clinical and counseling psychologists are trained to assist a variety of individuals with emotional diffi culties.
Counseling programs, similar to clinical psychology programs, usually teach the various theories of psychotherapy; however, training and supervision in the practice of psychotherapy usually are not part of the education for counseling, i.e., they are not an academic requirement. It is some practioners’ opinion that while psychotherapy tends to involve a complex change in the basic character and often works with unconscious confl icts, counseling tends to be more limited and concerned with the immediate situation. Still, many counselors disagree among themselves about the distinction between counseling and psychotherapy.
There is a growing need in our society to bring out the differences between counseling and psychotherapy. Most of the times, these terms are used interchangeably. Counselors as well as clinical psychologists are trained in talking therapy. While clinical psychologists cater to individuals with severe emotional diffi culties, counselors handle less intense problems. Thus, it can be said that clinical psychologists deal with disease while counselors deal with distress.
While counseling and psychotherapy have several different elements, the following information will also attempt to show the reader that there are some areas where the two disciplines overlap. A fi ne line divides the two topics and one must look carefully to see this division.
Definition of Counseling
A survey by Gustad (1953) suggests a defi nition of counseling in which he includes three key elements. He describes it as a learning-oriented process, which is carried on in a simple, one-to-one social environment, in which a counselor, professionally competent in relevant psychological skills and knowledge, seeks to assist the client by methods appropriate to the latter’s needs and within the context of the total personal program to learn more about himself; to learn how to put such understanding into effect in relation to more clearly perceived, realistically defi ned goals; and to the end that the client may become a happier and more productive member of his society.
In lay terms, counseling can be described as a face-to-face relationship, having goals that help a client to learn or acquire new skills, which will enable him/her to cope and adjust to life situations. The focus is to help a person reach maximum fulfi llment or potential and to become fully functional as a person.
Definition of Psychotherapy
As mentioned before, psychotherapy is well suited to those with psychiatric disorders and can also be very useful for people who lose meaning in their lives and who search for a greater sense of fulfi llment. It is typically used when dealing with severe psychological disorders. The clinical psychologist fi rst diagnoses the symptoms with the help of the Diagnostic Statistical Manual, Fourth Edition (DSM-IV). The DSM-IV is the classifi cation system of psychological disorders. The client must meet the specifi ed criteria for that disorder in order to classify him or her as having a particular disorder. The criteria are often a collection of symptoms exhibited by someone with that particular disorder. The psychologist also notes the duration of time for which the symptoms have been present.
Next, the psychologist, with the help of therapy models which are derived from the theories developed, decides on the type of therapy, which is most appropriate in treating the disorder. Each theory explains disorders differently; therefore,
recommending different treatments. Often, psychologists combine two or more models into their therapy.
In addition to psychotherapy, psychologists may have to recommend medication to calm psychotic clients or stabilize moods so that they become emotionally and cognitively available for talking therapy. As psychologists are by law not allowed to administer medications, clients are sent to a psychiatrist for administering pharmaco treatment or any other drug. Another possible treatment for clients is hospitalization for suicidal and extremely psychotic clients who may be in danger of harming themselves or others. This method of treatment is only meant to stabilize the client and will usually last a couple of days.
Psychotherapy is the process by which a therapist assists the client in reorganizing his or her personality. The therapist also helps the client integrate insights into everyday behavior.
The Practitioners: The Medical and the Non-medical Split Freud strongly supported the idea of lay psychoanalysts without medical training, and he analyzed several lay people who later went on to become leading psychoanalysts like his daughter Anna Freud and Otto Rank. And when Ernest Jones brought psychoanalysis to the UK, he followed Freud’s preference in this area and the tradition of lay involvement continues to this day, where most psychotherapists and counselors do not have a formal education in psychology.
In the United States of America Abraham Adrian Brill insisted that analysts should be medically qualifi ed. In 1926 New York State made lay analysis illegal;
and to this day almost all US psychoanalysts are medically qualifi ed and counselors typically study psychology as undergraduates before becoming counselors. As a psychologist, Rogers was not originally permitted by the psychiatry profession to call himself a psychotherapist. It was largely in response to the US prejudice against lay therapists that Rogers adopted the word counseling originally used by the social activist Frank Parsons in 1908.
Objectives of Counseling
The objectives of counseling, according to the Committee on Defi nition, Division of Counseling Psychology, American Psychological Association are to “help individuals toward overcoming obstacles to their personal growth, wherever these may be encountered, and toward achieving optimum development of their personal resources” (Arbuckle, 1967). Dr T. Millard, stated that “counseling provides clarity and a positive and constructive venue for the individual to sensibly examine the instinctive-emotional and rational (or irrational) motives which determine the drive, content, and even the form of human conduct.”
Objectives of Psychotherapy
According to Everett Shostrom (1967), the goal of psychotherapy is to help the client become an actualizer, a person who appreciates himself and others as persons rather than things, and who has turned his self-defeating manipulations into self-fulfi lling potentials (p. 9). Shostrom also felt that awareness is the goal of psychotherapy.
