What’s the difference, and why it often doesn’t matter
The terms “counseling” and “psychotherapy” are frequently used as synonyms, and in most cases there’s no real objection to that. They can indeed happen together. If one were to make a distinction, though, it would be fair to say that counseling is the process of guiding the client to find a solution to their problem. That solution may be quite straightforward or it may be a more complex one incorporating some of the elements of psychotherapy.
Psychotherapy is a healing process in which the client is attempting to correct long-standing non-adaptive behavior. It is a process of exploring issues from the past which are stored in the subconscious and which are, in fact, the dominant force in determining how a person thinks, feels, and behaves in the present. It is a therapeutic relationship between the therapist and the client in which revelations, new insights, and new possibilities are uncovered.
Expanding on the distinction
Counseling is generally more present and problem-focused. The person comes in with a very clear issue in mind (relationship difficulty, a work issue, bereavement following a loss, substance use, a life change, etc.) and the work is about understanding what’s going on and working out how to move forward. The counselor provides support and guidance and facilitates a structured conversation that helps the client clarify their options and take action. It’s a relatively short-term form of work (weeks or a few months), though it can be continued if needed. The focus is on the present and on the client’s ability to find solutions.
Psychotherapy, on the other hand, usually goes much further. It’s about dealing with the patterns that keep on recurring (the ways of thinking, feeling, and relating that started off earlier and which still have an effect on our current experience). It’s a collaborative process with the therapist and client working together to bring those patterns into awareness so that they lose some of their automaticity. Greater understanding leads to greater choice. It can be a longer-term process and is often more experiential in that it’s not just about what is said but how it is said, what is suppressed, and what comes up in the room.
In practice, the line is rarely that clear. Effective counseling often involves an element of deeper exploration, and psychotherapy will almost invariably involve some degree of practical problem-solving in the here and now. Many licensed professionals (including LPCs) are trained to do both and will move fluidly between the two depending on what the client requires on any particular day.
How this looks in Gestalt work
In my experience, the difference is less important than the quality of attention we bring to the here and now. Gestalt therapy is all about what is happening in the moment (the thoughts, the feelings, the body sensations, the way we relate to each other) rather than treating the past as a separate entity to be studied from afar. The past is relevant in the present when it is still active, and it usually shows up in session through interruption, recurrence, or the way we make or avoid contact. The aim is greater awareness, and awareness itself is the work. When a person can see more clearly what they are doing and what it is costing them, then choices which previously were not available to them often do become available.
This can be used for both the more targeted objectives of counseling and the longer-term work of psychotherapy. Some people will be looking for help with a particular issue and will finish once that’s been sorted. Others will stay on for longer because the patterns are more entrenched or because the relationship itself becomes a space in which new ways of relating can be explored. Either route is perfectly acceptable. The important thing is that it’s a collaborative process and that the client is the expert on their own life.
Choosing what you need
You don’t have to pre-emptively decide whether you need “counseling” or “psychotherapy.” Most people just know they want a conversation that is more honest and more useful than the ones they’re currently having with themselves. The first session is free, and there is no obligation at all. We can talk about what’s going on, what you’d like to see as the outcome, and whether the way I work seems appropriate.
Further reading
For a clear-cut overview of the differences, see this outside article.
