Psychotherapy vs. Counseling: Overcoming Anxiety & Mental Illness

Medically reviewed by April Justice, LICSW and Majesty Purvis, LCMHC

Updated February 5th, 2025 by BetterHelp Editorial Team

Content warning: Please be advised, the below article might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.

Although the terms counseling and therapy are often used interchangeably, there may be differences between them that mean one or the other could be better suited to your needs. Generally, mental health providers, such as therapists and counselors, can both give advice to clients to help them handle specific issues, but mental health counseling tends to involve short-term therapy, while psychotherapy is usually more long-term.

Psychotherapy, often conducted by clinical psychologists, helps people with past traumas and core issues that may be the underlying reasons for present behavior. Meanwhile, counseling provided by trained counselors tends to focus more on the current problem and life transitions.

If you believe you'd get value from therapy, you may wish to try it online.

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Psychotherapy vs. counseling for mental illness

Psychotherapy and counseling generally depend on a strong, trusting relationship between you and your chosen mental health professional. Both psychological methods usually rely on talking to work through emotional problems and mental health concerns.

However, there tend to be differences in the way counseling and psychotherapy function. Psychotherapy, often provided by clinical psychologists with a doctoral degree in psychology or a related field, usually relies on working with your therapist to understand overall patterns and how past experiences may have brought you to your current situation. In contrast, counseling, conducted by mental health counselors or family therapists specializing in marriage and family issues, is often more focused on the present, recent events, and their impact on your well-being. Counselors may offer individual, group, or family therapy, among other formats. If you're interested in learning about psychotherapy vs. counseling, read on to discover their differences and similarities.

Therapy for mental illness

A therapist may use both short-term therapy and psychotherapy to treat their clients, addressing issues like substance abuse, bipolar disorder, and how to manage stress. Mental health professionals who provide psychotherapy often have a master's degree, but others have completed medical school to become psychiatrists, who can prescribe medications in conjunction with therapy. Psychotherapists typically focus on determining the causes of chronic emotional concerns and understanding clients' feelings. They are often concerned with a person's thoughts, how they draw conclusions, and their reasoning for their behavior. Psychotherapists may treat clients on a long-term basis and help them make significant and lasting changes to their lives, such as how to improve relationships. They can sometimes fundamentally alter the way their clients see and adjust to the happenings in their world.

Psychotherapists can practice a number of therapeutic modalities, such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and psychoanalytic therapy. Cognitive-behavioral therapy, for example, is a modality focused on helping clients understand the connections between their thoughts, emotions, and actions. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), people participating in CBT can alleviate symptoms of mental health conditions by learning to replace unhelpful beliefs and developing useful coping skills.

Counseling for mental health: Cognitive behavioral concepts

A counselor is sometimes seen as an advisor who works with a client to find solutions to specific issues on a short-term basis. A counselor has often received training as a social worker or other mental health professional, although this is not always the case. They usually focus on present behavior with the idea of helping the client find ways to change it, and they generally rely on talk therapy. Cognitive behavioral concepts, such as identifying negative thought patterns and developing coping strategies, are often incorporated into counseling to promote healthier behaviors. Counselors may give advice and suggestions to handle grief, career frustrations, relationship concerns, and more.

When should I see a counselor or a therapist? Psychotherapy vs. counseling

You may decide to see a counselor when:

You’d like guidance regarding short-term concerns.
You’d like to learn coping skills for stress or relationship problems.
You’re finding it difficult to adjust your lifestyle to present challenges.
You’re experiencing concerns about substance use.

You may decide to see a psychotherapist when:

You need help coping with traumas from your past.
You have a chronic medical problem that is causing emotional stress.
You have been diagnosed with a mental health disorder.
You have seen a counselor, and they suggested further treatment.

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How does therapy work for conditions like anxiety or bipolar disorder?

Psychotherapy may be effective at finding the root cause for depression and other disorders. This type of therapy may discover that something in the past is responsible for your current mental health challenges. It can be difficult to determine if events in your past are affecting your mental health in the present, but a trained therapist may be able to identify whether traumatic events in the past are subconsciously affecting your present decisions, motivations, and behaviors.