“The reason is that change occurs with awareness!” (1967, p. 103); that awareness is a form of non-striving achieved by being what you are at the moment, even if what you are means the phony manipulative role that we all play sometimes for external support (1967, p. 103).
Focus
The main difference between counseling and psychotherapy lies in their focus.
Counseling focuses on the “here and now” reality situations, whereas psychotherapy focuses on the unconscious or past issues, which could have had an impact on, and led to, the present problem. Counseling and psychotherapy also differentiate with regard to the level of adjustment or maladjustment of the client. Counseling holds an emphasis on “normals.” One could classify “normals” as those without neurotic problems but those who have become victims of pressures from the outside environment. The emphasis in psychotherapy however is on “neurotics” or those with other severe emotional problems. Counseling can also be described as problem- solving whereas psychotherapy is more analytical.
Duration of Therapy
Psychotherapy tends to last longer, with sessions ranging from two to fi ve years.
Psychotherapy aims at a comprehensive re-education of the client. The intensity and length of therapy depends on how well the client can deal with all of the new found information. It could take quite sometime for the client to be able to live with these feelings, which originated in past experiences that are usually hurtful. A psychotherapist also needs time to modify all existing defenses.
Duration of Counseling
Counseling, as opposed to psychotherapy, is generally short term––8 to 20 sessions, sometimes even less. As people seeking counseling are fairly healthy and function cognitively well, the duration of problem identifi cation to problem solving is relatively shorter. Counselors should refrain from long term counseling as it can tax a person’s fi nances and schedule. It can also lead to undesirable dependency on the counselor. Also, long term commitment to problem solving is impractical and demotivating.
Setting
The setting of treatment between counseling and psychotherapy is also different.
A counseling session usually takes place in a nonmedical setting, such as an offi ce.
Psychotherapy is conducted in a medical setting such as a clinic or a hospital.
Transference Issues
Another difference between counseling and psychotherapy is with regard to transference. Though the counselor develops a close personal relationship with the client, she/he does not encourage or allow strong feelings to develop as she/
he feels that they interfere with the counseling process or render the counseling ineffective. Some counselors are also uncomfortable with the client’s transferences.
But the psychotherapist uses the transference to get an insight into the client’s unconscious.
Resistance
Resistance is another area of counseling that tends to differ with psychotherapy.
Counselors see resistance as opposing or going against problem-solving and therefore try to reduce resistance as much as possible. On the other hand, a psychotherapist fi nds resistance to be very important. Much insight is got from understanding the clients’ resistance. The therapist can then understand how to help the client change his or her personality.
Similarities between Counseling and Psychotherapy
Clearly there are many differences between counseling psychotherapy. However, there are some similarities too. Counseling and psychotherapy both concern themselves with elements that build a person’s personality. Each of these processes deal with attitudes, feelings, interests, goals, self-esteem, and related behaviors, all of which are affected by counseling and psychotherapy.
Both counseling and psychotherapy involve talking with the client. The communication and skills involved in both the processes are the same. The attitude of respect, empathy, and genuineness with which the psychologist approaches the client is the same. They are similar in the sense that each client brings with him or her assets, skills, strengths, and possibilities needed by them for therapy. Counseling and psychotherapy are similar in the way that they both use an eclectic approach.
The counselors and therapists do not use a particular technique, but they borrow from all different techniques.
Professional Opinions
Not all therapists feel that there is a distinction between counseling and psychotherapy. C.H. Patterson feels that it is impossible to make a distinction; and that that the defi nition of counseling applies equally to psychotherapy and vice versa.
Donald Arbuckle (1967) argues that counseling and psychotherapy are identical in all essential aspects. Others believe that there is a distinction. Psychotherapy is concerned with some type of personality change whereas counseling is concerned with helping individuals utilize their full coping potential. In Donald Arbuckle’s work, he included Leona Tyler’s thoughts on the differences between counseling and psychotherapy. Leona Tyler attempts to differentiate between counseling and psychotherapy by stating “to remove physical and mental handicaps or to rid of limitations is not the job of the counselor, this is the job of the therapist, which is aimed essentially at change rather than fulfi llment” (Arbuckle 1967).
Arbuckle argues that “counseling and psychotherapy are in all essential respects identical” (1967, p.144). He states that the nature of the relationship, which is considered basic in counseling and psychotherapy, are identical. Secondly, Arbuckle says that the process of counseling cannot be distinguished from the process of psychotherapy. Thirdly, he feels that the methods or techniques are identical.
Arbuckle lastly states that in the matter of goals and/or outcomes may appear to be differences but no distinction is possible.
Today the divide is largely academic. The use of psychoanalysis to denote long- term therapy adhering to the dynamic tradition and counseling to short-term work is largely prevalent. The two terms are used interchangeably in the United States with the obvious exception of guidance counseling, which is often provided in educational settings and focuses on career and societal issues.