Counselling or Therapy - what's in a name?

Identity is a common theme in the work I have done with clients, and I believe that’s because it’s such a huge theme in life itself. Knowing our own identity. Pressure to conform to a certain identity imposed on us by family, friends or society. How we feel about the way we look. How the outside world views us or treats us. How trauma or bereavement can alter our identity. All of these are issues that come up again and again with clients, and forms a large part of the work I’ve done over the years.

Interestingly it was this issue of identity that provided the first real headache of setting up a private practice service. It wasn’t the location, or the website, or the name, but how do I identify myself as a professional? Am I a counsellor? A therapist? Psychotherapist?

Each of these terms could equally apply to the work I do, and each word will evoke a different response in different people. As part of the research I did I (very unscientifically) consulted facebook to see if people leaned towards one word over another. While the overall results were interesting (about two thirds preferred counselling to one third therapy) what was more interesting was the variety of responses that came back. Some felt that therapist was too clinical and found it off putting, while others preferred the term because it suggested a higher level of qualification than a counsellor. For others counsellor was a warmer term that sounded more welcoming, while others said that it suggested someone telling you what to do - quite literally “giving counsel”.

What muddies the water a little is that there is no set definitions in the profession, and in fact neither the terms counsellor, therapist or psychotherapist are protected terms (this makes it important that you know what a person's background training is before choosing a counsellor/therapist). If the profession itself struggles to define itself it’s no wonder that people outside the profession are uncertain!

So what is the difference? The counselling directory has a page dedicated to trying to explain the different terminology here, but the generally held belief by a lot of people is that a psychotherapist tends to work with longer term, more complicated or in depth work than a counsellor. Counsellors may use psychotherapy as their skill set but tend to work more short term. It is also generally felt that psychotherapists are more equipped to deal with psychiatric conditions or psychosis. All of this is speculative, and none of it is set in stone. You could take two people with identical training and experience and if one referred to themselves as a counsellor and the other as a psychotherapist, the work they would do with a client could be exactly the same.

For me personally, you’ll notice throughout the website I use the terms counselling/counsellor and therapy/therapist interchangeably. The one word that I rarely use is psychotherapist, although if I was asked what my job title was I would lean towards psychotherapist, for no other reason that I think it sounds somehow more professional (and I base that on no hard evidence, just a personal feeling) and reflects the years of training I’ve gone through to get to this point.

The work I do could just as easily be described as counselling or therapy. I will always default to what my client prefers, since either term is acceptable to me but one of the terms may be less appealing to a client. One of the responses I got was that counselling was for minor issues and therapy was more like “man you’ve got some serious issues!”, and with that person it might be easier to use a term like counselling that softens the weight of what they’re going through so it doesn’t have as much impact on how they see themselves.

You will doubtless have your own responses to the terms counselling and therapy, and sometimes these responses can act as a barrier to seeking help. Just to give you an example the word therapist can be seen as a very Americanised word and can conjure up images of lying on a sofa while someone sits opposite making notes on a clipboard. Such an image might seem cold and distant, not the sort of support that you might be looking for. If you were to check that out with me I’d tell you that although there is often a sofa in my therapy rooms, clients rarely lie on it, and I don’t make notes during a session as I feel it breaks up the communication - if I’m writing down what you just said I’m not giving my full attention to what you’re saying now. Knowing that might change how you view therapy, and might reduce any anxiety you have.

I would encourage you to view either term as support, a word which usually comes with less of a loaded response but which accurately sums up what it is we offer. If one or other of the words creates an image or expectation for you that makes you nervous or anxious about seeking support, then get in touch with a therapist/counsellor and check it out. Almost all of the therapist's I’ve worked alongside are very open to being approached by people with questions about what we do, myself included. By checking out any fears you have before starting your journey you can reduce any anxiety you may be feeling and better understand what support can be offered to you.

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