Psychotherapy, Counselling and Coaching - What’s the Difference?

 

 

"Psychotherapy" and "counselling" are terms that are often used interchangeably, although if we look more in depth, there are some differences.

 

Counselling, in the context of mental health, usually refers to a short-term treatment to work on a specific situation or symptom. Clients wishing to have counselling usually agree a specific number of sessions with the therapist (e.g. 12 or 15). Having a clear end date may help them to stay focused on the issue they wish to  work on.

 

Psychotherapy on the other hand generally involves longer term work which focuses more on gaining insight into deep seated psychological and existential issues. The focus is on the client’s thought processes and way of being in the world rather than specific problems. Clients wishing to have psychotherapy usually agree to work on an ‘open-ended’ basis and the end date is discussed only at a later stage in the therapy. Although the frequency of the session is usually once a week, more in-depth existential analysis can take place 2 or 3 times a week.

 

Having identified the differences, there is a bit of overlap between the two. Generally speaking, however, psychotherapy requires more skill than simple counselling.  While a psychotherapist is qualified to provide counselling, a counsellor may or may not possess the necessary training and skills to provide psychotherapy. It is not uncommon for a therapeutic relationship to start on a ‘counselling’, short-term basis and then develop into psychotherapy as the client decides to continue to work at a deeper level.

 

The boundaries that exist in the psychotherapy (and counselling) relationship tend to be quite rigid and sanctioned by professional and ethical guidelines for clinical practice. This is necessary because clients may be very fragile emotionally, and breaching these boundaries could be very counterproductive for the client. Boundaries usually include no contact outside of the therapeutic setting (e.g. clinic or consulting room) except in rare circumstances, and the psychotherapist usually provides minimal self-disclosure, so the relationship can feel very different from a normal social interaction where there is a two-way dialogue. Sessions take place weekly at the same time and same place, at the therapist’s premises, and always last 50 minutes (or 60 minutes for couples therapy).

 

Coaching is in some way quite similar to counselling but more focused on proactively exploring life choices and their possible consequences for self and others, at times working in a solution-focused way. It has a more flexible set of boundaries compared to counselling and it offers an alternative to people who are not able (or ready) to embark on a regular weekly therapy programme. The work is usually short-term (although occasionally clients may want to continue for a longer period) and focused to address specific issues and problem areas, but unlike counselling, the coaching sessions can take place at different locations and times, they can last longer and take place at irregular intervals if needed. A tailor-made plan of action is designed with each client to address specific needs.