CBT, psychotherapy and counselling are terms you may hear a lot, but not always be sure of what exactly the difference is. Even in the field, professionals can disagree about definitions. Below gives you an idea of the differences and simiarities between these terms.
What is CBT?
CBT is an evidence based talking therapy that suggests that changing unhelpful thinking patterns and behaviours can make us feel a whole lot better.
CBT prefers a ‘here and now’ approach, such that thoughts and behaviours that are maintaining the problems can be tackled, although there is some reflection on the past and how this may have started the difficulties for the client.
CBT has protocols to guide CBT therapists on how to help clients with certain difficulties, which have been rigorously tested and are shown to be effective. However, we know that clients are all individuals and as such all have their differences, so CBT therapists use some flex with these approaches to adapt them to the client.
There are two types of CBT: low intensity and high intensity. Low intensity CBT is often offered as the first step in the NHS and is usually only 4-8 sessions lasting up to 30 minutes each, which are delivered weekly or fortnightly. These sessions usually focus on one or two key techniques due to the limited time of the treatment.
By contrast, high intensity CBT tends to last 8-30 sessions as it goes into more depth of the thoughts, looking at deep seated rules and beliefs, and challenging any unhelpful ones. 60 minute sessions sessions are delivered weekly by a fully trained CBT therapist, who has trained for a number of years (typically 4+ years). CBT therapists are generally accredited with the British Association of Behavioural and Cognitive Psychotherapies (BABCP).
A word of warning: there are always some therapists who say they are a CBT Therapist, but have not actually completed a postgraduate/graduate diploma, masters or doctorate. It can help to check the qualifications of the therapist you intent to work with. If they are also accredited with the BABCP, you know they meet the minimum training standards needed for CBT and continue to advance their skills each year, which is great.
High intensity CBT is the type of CBT we offer at Brighter Life Therapy, and all our CBT Therapists are fully qualified and BABCP accredited.
What is psychotherapy?
Psychotherapy is an umbrella term for lots of different kinds of mental health therapy. Practitioners train for a number of years, and are usually registered with the British Association for Counselling and Psychotherapy (BACP) or National Counselling and Psychotherapy Society (NCPS).
At Brighter Life Therapy, we offer psychoanalytic psychotherapy, which focuses on bringing consciousness to the past including childhood events.
We also offer existential therapy, which uses philosophy to help you better understand the anxieties and uncertainties that arise from the conflicts in our world, and allow you to lead a more liberating life. This a more ‘here and now’ style of approach, but uses the past to promote freedom.
What is counselling?
Counselling is a form of talking therapy designed to help people overcome their current difficulties, drawing particularly on difficulties in the last few weeks, rather than difficulties from the past.
Counselling takes the form of discussions, allowing you to express your feelings. Conversations can be about all sorts of different things that are affecting you at the time, e.g. relationships, childhoods, thoughts, difficult situations, etc. By having the space to talk, the counsellor can guide you to coming up with your own solutions to the difficulties you face.
There are many types of counselling, e.g. person-centred or gestalt counselling, all of which work in slightly different ways to support the client.
Therapists usually train for a number of years in counselling, and then become accredited with the British Association for Counselling and Psychotherapy (BACP).
Similarities and differences between CBT and counselling
As you can imagine, there are many similarities and differences between CBT, psychotherapy and counselling. A lot of people use the terms interchangeably and some therapists seem to offer both, so it can get very confusing! Below is a summary of the similarities and differences:
Similarities:
- CBT, psychotherapy and counselling are usually one to one sessions between the therapist and the client; however, other people can be involved as and when necessary with the client’s consent. Certainly, there are CBT groups out there to help people meet others in a similar position, which provides great peer support.
- Sessions are usually 50-60 minutes and occur weekly (or sometimes fortnightly if needed)
- Counselling, psychoanalytic psychotherapy and CBT have been shown to be effective for low mood or depression, and thus all are offered on the NHS. The client could choose any of those treatments depending on the main problem and the approach the client prefers.
- Both CBT therapists, psychotherapists and counsellors need to train to do their role over a number of years and can become registered or accredited with their own governing bodies.
Differences:
- CBT is generally more protocol-led than most psychotherapies and counselling which prefer a more fluid approach. Therefore, CBT has more structure and a general agenda for each session.
- CBT, existential therapy and counselling are much more based in the ‘here and now’ (although do draw on the past) whereas psychoanalytic psychotherapy looks more at the past.
- Research shows that CBT is most effective for anxiety, whereas counselling is less so, and as such counselling for anxiety is not offered in the NHS.
- There are two main forms of CBT, e.g. low intensity and high intensity, and many types of psychotherapy (e.g. psychoanalytic, existential, etc) and counselling (e.g. person centred).
- CBT is quite an active therapy, in that sessions will include discussing current ways of coping and looking at new, more helpful ways. Sessions tend to use a mix of discussion, little experiments, worksheets, writing on whiteboards, role plays, etc. Psychotherapies can combine discussion techniques with coping strategies too. In comparison, counselling utilises more discussion, with some additional elements of drawing things out such as family trees and other active techniques.
What’s right for me?
It depends on the difficulties you have. As above, part of your decision should be based on what the research evidence suggests. The go-to place to check this out is the National Institute of Health and Care Excellence (NICE). Here you can search for different difficulties and the recommendations for treatment from NICE. However, this can be a bit tricky to navigate. We have written a blog outlining the recommended treatments for depression in more detail here.
Another part comes down to you as an individual and what you want to get out of therapy. If you’re after some techniques and new coping strategies, CBT is probably better suited for you. If you’re looking for a space to process and explore difficulties, including how that’s impacting on you now, and come up with your own solutions, counselling or psychotherapy is probably more up your street.
Most therapists are happy for you to contact them and find out a bit more about their way of working (you can read more about choosing the right therapist here).
Get in touch for further support
If you are interested in using our service, we provide CBT and psychotherapy sessions for children, young people and adults, and can help you to manage your difficulties. Please don’t hesitate to contact us using the enquiry form below.
Get in touch to discuss your counselling needs
and find the right therapist for you
Please fill in the details below, then press ‘submit the form’. Our Clinic Manager, Rhianna, will review the form and be in touch via email within 1 working day to discuss her recommendations. If we can help, we will provide you with a link to book an assessment with the most appropriate therapist.
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