What is the difference between a counsellor and a therapist?

Ordinary people are confused by the terms counsellor and psychotherapist and for good reason: there is no sensible difference between what they are attempting to do, which is help people with emotional disorders. (That is why we tend to use the terms interchangeably on our mental health websites.)

No matter what they call themselves, psychotherapists and counsellors can only be assessed on their ability to deal with the common disorders that present themselves. These are usually one or more of the following: depression, anxiety, behavioural problems, psychological trauma (including PTSD symptoms), obsessional behaviour (OCD), addiction and relationship difficulties.

We have prepared an effective counselling checklist to make it easier to find a therapist with the skills to best help those suffering from mental illness. It's worth a read if you're looking for a therapist to help you regain your emotional wellbeing. Ask a potential therapist questions about items on the list in your initial conversations, or check their website to see how they approach problem like trauma, depression or anxiety.

A good therapist will set clear goals with you and have effective tools to make sure you feel more positive and confident quickly and you should leave each session feeling better than you did when you went in. If that doesn't happen, change your therapist.

The three causes of mental and emotional distress 

An effective counsellor or psychotherapist will understand the innate needs of human beings (the human givens). That is because it is only those who are not getting their innate needs met that have mental health problems.

There are three conditions that prevent people from getting their needs met:

 1. The person is living or working in a ‘sick’ environment that prevents them from doing so. Perhaps they are living in an aggressive or abusive home atmosphere or in an aggressive neighbourhood, or are suffering from bullying or humiliation at school or in the workplace. Or maybe they are not being sufficiently stretched at school or by the work they are doing.

2. The person doesn’t know how to operate their internal guidance system so as to get their needs met. They may not have been properly socialised when young or they may have been conditioned by their parents or school to have low expectations of themselves and so have developed learned helplessness, negativity and blindness to opportunities life presents them with, or they may have been conditioned into having unrealistically high expectations.

 3. The innate guidance system is damaged: perhaps through faulty transmission of genetic knowledge (as in autism spectrum disorders – caetextia), poor diet, poisoning, accident causing brain damage, sub- threshold trauma, molar memories or deep psychological trauma (post traumatic stress disorder, PTSD).

How to find an effective psychotherapist or counsellor 

Check them out. Ask for testimonials. Do not just rely on academic qualifications since these do not automatically mean a person has ‘nous’ and people skills.

Effective practitioners know how to build rapport and relax you by reflective (active) listening. They will be proactive and set clear goals for the therapy early on because they understand that the brain cannot work with abstractions. They are also skilled at harnessing your imagination to help you solve problems and rehearse new behaviours. (They usually do this by using guided imagery.) They will also have skills such as the rewind technique that they can use to detraumatise sufferers of phobic responses, PTSD symptoms and memories of abuse. They will keep the number of sessions to the minimum you need.

One of the most important things to look for in a practitioner is that you feel comfortable with them. The rapport between you and your therapist is an effective element to a good outcome in itself; so don't feel bad about shopping around. Find a therapist who doesn't make you feel uncomfortable. Often this can be done by a short free phone session before committing to any sessions, and a good therapist will not be offended if you do decide to move on because they will understand the importance of rapport.

It surprises many people to learn that feeling excessive amounts of emotional pain is not a pre-requisite for positive emotional change, and neither is committing to years of expensive ‘analytical’ sessions negative rumination about your past is encouraged. A skilled therapist usually takes only a few sessions to bring about a deep and positive lasting change so that you can move forward.

The plague of experts who aren’t 

The reason it is difficult for ordinary people to work out exactly what a mental health professional does by what they call themselves is that in the modern world there is no straightforward way of assessing expertise. In the past, when people lived in smaller communities, it was easy to see who was skilled at the various crafts. If you were a good cook, everyone could tell and enjoy the results. If you were a good builder it soon became obvious and people would seek your help and advice, you were an expert.

In ancient times the whole tribe would know who were the best hunters, tool-makers, fishhook-makers, childminders, and so on. People would know who was best at sorting out certain types of medical problems with herbs, who was good at setting broken bones and who had the most wisdom and authority to sort out relationship difficulties and conflicts. Thus genuine expertise was widely valued within the community.

Our vulnerability in the complex crowded society we live in is that we can’t rely upon our own observation of human capabilities to assess expertise. Today status is mostly awarded, or claimed for, without our being given observable proof of whether a person really has expertise and skill before we employ them.

We try and overcome this by devising various systems that are, in effect, ways of dispensing ‘badges of status’ to indicate who is or is not an expert. We allocate status through academic qualifications such as degrees, diplomas and doctorships, or through membership of trade associations such as, in the case of counsellors and psychotherapists, the BACP. Experiential knowledge about who has expertise has been replaced with the letters following a person’s name or the jargon they use.

Because we have become an appearance culture, instead of a knowledge culture, the badge of accreditation is now more important to people than the knowledge or skill that the badge was originally intended to denote. We are faced with the fact that just because somebody has qualifications it does not mean they are a competent. This causes great problems.

Remember the common-sense rule: it is always what people do that counts, not what they say they can do.

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A list of registered Human Givens Therapists and how we can help.