A psychotherapist is often skilled in the use of many different types of therapy. They may rely on the therapeutic relationship with their clients to achieve an understanding of which therapeutic modality to use. The choice of therapy can depend on the diagnosis needs of the client, and format (e.g., individual, group, or family therapy). For example, a marriage and family therapist may utilize principles of dialectical behavior therapy when helping a couple address a mental illness that’s affecting their relationship.

How does counseling (talk therapy) work?

Effective counseling tends to involve a healthy therapeutic relationship in the same way therapy does. The general goal of counseling is usually to use talk therapy to help clients work through the concerns that are affecting them negatively. Counselors often listen and provide feedback . They may not provide answers directly but guide their clients to uncover answers for themselves.

Counselors may discuss present behaviors and help you understand how these behaviors elicit unwanted results. They may work to understand you and your life by asking questions that reveal your thought processes. The more they know about you, the more effective their counseling may be.

Explore online therapy for mental health concerns

Therapy can be an appropriate treatment for a variety of mental health concerns, such as anxiety, depression, stress, phobias, and personality disorders. If you are experiencing challenges that make it difficult to visit a therapist’s office, you might try online therapy, which has been shown by medically-reviewed studies to be just as effective as in-person therapy. One of the advantages of choosing online therapy over traditional in-person therapy is that you can connect with a licensed therapist from the comfort of your own home at a time that fits into your schedule. In addition, it’s often just as affordable as in-person therapy without application of insurance.

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Address your mental health concerns with a professional

Try online therapy

Takeaway

If you have questions about whether therapy vs counseling would be best for you, you don't have to navigate this process alone. With BetterHelp, you can choose from among thousands of mental health professionals with experience in both counseling and therapy, who often use terms interchangeably. Also, you can change therapists or counselors if needed until you find the right fit for your particular needs. They can share feedback and provide other helpful reports to guide you on your journey. Take the first step and get matched with a BetterHelp professional today.

Frequently asked questions

Read more below for answers to questions commonly asked about this topic.

Is a psychotherapist better than a psychologist?

Determining whether a psychotherapist is "better" than a psychologist for your needs depends on several factors, including your concerns, your therapeutic goals, and the specific qualifications and expertise of the individual professionals you're considering.

When seeking professional help, it's essential to understand the distinctions between psychotherapists and psychologists:

Qualifications and training

Typically, a psychotherapist can come from various educational backgrounds and may have training in different therapy modalities. Psychotherapists focus on treating clients through talk therapy and may be trained in specific approaches like cognitive-behavioral therapy, psychodynamic therapy, or other therapies. Psychologists, especially clinical psychologists, usually hold a doctoral degree (Ph.D. or Psy.D.) in psychology and have extensive training in psychological testing, assessment, research methods, and therapy. They can diagnose and treat a range of mental health conditions using various therapeutic techniques.

Approach to treatment

If your needs are more aligned with talk therapy to address life's challenges, relationship issues, or personal growth, a psychotherapist might be a good fit. However, if you require psychological testing, diagnosis, or treatment for more complex mental health conditions, a psychologist might be more suitable.

Other therapies and treatments

Both psychologists and psychotherapists can offer a range of therapies. The best choice depends on your needs and how well a particular approach aligns with your therapeutic goals. Some therapists may combine different therapies to provide more comprehensive and tailored treatment.

The effectiveness of therapy depends more on the individual professional's experience, your therapeutic relationship, and their alignment with your specific needs and goals. It may be necessary to explore both options before deciding which professional is the best fit for you.

Do I need counseling or talk therapy?

Deciding between counseling and psychotherapy largely depends on your specific needs and the nature of the issues you're facing. Both counseling and psychotherapy offer valuable avenues for support and healing, but they have distinct focuses that make them suitable for different challenges.

Counseling typically deals with present-day problems and offers support for current issues, decision-
making, and managing specific life transitions or stressors. Counseling tends to be more short-term and focused on specific present issues or goals. Counseling might be the most beneficial approach if you face immediate challenges, such as relationship difficulties, work stress, or coping with recent life changes.

Psychotherapy, on the other hand, is often more long-term and addresses deeper emotional difficulties.

