 had recovered.
  • It can address the root cause of certain mental health conditions

What are the cons of psychotherapy? 

Although psychotherapy has a lot of benefits, all types of therapy have their downsides, and not every type will be effective for every person. A few of the negative aspects of psychotherapy include things like:

  • Reliving unpleasant or traumatic memories – one study saw 57.8% of participants report negative effects from this.
  • Misunderstanding the aim of therapy – one study found between 18.4 and 19.3% of participants had a lack of understanding of the treatment they were receiving.
  • Strain in family relationships – a recent 2024 study asked CBT therapists and psychodynamic therapists about the side effects found in their patients after therapy, and reported that one of the most common was strain in their family relationships.

A 2020 article in Psychology Today stated some other frequently reported downsides of psychotherapy include things like the emergence of additional symptoms, suicidal feelings, stigmatisation, dependence on therapy, and more. 

What is counselling?

Counselling is a type of talking therapy which focuses on the patient talking about their thoughts, feelings and behaviours in order to further explore the potential causes of these in an unstructured way. 

Counselling is often confused with other talking therapies such as CBT, but its approach is different. Typically, CBT will involve discussing similar topics, but will aim to provide coping strategies to help address negative thoughts in order to positively influence behaviours through a structured program. 

Counselling, on the other hand, is less structured, allowing the individual to shape and guide where the conversation goes based on the insights they gain throughout. Counsellors will listen and provide a space for the person to explore the root causes of their issues and make sense of their feelings without influencing these. 

What is counselling used for?

Counselling can be used for many of the same conditions as psychotherapy, including specific mental health conditions, anxiety and depression, general unhappiness in life, or other situations that can cause emotional upheaval such as divorce, grief and more. 

Due to its open-ended nature and emphasis on talking, this type of therapy can be extremely helpful for those who do not have any particular mental health concerns, but would like to explore their own mind, thoughts, feelings and behaviours to gain further insight. 

Counselling offers a time and place to prioritise oneself, think about what may be challenging or causing discomfort in life, discuss possible solutions to dilemmas, talk about past experiences, work on issues like self-esteem or low confidence, and much more. It is a space held just for the individual, and allows them to move in any conversational direction they feel is most helpful. 

What is counselling?

What are the pros of counselling?

Counselling has a number of benefits for many people. For example: 

  • It is much more flexible than other types of therapy due to its unstructured nature.
  • It is open-ended (rather than being a specific number of sessions) so insights can be gained on an ongoing basis.
  • It can help people of all ages – according to a report from, counselling is thought to be as effective in older people as it is in younger people.
  • It is easy to access as it can be delivered in-person, or online with a video call.
  • It can lead to a long-term counsellor-patient relationship which can be adapted to help with future situations as well as current ones.
  • It could achieve the desired outcomes faster than other types of therapy – data from the British Association for Counselling and Psychotherapy suggests counselling could be as effective as CBT, or possibly moreso, and could provide results faster. Further studies have found patients attended fewer counselling sessions overall before seeing results than other therapies like CBT. 

What are the cons of counselling?

All forms of therapy come with their downsides, and when it comes to counselling, these include things like: 

  • Being unhelpful for people who struggle to open up – as counselling is more unstructured and open-ended, people may find it difficult to talk about their feelings and experiences unprompted. 
  • Discussing difficult and upsetting subjects – with no structure to find clarity on feelings before the session ends, this can leave people with unresolved emotions.
  • A lack of advice on coping mechanisms – due to the focus on talking, there may not be as many useful tools provided to patients.
  • A lack of an overall ‘ending’ to the counselling – the ongoing nature of counselling could make it harder for patients to feel a sense of recovery or ability to manage issues alone. 

Counsellor vs psychotherapist: What qualifications do they need?

Generally a therapist will specialise in either counselling or psychotherapy, since psychotherapy usually requires more qualifications and training than counselling. To be clear, a psychotherapist may be qualified and trained to provide counselling, but a counsellor may not be qualified and trained to provide psychotherapy. 

Psychotherapist vs counsellor qualifications

Finding an appropriately qualified and experienced therapist is important to ensure they can meet your needs and provide the type of therapy best suited to your situation. According to the National Careers Service, the below qualifications are required for each role. 

