The process through which words and concepts are defined is fascinating. By definition, definitions need to be sharp and make distinctions, and yet they also sometimes be inclusive and blurry on the edges.
In the latest (3rd) edition of Counseling and Psychotherapy Theories in Context and Practice, Rita and I take aim at the definitions of counseling and psychotherapy. Read on, and if you’re inspired to do so, let me know what you think.
Definitions of Counseling and Psychotherapy
Many students have asked us, “Should I get a PhD in psychology, a master’s degree in counseling, or a master’s in social work?”
This question usually brings forth a lengthy response, during which we not only explain the differences between these various degrees but also discuss additional career information pertaining to the PsyD degree, psychiatry, school counseling, school psychology, and psychiatric nursing. This sometimes leads to the confusing topic of the differences between counseling and psychotherapy. As time permits, we also share our thoughts about less-confusing topics, like the meaning of life.
Sorting out differences between mental health disciplines is difficult. Jay Haley (1977) was once asked: “In relation to being a successful therapist, what are the differences between psychiatrists, social workers, and psychologists?” He responded: “Except for ideology, salary, status, and power, the differences are irrelevant” (p. 165). Obviously, many different professional tracks can lead you toward becoming a successful mental health professional – despite a few ideological, salary, status, and power differences.
In this section we explore three confusing questions: What is psychotherapy? What is counseling? And what are the differences between the two?
What Is Psychotherapy?
Anna O., an early psychoanalytic patient of Josef Breuer (a mentor of Sigmund Freud), called her treatment the talking cure. This is an elegant, albeit vague, description of psychotherapy. Technically, it tells us very little but, at the intuitive level, it explains psychotherapy very well. Anna was saying something most people readily admit: talking, expressing, verbalizing, or sharing one’s pain and life story is potentially healing.
As we write today, heated arguments about how to practice psychotherapy continue (Baker & McFall, 2014; Laska, Gurman, & Wampold, 2014). This debate won’t soon end and is directly relevant to how psychotherapy is defined (Wampold & Imel, 2015). We explore dimensions of this debate in the pages to come. For now, keep in mind that although historically Anna O. viewed and experienced talking as her cure (an expressive-cathartic process), many contemporary researchers and writers emphasize that the opposite is more important – that a future Anna O. would benefit even more from listening to and learning from her therapist (a receptive-educational process). Based on this perspective, some researchers and practitioners believe therapists are more effective when they actively and expertly teach their clients cognitive and behavioral principles and skills (aka psychoeducation).
We have several favorite psychotherapy definitions:
- A conversation with a therapeutic purpose (Korchin, 1976, p 281).
- The purchase of friendship (Schofield, 1964, p. 1).
- When one person with an emotional disorder gets help from another person who has a little less of an emotional disorder (J. Watkins, personal communication, October 13, 1983).
What Is Counseling?
Counselors have struggled to define their craft in ways similar to psychotherapists. Here’s a sampling:
- Counseling is the artful application of scientifically derived psychological knowledge and techniques for the purpose of changing human behavior (Burke, 1989, p. 12).
- Counseling consists of whatever ethical activities a counselor undertakes in an effort to help the client engage in those types of behavior that will lead to a resolution of the client’s problems (Krumboltz, 1965, p. 3).
- [Counseling is] an activity … for working with relatively normal-functioning individuals who are experiencing developmental or adjustment problems (Kottler & Brown, 1996, p. 7).
We now turn to the question of the differences between counseling and psychotherapy.
What are the Differences Between Psychotherapy and Counseling?
Years ago, Patterson (1973) wrote: “There are no essential differences between counseling and psychotherapy” (p. xiv). We basically agree with Patterson, but we like how Corsini and Wedding (2000) framed it:
Counseling and psychotherapy are the same qualitatively; they differ only quantitatively; there is nothing that a psychotherapist does that a counselor does not do. (p. 2)
This statement implies that counselors and psychotherapists engage in the same behaviors—listening, questioning, interpreting, explaining, and advising—but may do so in different proportions.
The professional literature mostly implies that psychotherapists are less directive, go a little deeper, work a little longer, and charge a higher fee. In contrast, counselors are slightly more directive, work more on developmentally normal—but troubling—issues, work more overtly on practical client problems, work more briefly, and charge a bit less. In the case of individual counselors and psychotherapists, each of these tendencies may be reversed; some counselors work longer with clients and charge more, whereas some psychotherapists work more briefly with clients and charge less.
A Working Definition of Counseling and Psychotherapy
There are strong similarities between counseling and psychotherapy. Because the similarities vastly outweigh the differences we use the words counseling and psychotherapy interchangeably. Sometimes we use the word therapy as an alternative.
To capture the natural complexity of this thing called psychotherapy, we offer the following 12-part definition. Counseling or psychotherapy is:
(a) a process that involves (b) a trained professional who abides by (c) accepted ethical guidelines and has (d) competencies for working with (e) diverse individuals who are in distress or have life problems that led them to (f) seek help (possibly at the insistence of others) or they may be (g) seeking personal growth, but either way, these parties (h) establish an explicit agreement (informed consent) to (i) work together (more or less collaboratively) toward (j) mutually acceptable goals (k) using theoretically-based or evidence-based procedures that, in the broadest sense, have been shown to (l) facilitate human learning or human development or reduce disturbing symptoms.
Although this definition is long and multifaceted, it’s still probably insufficient. For example, it wouldn’t fit for any self-administered forms of therapy, such as self-analysis or self-hypnosis—although we’re quite certain that if you read through this definition several times, you’re likely to experience a self-induced hypnotic trance state.
*To learn more about our Counseling and Psychotherapy Theories text, all you have to do is Google it. If you’re looking for an instructor’s copy, Google the book title and then go to the Wiley website and request one. If you have troubles with that, email me . . . and I can likely help out.