Counselling and psychotherapy

British Association for Counselling & Psychotherapy  , (BACP) has stated:

Counselling and psychotherapy seem to be umbrella terms that cover a range of talking therapies. They are delivered by trained practitioners who work with people over a short or long-term to help them bring about effective change or enhance their wellbeing.

The BACP now uses both terms interchangeably when talking about therapists and states:

 ...it is not possible to make a generally accepted distinction between counselling and psychotherapy

Some generally perceived descriptions are as follows: 

Counsellors

• Help people identify problems and crises and encourage them to take positive steps to resolve these issues 
• Provide the best course of therapeutic treatment for anyone who has an understanding of wellbeing, and is able to resolve issues 
• Offer a short-term process that encourages the change of behaviour 

Psychotherapists

• Help people with psychological problems that have built up over the course of a long period of time 
• Help clients understand their feelings, thoughts and actions more clearly 
• Offer a longer-term process of treatment that identifies emotional issues and the background to problems and difficulties 

Making sense of an individual's thoughts, feelings and actions

Both counselling and psychotherapy can be long- term or short-term, they can focus on the here and now or past experiences. They both help someone to make more sense of their feelings, thoughts and actions.

Arguably the process is helped greatly if there is some degree of psychological awareness, but it isn’t necessary. However, counsellors do not tend to rely on analysis and diagnosis of psychological or mental health problems, although they are aware of them and able to identify them and refer on if necessary.

Training

Both counsellors and psychotherapists must undergo in-depth training before they can practise professionally. Both are expected to engage in experiential training which can last for a number of years – four to six if taken to masters level – and gain considerable practise in a voluntary (unpaid) capacity. They also both have to be ‘supervised’ by another trained and experienced professional who will have undergone further training in supervision. There is an expectation that they will continue with continuous professional development (CPD) by regularly attending training courses.

Personal therapy is a requirement of the training and most professionals will attend this as and when they feel they need it over the years. 

Any real differences seem to be in the individual practitioner’s training, theoretical approach and interests as well as the setting in which they work. It is also generally perceived that psychotherapy training takes longer than counselling training. 

Work environment

A psychotherapist might work in a health organisation such as the NHS which might bring them into contact with more severe psychological disorders than a counsellor might see. Counsellors are more likely to work in education or the corporate world as well as in private practice which could gain them more exposure to everyday problems like relationship problems and exam stress. However, in reality both are likely to deal with a great variety of issues with a broad selection of clients. 

Psychotherapy is occasionally confused with psychiatry which is, basically, the study of mental disorders and their diagnosis, management and prevention. Psychiatrists are qualified medical doctors who have specialised and qualified in psychiatry. 

Counselling and psychotherapy have helped many people deal with mental health issues or emotional distress, which can be experienced in many ways including: 

• Anxiety or an inability to cope or concentrate 
• Inability to deal with stress or recover from stressful situations 
• Lack of confidence or excessive shyness 
• Coping with the effects of abuse 
• Feelings of depression, sadness, grief or emptiness 
• Extreme mood swings 
• Difficulty making or sustaining relationships, or repeatedly becoming involved in unsatisfying or destructive relationships 
• Sexual problems 
• Difficulties in coming to terms with losses such as bereavement, divorce or loss of employment 
• Eating disorders 
• Self-harm 
• Obsessive behaviour 
• Panic attacks and phobia 
• Addiction 

Source: UK Council for Psychotherapy 

There are many different approaches in counselling, psychotherapy or talking therapies, the most common ones include: 

• Cognitive behavioural therapies (CBT) 
• Psychoanalytic therapies 
• Psychodynamic therapies 
• Gestalt therapy 
• Transactional analysis therapy (TA) 
• Systemic and family psychotherapy 
• Arts and play therapies 
• Dance and drama therapies 
• Humanistic and integrative psychotherapies 
• Hypno-psychotherapy (Hypnotherapy) 
• Experiential constructivist therapies 
• Group therapies 
• Solution-focused brief therapy 
• Eye movement desensitization and reprocessing (EMDR) 
• Neuro-linguistic programming (NLP) 

Counselling provides a supportive service that creates a safe emotional environment in which an individual can explore difficult personal issues. Fear, anger, abandonment, rejection, trauma and confusion can all be examined and clarified by using the counsellor as a mirror to reflect back the truth of the issues and/or problems, in order to find resolution. 