To become a psychotherapist in the UK, a person must:

  • Have a degree in the fields of psychology, nursing, medicine or social work
  • Take an accredited postgraduate qualification recognised by either the UK Council for Psychotherapy, the British Psychoanalytic Council, or the British Association for Counselling and Psychotherapy 
  • Train for 3-4 years, and have completed 450 hours of practice 
  • Complete 4 years of training with the Association of Child Psychotherapists (if working with children) 
  • Gain relevant experience working with children or vulnerable adults
  • Have undergone therapy themselves (required with some training courses) 

To become a counsellor in the UK, a person must:

  • Have a diploma, degree or postgraduate qualification in counselling, or complete a series of college courses such as Level 3 certificate in counselling skills, Level 4 diploma in counselling skills and theory, and Level 5 diploma in therapeutic counselling
  • Have undergone practical skills training or supervised work placements

Many therapists aim to become qualified in multiple therapy disciplines so they can offer their clients a selection of therapy modalities based on what may be a good fit for the person’s mental health condition, situation, or what they believe is needed.

What is the best choice for me?

If it has been recommended you try therapy, or you feel you could benefit from some sort of therapy but aren’t sure what type is best for you, you are not alone. Many people find the world of therapy difficult to navigate, asking questions like; “Where do I look for a therapist?”, “What kind of therapy is right for me?”, “How do I know if my therapist is the right fit or not?” and more. 

To make choosing a therapist easier for you, we have broken down a few common conditions that can benefit from therapy, and which therapy types may be most helpful: 

  • Depression and anxiety: Most therapists will offer some therapy option for depression and anxiety since they are very commonly experienced conditions. According to the World Health Organization, both counselling and psychotherapy can be beneficial for depression. This may also depend on the type of depression someone has. For example, chronic depression may be helped more by psychotherapy, whereas those with more moderate depression could see improvements from counselling. Recommended therapies for depression can include cognitive behavioural therapy (CBT), dialectical behaviour therapy, psychodynamic therapy, interpersonal therapy, and more. 
  • ADHD: Those with attention deficit-hyperactivity disorder (ADHD) may benefit from therapy to help manage their symptoms, and the Centers for Disease Control and Prevention (CDC) recommends psychotherapy such as behavioural therapy to manage this. CBT is also thought to be helpful for ADHD, and you may find more information on this in our article: CBT For ADHD: How Well Does It Work?
  • Autism: Certain therapeutic approaches can help autistic people to better manage associated symptoms such as anxiety and depression, and psychotherapy is thought to be the most beneficial for this. The CDC recommends therapies such as cognitive behavioural therapy (CBT) to help autistic people understand how their thoughts, feelings and behaviours are connected.
  • Personality disorders, such as borderline personality disorder (BPD): Talking therapies are often recommended to those with personality disorders like BPD and others. These include things like dialectical behaviour therapy (DBT) and cognitive behavioural therapy (CBT). 
  • Physical health problems: Things like chronic pain can affect our mindset, so counselling can help if you just need someone to talk to, while psychotherapy can provide more structured resources to help address your feelings about your health. 
  • Relationship problems: Therapists who specialise in family therapy or relationship counselling can be the best fit for those who are struggling with relationship problems, and typically a counsellor would be the best person to help with this. 
  • Stress: If you would primarily like to discuss the origins of your stress, a counsellor could be a good fit. Or, if you think you could benefit from learning some coping mechanisms to de-stress, a form of psychotherapy such as CBT could be useful. 
  • General life issues: If you have a specific problem you would like to talk about, or a shorter-term problem (such as divorce or grief), a counsellor could be the best fit for you to provide a space to talk about how you are feeling. 

It is not always easy to find the perfect type of therapy for what you need, so it is best to approach the situation with an open mind and explore the many options available to see if there is something that could work for you. Often this means finding the type of therapy recommended for your needs, a therapist that puts you at ease, and a frequency of therapy that helps you see results. 

Our free 15 minute consultation is designed to help you discover the most relevant type of therapy and therapist for you. By speaking to our trained therapists about your current situation, your needs, and your therapy goals, we can match you with a therapist who understands what you need and want, and has the credentials and experience to help you. 

Once you have settled on the type of therapy you believe is the best fit, you can speak to your GP to find out if this is available to you through the NHS, or look for a private therapist (such as the therapists we can connect you to at Augmentive) who can offer you either face-to-face or online sessions. 

Choosing psychotherapy vs counselling

You may find more information on accessing a private therapist in our articles: 

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments and reviews to helping you to find a therapist that’s right for your journey.

If you have a question about mental health, like the differences between CBT vs counselling, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.

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