Therapy is particularly beneficial if you've experienced past trauma. Psychotherapy aims to explore and

understand behavior and thought patterns that have developed over time, often rooted in past events or

experiences. It can help you unpack complex emotional issues, understand the impact of past trauma on your current life, and work towards deep-seated change and healing.

If your concerns are more focused on resolving or understanding deeper psychological concerns,
particularly those stemming from past experiences, psychotherapy may be a better choice. It provides a
space to explore and heal from past traumas and understand how these past experiences influence your current behavior and feelings.

Both counseling and psychotherapy can be immensely beneficial, and the best choice depends on your

specific situation, the nature of the challenges you're facing, and your personal goals for therapy. In some cases, a combination of both might be ideal. A consultation with a mental health professional may help you determine the most suitable approach for your needs.

Can a therapist diagnose?

To practice psychotherapy, a professional must hold a license in their state and follow specific guidelines and ethical standards. Depending on their education, training, and experience, psychotherapists may have different abilities to diagnose mental health conditions.

Some states allow licensed therapists, such as social workers or counselors, to make diagnoses and treat mental health disorders. However, only licensed psychologists can provide an official diagnosis of a mental health condition.

Researching and asking about a professional's qualifications and experience before engaging in therapy is essential. If you're seeking an official diagnosis, make sure to choose a licensed psychologist or another qualified professional who is trained in diagnosing mental health conditions.

What is the difference between a counseling psychologist and a psychotherapist?

The difference between a counseling psychologist and a psychotherapist lies in their training, scope of
practice, and, often, their approach to treatment, particularly in how they address a person's feelings and emotional well-being.

Counseling psychologists typically hold a doctoral degree in psychology and are trained in various
psychological theories and techniques. They focus on helping individuals cope with everyday stressors
such as career challenges, relationship problems, stress management, and life transitions.

Counseling psychologists pay close attention to a person's feelings regarding current life situations and

work to develop strategies to help clients manage these feelings. Their approach is often more holistic,

considering the individual's environment, cultural background, and life experiences.

Psychotherapists, on the other hand, may come from various educational backgrounds (including
psychology, social work, counseling, or psychiatry) and are trained in specific therapy modalities. They address a broader range of mental health issues, including psychological disorders like depression or
anxiety.

Therapists explore past experiences, traumas, and unconscious processes that may influence a person's emotional state. Their work is often more intensive and long-term, focusing on uncovering and healing underlying mental health conditions.

Both professions are equipped to address mental health concerns and can provide valuable support to

individuals seeking help. However, the approach and depth of exploration can vary. The choice between

the two depends on the individual's specific needs and goals for therapy.

Do I need therapy, or am I just overreacting?

Determining whether you need therapy is not about whether you are "just overreacting." This decision is about assessing your mental health needs and recognizing that seeking help can be a proactive step toward improvement.

A helpful report from The World Psychiatric Association indicates that psychotherapies can result in the improvement of quality of life in most mental disorders. This research underscores the broad effectiveness of therapy for a range of mental health challenges.

It's important to understand that therapy isn't just for severe or diagnosed mental disorders. Psychotherapy can be beneficial for anyone who is experiencing emotional distress, persistent negative thoughts, or challenges in coping with daily life. Common reasons for seeking therapy include feeling overwhelmed, persistent anxiety or sadness, difficulty coping with stress, relationship issues, or wanting to understand oneself better.

If you're questioning whether your reactions or feelings are '"normal" or if they warrant professional help, you may consider the following:

Duration and intensity: If your feelings are intense and persistent over a prolonged period, it may be worth seeking professional advice.
Impact on daily life: If your emotional state affects your ability to function — in your job, relationships, or daily routine — therapy can provide support and strategies to cope more effectively.
Desire for change: If you seek change or a better understanding of your emotional responses, therapy can offer insights and tools to support your personal growth.

Seeking therapy is a sign of strength and self-awareness, not weakness or overreaction. Therapy is a proactive step towards improving your mental health and overall quality of life.

Is it common for a therapist to see a therapist?