The rapport and relationship that is built between the counsellor and client is the supportive mirror that allows the client to take action towards creating positive changes in their life. Reflective mirroring, in the form of the trust between client and counsellor, can provide a fresh perspective and make a huge difference to an individual’s emotional life. 

Some myths about counselling 

Although interests in self-development and self-empowerment  are steadily growing there are still, unfortunately, many people who have preconceived ideas about what counselling is all about, and what it can and cannot do. These myths and misconceptions can often be enough to stop someone accessing counselling as a route to self-improvement, because these ideas will influence the potential client in a negative manner. 

Myth: Only people with mental health issues need counselling 

Reality: The vast majority of people, who undergo some form of counselling, do so simply because they are experiencing difficulties and problems with situations that occur in everyday life. Stress caused by these issues can be overwhelming, and may make a person feel that they are unable to cope with the pressures of life. This type of client seeks help from a counsellor so that they can gradually take back control of their life. Counselling can provide empowerment and can also enable a client to view their problems from a clearer perspective. Those suffering from depression and anxiety will also benefit from counselling. 

Myth: Counselling will provide all the answers 

Reality: Although a counsellor will listen and interact with a client, and may even offer different suggestions or actions to try to resolve the client’s issues, he or she will not give advice. The counsellor will merely strive to help a client see things from a different perspective, enabling them to begin to work out their own course of action and maybe rethink their own attitudes and behaviours. 

Myth: Counsellors sit there and say nothing 

Reality: Counsellors are proactive therapists who work with someone to identify core issues and to clarify perspective. They mentally challenge and stimulate a client and encourage the individual to explore their limiting beliefs and ideas with the goal of ultimately facilitating changes in the client’s ways of interacting. 

Myth: Counselling takes forever 

Reality: Counselling takes as long as it needs to. It would be very difficult to put a time limit on the amount of care, thinking space and attention that a client may require. The more complex and severe the issues that a client is dealing with, the longer the counselling process may take. Short-term counselling, that lasts a period of weeks or months, may be sufficient for clients who are more goal- focused. Longer-term counselling however, will concentrate on the development of the client’s mental wellbeing and personality. 

Myth: Counselling will change the client as a person 

Reality: Counselling will allow a client to explore core issues from their past, and to identify ways of moving forward with life. Change is a constant thing, and a client will therefore experience a change in their thinking, from session to session. This is all positive progress that will help the client to free themselves from all the negativity they are mentally carrying around with them. It enables the client to change as much or as little as they feel able to. 

There are several roles within the psychological therapies, including: 

• Assistant clinical psychologists – providing a clinical service under the direction and supervision of a qualified psychologist
• Genetic counsellors – who provide counselling in many diverse areas, for example those related to oncology, genetics, sickle cell anaemia or unplanned pregnancies 
• High intensity therapists – work with clients who have a range of complex problems related to anxiety and depression. 
• Primary care graduate mental health workers – work in primary care settings, such as GP surgeries and clinics and help to improve the management of common mental health problems. 
• Psychological wellbeing practitioners – provide high volume, low intensity interventions for clients with mild to moderate depression 
• Psychologists – deal with the way the mind works and can specialise in various areas such as clinical, counselling, forensic and health psychology 
• Psychotherapists – help people to overcome stress, emotional problems, relationship problems or troublesome habits. 

