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Counselling versus psychotherapy

I am taking a counselling and psychotherapy class and some of the topics are very relevant to those that are considering getting treatment. For example, what the difference is between counseling and psychotherapy (most people don’t even know there is a difference), what you can expect from treatment, including realistic expectations, and things you can do to prepare for treatment. To keep things simple, I’ll just talk about the difference between the two in this blog.

Cost and duration are two major differences between the two forms of treatment. Counselling is typically short-term (on average 6-12 sessions) and is less expensive than psychotherapy. This cost may be covered by the mental health agency you go to or by your benefits or Employee Assistance Plan (EAP) or the agency may allow you to pay based on your income (called a sliding scale). However, there may be no coverage at all.

Unfortunately, cost can be an issue for both treatment types. Most psychotherapy sessions can run anywhere from $140-200/hour. They are sometimes covered by benefits and sometimes covered by government health insurance (e.g. OHIP), but for the most part, it can be expensive. Unfortunately, the price of treatment for mental health issues is a barrier to getting treatment. If you have someone that can help you make phone calls and look into getting help with you, this can take off some of the burden of sorting out cost.

While counseling may sound more appealing than getting treatment for years, as psychotherapy can often take that long, and it may be cheaper, it may not be the right treatment option for you. If you’re dealing with a mental illness or emotional problems of a more serious nature, 6-12 sessions may only skim the surface. Counselling simply doesn’t allow for the indepth and more intensive analysis that psychotherapy (also called therapy) provides. On the other hand, you may not need to go as deep as you do in therapy and counseling may be a more immediate and appropriate solution for you.

Ok, so how do you know if your issues are serious enough for psychotherapy or if counseling will suffice? There is no easy answer. If you are in crisis, of course calling or going to your nearest crisis centre or hospital is the best option and you should do it immediately - any treatment in fact, is better obtained sooner than later. Not only do you not prolong your misery, but you also increase your chances of getting better and you start to do it sooner. If I were to simplify, I’d put it like this: if what you’re dealing with is an isolated incident as opposed to a lifelong or long-term pattern that you have been dealing with, then counseling may help you to sort that out. For example, you may choose to see a counsellor to help you through your parents divorce or your own divorce, or to help you through a break up, or the death of a loved one. However, if your issues are more deep rooted (started earlier or early on in your life), if they are of a more serious nature, if they are severely affecting your mood, preventing you from having healthy relationships, affecting your school or work performance in a serious way, you may need psychotherapy to go deeper into some of those issues.

When you are assessed, either by a mental health agency, an individual counselor or a psychotherapist, they will let you know if they think their treatment is going to be a good fit for you – or at least they should. You can let them know that you’re unsure of whether counseling or psychotherapy is best for you. But it is important to be aware that there is a difference. Getting the wrong treatment can be discouraging and may turn you off of treatment altogether, when it may simply be a case of it not being a good fit for you. Whatever the case, it is important to keep trying! Maybe the therapist or counselor is not a good fit – but you can still use the treatment as an opportunity to learn about yourself, your needs, what works for you and what doesn’t. Eventually you WILL find something that works and is helpful to you.

There are great similarities between both treatment types as well though. You can expect both treatments to be safe, positive, encouraging and non-judgmental. While counselors may provide you with some guidance to change in the direction you both agree upon, psychotherapists will take a less directive approach and not give advice in order to allow you to freely work through your problems, however, they should both provide a supportive and accepting environment. Both forms of treatment offer you an outlet – it is a place where you can freely say whatever is on your mind with no negative consequences – it is designed to help you through emotions you find difficult, such as shame, guilt, anger, fear or deep sadness, to name just a few. Counseling and therapy are both meant to empower you and give you an opportunity to gain some self-awareness that you may not have previously had. It is meant to improve your quality of life and wellness and in one study, was found to benefit 80% of clients.

Doing something is usually better than doing nothing. If you’re not happy with something, take steps to create change. It likely won’t be easy, but it will be worth it.