Psychotherapy and counseling are both types of mental health therapy but with differences. Psychotherapy focuses more on long-term issues and growth, while counseling aims to help people resolve current issues.
Psychotherapy and counseling are types of therapy that can help boost mental well-being.
Psychotherapy is typically a more in-depth, long-term process that focuses on a person’s feelings and past experiences. It can lead to personal growth.
Counseling, meanwhile, is more likely to refer to short-term talk therapy. It focuses on helping a person find solutions to current issues. An individual can use it to develop strategies, actions, and behaviors that can help make daily life more manageable and enjoyable.
However, there are many cases where either will help, and a person may also have both types of therapy.
This article discusses the differences between psychotherapy and counseling, how to choose between them, and preparing for an appointment.
Psychotherapy and counseling are closely linked and share many features, but there are distinctions.
The following table outlines some differences between psychotherapy and counseling.
| Psychotherapy | Counseling |
| Focuses on recurring or chronic issues. | Focuses on short-term, or current issues. |
| Psychotherapy relies on the application of treatment guided by manuals and protocols. | It is less likely that a counselor will deliver the therapy with the aid of a treatment manual. |
| Treatments are more likely to be theory-driven, such as cognitive behavioral or Jungian. | Less likely to be theory-driven. |
| Types of psychotherapy can involve talking, cognitive behavioral, art, drama, music, animal, and movement. | Involves talk therapy. |
| Therapy may focus on a person’s entrenched and long-held patterns of thought and behavior. | Therapy may focus only on specific behaviors or situations. |
| Therapy may be long term and can take place over many years. | Therapy may be short term. |
| A psychological professional delivers the therapy. | A psychological professional usually delivers counseling, although people, such as volunteers or pastoral counselors, may also offer counseling. |
| Therapy may focus on a psychological disorder or problem with psychological functioning. | May deal with functioning individuals who are experiencing difficulties in their current situation. |
| Therapy may use experiences and feelings as the basis. | Therapy may focus on behaviors and actions. |
| Therapy may focus on personal growth from an in-depth focus on core issues. | Therapy may focus on support, guidance, and problem-solving for current issues. |
What is the difference between psychotherapy and psychiatry?
Psychotherapy can help people with emotional difficulties and mental illnesses. It may improve a person’s well-being and equip them to function better in daily life.
Psychotherapy can help a person deal with longstanding and complex issues. The individual and the therapist will decide together on treatment goals.
According to research, around 75% of people who receive psychotherapy experience some benefit. They can function better and experience some relief from symptoms.
A person may contact a therapist to treat a range of mental illnesses, which include:
- anxiety disorders
- depression
- eating disorders
- bipolar disorder
- schizophrenia
- borderline personality disorder (BPD)
- post-traumatic stress disorder (PTSD)
- obsessive-compulsive disorder (OCD)
There are several different types of psychotherapy. Some may be more beneficial for certain illnesses.
Types of psychotherapy
Types of psychotherapy include the following.
Cognitive behavioral therapy (CBT)
Therapists may use CBT to treat various conditions, such as depression, anxiety, schizophrenia, and eating disorders.
CBT explores the relationship between feelings, thoughts, and behaviors. The therapist will help a person identify unhealthy thought patterns and how they contribute to damaging behavior and beliefs.
Once the therapist and the individual have identified these patterns, the therapist can help develop new, constructive ways of thinking, beliefs, and behaviors.
Can CBT help people with schizophrenia?
Dialectical behavior therapy (DBT)
Therapists first developed DBT to treat people with borderline personality disorder who were considering suicide. It is the main treatment for BPD but can also treat other mental health conditions.
DBT is based on CBT and is very similar. However, DBT encourages people to accept and come to terms with uncomfortable thoughts, feelings, and behaviors.
How can DBT help people with BPD, and what other options are there?
Exposure therapy
Therapists may use exposure therapy to treat phobias, OCD, and PTSD. It can help a person identify anxiety triggers in a safe space and learn techniques to avoid anxiety when meeting these triggers in daily life.
A therapist may present the person with small amounts of their triggering stimulus and gradually increase it, or they may “flood” the individual with their trigger.
How can exposure therapy help people with a fear of heights?
Psychodynamic therapy
Psychodynamic therapy can help treat various conditions, such as BPD, anxiety, and depression.
It centers on the idea that childhood experiences, inappropriate repetitive feelings, and unconscious thoughts affect a person’s mental well-being and behavior.
The therapist helps the individual change unhealthy patterns and improve their self-awareness.
Eye movement desensitization and reprocessing therapy (EMDR)
Therapists may use EMDR to treat people with PTSD.
While the person focuses on a traumatic memory, the therapist will use bilateral stimulation — for example, back-and-forth eye movements, buzzing hand sensors, or playing audio tones alternating between the ears.
This technique aims to reprocess the memory and install a positive belief to replace the previous negative belief or traumatic memory.
What role can EMDR play in treating PTSD?
Interpersonal therapy
Interpersonal therapy can help treat depression and other conditions. It focuses on a person’s relationships with others. It helps individuals evaluate their social interactions, identify negative patterns, and learn strategies to understand and interact positively with others.
Counseling involves a purposeful conversation between the counselor and the client. The discussion will aim to reflect on and resolve a current issue.
It takes place in a supportive, confidential environment. The counselor aims to support the individual and help them either solve problems or manage them in a more empowering way.
The therapist, or counselor, will typically guide the conversation toward topics such as thoughts, feelings, relationships, and current difficulties. They will then try to help the individual make connections and provide helpful insight.
Counseling may enable a person to develop their own resources and strengthen their coping mechanisms. These skills can help them function better and overcome specific and current issues.
Various factors can affect the choice between psychotherapy and counseling. They include personal preference, access to each type, and a person’s insurance coverage and affordability.
Both counseling and psychotherapy can help people with depression and other conditions. However, people with longer-term emotional issues or severe mental illness may benefit more from psychotherapy.
Psychotherapy may be a better option for someone who:
- has a diagnosed mental illness, such as BPD, depression, or PTSD
- has tried counseling and found it ineffective
- is experiencing chronic or recurring emotional or mental difficulties
- is coping with past trauma or is negatively affected by past situations
- has emotional or mental health challenges that are affecting their daily life and relationships
Counseling may be more suitable for someone who is:
- experiencing a short-term, specific problem
- looking for guidance and support for issues they wish to solve
- coping with substance or alcohol dependence
- looking to learn coping skills to manage stress
- dealing with a life adjustment, such as losing a loved one or divorce
A person may find it helpful to define what they wish to address and achieve through psychotherapy or counseling before their first appointment.
This may involve listing:
- questions to ask the therapist or counselor
- issues they wish to address in therapy
- recent changes in their lives
- possible triggers of current emotional or mental difficulties
- symptoms of mental ill health or emotional distress
- medications they are taking
Psychotherapy and counseling share some features. They are both therapies that address emotional issues or mental health challenges.
Psychotherapy is typically a long-term process that addresses a person’s feelings and experiences, helping them develop and grow personally.
It may benefit someone with past trauma, diagnosed mental illness, or longstanding or chronic issues they wish to address.
Counseling is often a shorter-term process. It can involve talking together through a person’s current issues to guide and support them toward a solution. It may result in the person changing their behaviors and actions.
It may suit a person seeking to cope with a specific challenge or looking for a solution to an issue that affects them emotionally.