What is therapy vs. psychotherapy vs. counselling?
Therapy, in the field of mental health, is when a clinician (mental health professional) meets with a client to discuss concerns. It is also known as “psychotherapy,” a “counselling session,” “talk therapy,” or “individual therapy.” Each clinician has a different way of practicing, known as their “modality,” that they typically specialise in. Examples of modalities include Psychodynamic psychotherapy, Acceptance and Committment Therapy, Cognitive Behavioural Therapy, and Dialectical Behavioural Therapy.
A “session” is the meeting a client has with their clinician. Frequency of sessions depends on what the clinician and client agree is appropriate for the client, whether a few times a week, once a week, once every 2 weeks, or once a month.
How a session is run will look different depending on the clinician’s modality, e.g. whether more structured (clinician has client complete worksheets and in the moment exercises), or less structured (the clinician asking about the client’s history and considers how it may be impacting their present functioning).
What is the difference between a therapist, psychotherapist, counsellor, psychologist, and psychiatrist?
What a clinician calls themselves depends on their training.
“Therapist” and “psychotherapist” are catch-all terms that clinicians use to describe themselves. They could have a training background of any of the categories below.
“Counsellors” have a degree in counselling (typically a two year degree).
“Psychologist” sought a degree in psychology. People with this degree have acquired either a Master (2 years of school) or a Doctorate (5-6+ years of school).
“Clinical psychologist” sought a degree in psychology (Master or Doctorate) and then completed additional supervised hours to receive the specialisation as a “clinical psychologist.”
“Psychiatrist” sought a degree in medicine (MD) but specialised in psychiatry. Often provides diagnoses and prescribes/ manages psychiatric medication. Some psychiatrists decide to provide psychotherapy instead of medication management. Seeing a psychiatrist for therapy means your medicare coverage will be different.
“Social workers” have a degree in social work (typically a two year degree).
Who do therapists see/ who needs therapy?
Clinicians see “clients” or “patients” (interchangeable terms).
People seek individual therapy for a number of reasons, whether they have a diagnosed mental health issue, or they want support discussing recent or past events that have impacted them.
Typically someone decides to see a therapist when they feel their day to day activities, such as their work, school, social, and intimate life are being impacted by how they feel. These issues could be long-standing or have just begun, such as during/ after a stressor, like a lay-off, recent break up, recent diagnosis, or a death to a loved one.
Mental health is closely linked to one’s physical health. As a result, individuals often come to therapy with physical symptoms as much as they do emotional symptoms.
Common physical symptoms adjacent with mental health concerns include:
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Headaches
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Tearfulness
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Sleep issues (too much or too little)
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Appetite/ eating changes (too much or too little)
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Lack of libido
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Tension in the chest
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Digestive troubles
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Racing heart
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Difficulty concentrating
Common emotional symptoms emblematic of mental health concerns include:
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Emptiness
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Loneliness
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Worthlessness
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Irritability
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Lack of interest in previously loved hobbies
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Sense of impending doom
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Indecision
It is common for people to decide to use other coping methods prior to seeking therapy. This could include gambling, use of alcohol or other drugs, promiscuity, eating disorders, and isolation. These coping methods can often become excessive, which is what encourages individuals to urgently require support through therapy.
Therapy helps people feel that they are not alone in their concerns, and that their experience is normal.
What to expect?
What does a therapist’s room look like?/ where do I sit?
A therapist’s office will typically have a chair and a couch, or a number of chairs. Typically, the clinician will have a seat they usually use, most often the chair closest to the door. Feel free to ask the clinician where you should sit if this part makes you nervous, and to move the pillows/ blankets etc. to suit what you might need to be comfortable.
How does a therapy session work?
This is a difficult question, as every clinician has their own way of conducting a session.
Put simply though, in your first session you should assume that you will be invited into the clinician’s office and they will have you complete some final paperwork. Afterwards, they will inform you of your rights to confidentiality and the limits to confidentiality. They will then ask you some questions to help them get to know you further and your intentions of what you would like to get from treatment. If you are unsure of your goals, you and your clinician will come up with them collaboratively. You will also agree upon how frequently you will have sessions.
"The mind is its own place and in itself can make a heaven of hell or a hell of heaven"
Paradise Lost by John Milton