NHS Careers website: Find out more about these roles

Take a look at the Psychological Professions Network's career map

UKCP - How I became a therapist

An important first consideration for prospective candidates is whether or not their chosen course is accredited by the BACP.  The BACP states: 

BACP course accreditation is recognised by training providers, employers and students as the mark of a high quality, professional practitioner training course. For prospective counsellors and psychotherapists, it guarantees a standard of training accepted for BACP membership, registration and accreditation.

 Source: BACP

If the training course is accredited by the BACP, it should have individual accreditation embedded within the curriculum. If not you will probably have to work through this after qualifying with the help of your supervisor. 

Training courses

Candidates should be aware that counselling training differs from other training courses in a number of ways. 
 
Although courses are described as ‘taught’, they are largely delivered as ‘experiential’. This means that students will engage with each other at a much deeper level through group discussions, process groups and counselling practice groups. These groups foster an atmosphere of sharing personal information, opinions  and experience which can sometimes result in highly charged emotional encounters. This will need to be managed by individual students, the group and the group leader. This can feel threatening or overwhelming at times to some students. 
 
Distance learning courses are not recommended because of the emphasis on experiential learning, requiring interaction to enhance listening and interpersonal skills. Also it is compulsory (and best practice) to have a placement to facilitate real-life counselling practice. Distance learning courses are also not recognised by BACP for accreditation. 
 
It is advantageous to have a depth of self-awareness and to be aware that the course can facilitate changes in your perception, behaviour, self-image and relationships.  While this is a required development, it might not be appreciated by partners, parents, co-workers or friends.

Personal relationships can sometimes be seriously affected. Therefore, personal development and developing better self-awareness will play a big part of this course. It can also be said that a certain degree of ‘life experience’ would be beneficial on this course, in order to be better able to understand, and be empathic with, other students and/or clients. 

Time 

You need to consider the time commitment required by a course. There are requirements for placements which will probably involve working unpaid as a volunteer for a number of years. This might be in the evening or at weekends, in order to accrue the necessary hours needed to practice as a paid counsellor. 
 
The commitment to writing assignments, attending weekend workshops, study time, personal therapy, supervision and attending weekly classes can add up to a large chunk of a your time. The time commitment needs careful consideration, especially if you have a family or work. Training can take place over several years; four years through introduction, certificate, diploma to degree level, followed by an option to specialise or go on to a masters. All in all, it can take up to six or seven years to achieve professional status, a lot of which will have been unpaid. 

Finance 

The cost of the course can be financed with a loan and bursaries. Trainee counsellors must achieve a certain number of practice hours in a volunteer capacity. 

If a course is not accredited, those completing the course will need to become accredited by the BACP which they cannot attempt until they have achieved 460 hours of supervised practice. This can be costly and time-consuming as they will need the support of their supervisor and to pay a BACP fee for administering the process. 
 
During and after training and accreditation, there is an annual requirement for a certain amount of continuing professional development (CPD) which must be paid for. There is also the very real possibility that the student will have to pay for personal therapy and supervision, a requirement for placement, which can add up to a considerable amount over two or three years. It is recommended that personal therapy continues after accreditation, as part of CPD. 

Stage one - Introduction to counselling

Taking an introductory course will help you decide if counselling is the right career for you. This will help you gain basic counselling skills and give you an overview of what the training involves before you commit fully. These courses are usually run at local further education (FE) colleges or adult education centres and last from eight to 12 weeks.  

Source: BACP  

In summary 

• Informal ‘taster’ courses 
• Development of listening skills 
• Introduction to theory of various modalities 
• No requirements for personal therapy, practise or supervision 
• Entry requirement for higher level courses 
• Alternatives are one-year counselling skills and studies courses to springboard onto diploma, degree or masters. 

Stage two - Certificate in Professional Counselling

This course will develop your counselling skills and give you a deeper understanding of counselling theories, ethics and self-awareness. This training may also be useful if your job involves advising or helping people, even if you don't plan to become a therapist. These courses run at local colleges and are generally one year part-time.

