Counselling and Psychotherapy

"Counselling takes place when a counsellor sees a client in a private and confidential setting to explore a difficulty the client is having, distress they may be experiencing or perhaps their dissatisfaction with life, or loss of a sense of direction or purpose. It is always at the request of the client as no one can properly be sent for counselling".   B.A.C.P. definition.

There can be a lot of confusion between the terms counselling and psychotherapy and in practice when time is spent focusing on one issue, another, deeper one may well emerge later on. I have worked with grieving clients who were being held back by relational issues, once these were successfully addressed, they were able to move on with working through their grief. Although registered by the B.A.C.P. to provide both (Counselling Directory) I don't differentiate between the roles but aim to focus on the needs and wishes of each client and create the most effective treatment plan tailored to their needs, adapting these when necessary or beneficial.

The confusion is also not helped by the wide range of alternative therapies on offer, and the equally wide range of levels of training, experience and supervision. There are no legal definitions or protections for the title of Counsellor or Psychotherapist, it is quite possible for someone with nothing but enthusiasm and the money for a weekend course to set up in practice on the following Monday. 

My formal training (four years post graduate, at Master's level) required continued supervision of my work, personal therapy at the professional level I practice at and adherence to very strict codes of practice. A lot of what we learn is counter-intuitive - even having completed a Diploma in counselling and psychotherapy, I was still required to take a further exam before being accepted onto the formal register. If you would like to know more there is a video on YouTube about their Certificate of Proficiency  

Counselling

Sometimes we experience moments in our lives where we need help to overcome, or understand a problem. We may be lucky enough to have friends or family who understand the skills required to help through 'active listening', but how much time can they spare? There may also be things that you would rather talk through with an independent stranger, someone whose discretion you can trust absolutely. 

Counselling offers the chance to talk with a trained professional and work through issues - to return to how we were before.

Psychotherapy

Psychotherapy tends to be a deeper, longer term process to discover and treat the cause rather than the symptoms.

A psychotherapist can offer counselling, the reverse may not be possible. Just as a decorator and a builder can both fill in a crack, the builder can use their skills to understand what caused the crack in the first place then take the necessary action. 

It is also worth bearing in mind that unusual conditions (a drought with a building, a divorce marriage or bereavement for a person) can prove to be the last straw. Preventative work beforehand can be quicker, cheaper and far less painful.

To take the 'house' metaphor a stage further, a competent builder will have props and supports in place before repairs are undertaken, understand the work to be carried out and possible risks then work carefully and safely. A competent therapist will work in a similar way with traumatised clients. Just as a well meaning but inexperienced person may make a problem far worse when tackling building repairs with little more than enthusiasm and a sledge hammer, so a 'let's bring your problem out into the open as quickly as possible and you'll be cured' approach can have serious and long term consequences. Perhaps a better comparison would be based on who you would prefer to tackle an unexploded bomb.

Just to complicate things a bit more, I am also trained and experienced in a third area - 

Pastoral Care

Where counselling and psychotherapy have the aim of helping a client make changes to their life, pastoral care is more about being someone as they face difficult challenges. The relationship is more open, with a more equal sharing of personal details. As we may be meeting only once, or a few times, this helps to establish a relationship - with one end of life client this enabled me to find a way we could communicate at a point where they were no longer able to say anything more than single words.

Although there are boundaries and limits between this and counselling / psychotherapy, a lot of the core skills are the same. A member of the British Humanist Association, I was trained and accredited by them to provide non-religious pastoral care. In practice this means I can work alongside fellow members of a chaplaincy team - whilst we are all available to any patient if required, there may be times when patients have a preference. I have also been asked to provide support privately. 

About half of the population of the UK now select ‘none’ when asked to state their faith. All of us are likely to end up in hospital at some point and can all have general concerns on non-medical issues as well as facing challenges over our beliefs.  Just as the religious may wish to chat with someone who shares their background, experience has shown that those without a faith may wish to do the same. Whilst my training and background cover working equally with all regardless of faith, race, gender, sexuality or background, I may be of particular interest to someone who has no faith, or who wishes to talk to someone with a neutral background.