Counselling and psychotherapy: what do they involve?
Counselling and psychotherapy are "talking therapies"; they are processes of talking through potentially difficult and sensitive issues in a confidential setting with a trained counsellor or psychotherapist.
The aim of the process is to promote change through insight and through emotional adjustment, although the nature of this change will vary from person to person, depending on the issues they bring, their circumstances, their goals and aspirations and the choices they are willing to make. Defining the aim of the process is one of the first things that the therapist and the client will do together.
Of equal importance to any techniques that a therapist might use are the personal qualities that s/he brings to the work and the rapport that develops between the therapist and the client. Good therapist qualities might include: respect, support and encouragement of personal autonomy; the willingness to explore issues without prejudice or preconceptions; compassionate curiosity; and the provision of a setting which is safe and confidential.
The differences between counselling and psychotherapy
Counsellors and psychotherapists often have very different answers to this question. My own view is that counselling and psychotherapy aim at different types of outcome while employing similar methods.
Counselling generally tends to be more focussed on one or two main issues that the client wants to resolve and is likely to involve a relatively short-term commitment of a few months. Counselling may also be a support for individuals through dark and difficult periods of life.
Psychotherapy is a more exploratory, open-ended process, addressing problems more globally in the context of an individual's life. It might enable broader or deeper change over time; or it might be a preferred option to short-term counselling when problems are particularly longstanding and difficult to overcome.
In practice, both processes contain elements of the other and tend to overlap.
The potential benefits and limitations of therapy
The answer to this question will of course be different for everyone and it is important to understand before embarking on a process of counselling or psychotherapy that specific results are not guaranteed.
Potential benefits include:
stabilisation of difficult moods and emotions
clearer thinking about problems and choices
clarification of personal values and direction
greater emotional awareness
a more solid sense of who one is
clarity about relationships
changes in problematic behaviours
new resources to deal with challenges in life
greater openness to new experiences
Limitations
Counselling and psychotherapy do not cause problems and suffering to disappear; life inevitably continues to bring difficulties and challenges. A good experience of therapy can give someone the resources with which to meet these challenges with greater confidence. While most people who embark on therapy will experience gains, there will always be some cases little improvement is seen and, on rare occasions, there may be a worsening of the condition.
Choosing a suitable therapist
Registration
You should be sure that the therapist you choose is registered or accredited.
At present in the United Kingdom, psychotherapy and counselling are self-regulated professions (that is, they are not regulated by the government).
The two main registration bodies are the UKCP (United Kingdom Council for Psychotherapy) and the BACP (British Association for Counselling and Psychotherapy) (there are other registration bodies, see below). These organisations ensure that therapists and counsellors meet specific professional standards of training, experience, continuing professional development, reflective practice and frequency of supervision, professional indemnity insurance and adherence to professional codes of ethics.
The standards are similar, but not identical, for both organisations.
UKCP registration requires a substantial training period as well as a minimum level of experience. Training typically covers a three to five year period and will involve both academic and practical components. During this time, trainees will also work on supervised placements and in most cases will be required to undertake their own personal therapy. Once the trainee has qualified and has completed a minimum of 450 hours of supervised face to face work with clients, s/he will be eligible to apply for registration with the UKCP.
BACP currently has different levels of membership. Counsellors who are authorised by BACP to practise are indicated by the initials MBACP (member of BACP) and MBACP Accred. (accredited member). In order to become an accredited member (MBACP Accred.), the counsellor will have built up a sufficient supervised post-training experience and possibly meet other criteria, such as completion of further training. BACP uses the terms "counsellor" and "psychotherapist" interchangeably, whereas UKCP makes a distinction.
There are a number of other registration bodies (click here for more information).
Practical considerations
Before starting your search, you may want to think about some basic practical issues, such as:
location - where would you prefer your therapist to be based?
days, times and frequency of sessions
cost - this is often a major consideration when seeking private therapy. Typical costs in the Bristol area range from £30 to £50, with some therapists offering lower rates for those who need them.
specific therapist qualities - sometimes people will have preferences regarding the therapist's gender, age, ethnicity, sexual orientation, religious beliefs etc.