John's Blog

The Blog of John Gibson, PhD


Are "Counseling" and "Therapy" the Same Thing?

Technically speaking, no. But in everyday language these words have become interchangeable.

Consider an example. If you’re looking to make a career change, you can seek out “career counseling” (which I sometimes do, by the way), but no one would mistake this service for psychotherapy. It simply does not have the psychological depth that true psychotherapy does. “Counseling” is a broad term. (An attorney will give you legal “counsel,” for instance.)

Admittedly, the line between “personal” counseling and psychotherapy can be so thin as be appear invisible. Which is probably why these words have come to be used as synonyms for each other. But ideally, therapy should deal with your inner life, your relationships to self, others, and world, and your behavior patterns. “Personal” counseling is concerned with these same processes, though some practitioners shy away from using the counseling label because they think it does not imply the depth that the psychotherapy label does.

Unfortunately, all of this can be a little confusing if you are the person who is trying to get help. Psychotherapy is a pie that’s divided among psychiatrists, psychologists, social workers, and counselors. (There are also pastoral counselors and nurses with graduate degrees in mental health.) These days, most psychiatrists specialize in treating mental disorders with medications, leaving the other occupational groups to duke it out for a piece of the psychotherapy/counseling pie.

Unless you need medication, don’t get too caught up in the title or degree when you’re looking for a mental health practitioner. What you want is the
right practitioner, one who has experience with your type of concern. You also want to feel comfortable with that person. As it turns out, the fit between client and therapist is a bit mysterious. It’s not always clear why one pair clicks and another doesn’t. What we do know, however, is that this bond or connection is crucial to establishing a good working relationship. Indeed, a good relationship is a much stronger predictor of therapeutic success than the title or degree held by the practitioner.

In sum: I don’t care if you call me a psychologist, psychotherapist, therapist, or counselor. Frankly, I am all of these things. What I do care about, however, is whether you and I can establish a productive relationship that is useful to you. The stakes of your emotional life are just too high for it to be otherwise.