Source: BACP 

In summary 

• Introduction to counselling theories (such as: Psychodynamic, Humanistic, Gestalt, Integrative, Transactional Analysis, CBT and Existential) and ethics, practical counselling skills and building self-awareness 
• Usually requires prior attendance on an introductory course 
• One or two years usually at a university or further education college. Also run by some counselling services and professional counselling training organisations 
• Requires a certain number of hours of personal therapy and a supervised placement (working on an unpaid, voluntary basis) are requirements of training 
• Students are expected to be self-funding throughout for personal therapy, placement and often supervision. Some counselling organisations will offer free placement and supervision 

Stage three – Core Practitioner Training 

This course will give you the skills, knowledge and competence to work as a counsellor or psychotherapist. Your core practitioner training should be at the minimum level of a diploma in counselling or psychotherapy, but could be a bachelor's degree, master's degree or doctorate. These courses usually run at further or higher education colleges or universities.

Source: BACP

In summary 

• This is the minimum qualification required in order to practise as a professional counsellor in private practice or within an organisation (such as the NHS) 
• On diploma courses 20 hours of personal therapy and a supervised placement for 100 hours (working on an unpaid, voluntary basis) are requirements of training 
• Students are expected to be self-funding (throughout training) regarding personal therapy, placement and often supervision – some counselling organisations will offer free placement and supervision 

Stage four – BA (Hons) Humanistic Counselling Practice 

Three years full-time and four years part-time course, usually at a university. Often inclusive of diploma qualification awarded if the student leaves the course at end of year two. 
 
Due to BACP accreditation regulations it is advisable to choose a BACP Accredited course. This enables easier access to accreditation to BACP in later stages of training. On degree courses a certain number of hours of personal therapy and a supervised placement (working on an unpaid, voluntary basis) are requirements of training. 
 
A minimum of 40 hours of personal therapy in years one and two and a minimum of 20 hours personal therapy in year three or equivalent professional development i.e. training courses. Students are expected to be self-funding regarding personal therapy, placement and often supervision – some counselling organisations will offer free placement and supervision. 

Stage five (optional) - Postgraduate certificate

Candidates should normally hold an approved first degree in counselling with at least a second-class honours (or equivalent) or an approved professional qualification deemed equivalent to a second-class honours degree. 

Options to study at postgraduate level, that is Advanced Counselling Practice, are usually at a university. One year part-time course will:

facilitate the development of competent and effective practitioners and prepare trainees for counselling in a range of professional contexts.

(Source: BACP) 

There is the opportunity to specialise or diversify by studying different modalities/aspects of practice: psychodynamic, integrative, Gestalt, art therapy, EMDR, solution-focused brief therapy and group therapy. There is also opportunity to gain training in working with children, learning difficulties and trauma. 

Stage six (optional) – masters 

In summary 

• Taught course is a one year full-time or two years part-time study 
• Applicants will need an honours degree (any discipline), lower- second-class or higher or Certificate in Counselling Skills (or equivalent) may also be required 

Two routes: 

• Practice: working as a counsellor with 100 hours practise, working towards or achieved BACP accreditation 
• Applied: working in the caring profession, using counselling skills but not wishing to become a counsellor 

• Practice route requires supervised placement of at least 100 hours. On the Studies route the placement is voluntary and not necessary for academic marks 
• On course requirements for 40 hours of personal therapy funded by the student (both routes) 
• Opportunity to specialise in chosen area, for example, bereavement, PTSD, family therapy and child therapy 

British Association for Counselling and Psychotherapy 

UK Council for Psychotherapy

Sherwood Psychotherapy Training Institute

Temenos Academy

Examples of voluntary organisations

• Barnardos
• Childline
• Cruse Bereavement Care
• Nottinghamshire Sexual Violence Support Services
• Relate
• Samaritans
• The Place 2 Be (Nottingham)