It is quite common for therapists to see a therapist themselves. Many therapists are either currently in therapy or have received therapy at some point in their careers. There are several reasons why therapists might choose to engage in therapy:

Self-awareness and personal growth: Therapists, like anyone else, can benefit from gaining deeper self-awareness and working through their own personal issues. Therapy provides a space for them to explore their feelings, thoughts, and behaviors, which is crucial for their well-being and professional effectiveness.
Counteracting burnout: The nature of therapeutic work can lead to emotional exhaustion and burnout. Therapists often deal with heavy and complex issues, and this can take a toll on their mental health. Seeking therapy helps them manage stress, prevent burnout, and maintain emotional and mental resilience.
Professional development: Therapy can also be a form of professional development for therapists. It helps them better understand the therapy process from the client's perspective, gain insights into different therapeutic techniques, and refine their counseling skills.
Ethical practice: Many in the field consider it an ethical responsibility for therapists to manage their mental health to provide the best possible care to their clients. Therapy helps ensure their personal issues do not interfere with their professional responsibilities.

Therapists seeking therapy is a common and healthy practice. Therapy supports their personal well-being, enhances their professional capabilities, and ensures that they provide the most effective care to their clients.

What are the disadvantages of therapy?

Therapy can be a highly effective tool for mental health treatment, but it does have certain disadvantages that are important to consider:

Requires several sessions: Often, the initial appointment with a therapist is not sufficient to fully diagnose a mental illness or create a comprehensive treatment plan. The therapist may need several sessions to understand an individual's challenges and develop an effective treatment strategy. As a result, therapy can be time-consuming and may require patience as the process unfolds.
Financial commitment: Therapy can be costly, especially if it requires multiple sessions over a lengthy period. While some insurance plans cover mental health services, the extent of coverage can vary, potentially making therapy a significant financial commitment.
Emotionally challenging: Therapy often involves examining deeply personal and sometimes painful emotions or memories. While ultimately beneficial, this process can be emotionally challenging, particularly in the initial stages.
Time and effort: Therapy requires not just a financial investment but also a considerable investment of time and personal effort. Attending regular sessions and working on oneself outside of these sessions can be demanding, especially for individuals with busy schedules.
Finding the right therapist: It can sometimes be challenging to find a therapist who is the right fit in terms of their therapeutic approach, specialization, and personality. The process may require trying out several therapists, which can be time-consuming and potentially frustrating.

Despite these drawbacks, many find that the benefits of therapy — such as improved mental health, greater self-awareness, and the development of coping strategies — outweigh the disadvantages. Being aware of these challenges can help individuals set realistic expectations and prepare for the therapy process.

Is psychotherapy effective for improving mental illnesses, like anxiety or bipolar disorder, through cognitive behavioral therapy?

Psychotherapy is widely recognized as an effective intervention for many psychological, behavioral, and somatic problems and disorders. It is rightfully considered the primary line of treatment in mental and somatic health care management. The efficacy of psychotherapy, including approaches like Cognitive Behavioral Therapy (CBT), has been demonstrated through extensive research and clinical studies, which show that it can lead to improvements in various areas of mental health, such as anxiety and bipolar disorder.

Several key points highlight the effectiveness of psychotherapy:

Wide range of applications: Psychotherapy has been successfully used to treat a variety of mental health conditions, including depression, anxiety, post-traumatic stress disorder (PTSD), and personality disorders. It also effectively addresses behavioral concerns, relationship problems, and coping with life transitions or crises. CBT, in particular, has shown significant results in managing anxiety and mood disorders, including bipolar disorder.
Improvement in symptoms: Many individuals who undergo psychotherapy experience a reduction in their symptoms. This improvement is not just limited to psychological symptoms but can also include somatic symptoms, as mental and physical health are closely linked.
Long-term benefits: Psychotherapy offers long-term benefits, helping individuals develop sustainable coping strategies and skills beyond the treatment period. These results can lead to lasting changes in behavior and thought patterns.
Customizable and holistic: Psychotherapy can be tailored to meet each person's individual needs, making it a flexible and holistic approach to mental health care.

Is a psychotherapist the same as a clinical psychologist?

While clinical psychologists can also provide psychotherapy, the two roles are distinct. A psychotherapist is a licensed mental health professional who specializes in administering therapy to individuals, couples, or groups. They may hold various degrees and certifications, such as a Master's degree in counseling or social work.

However, a clinical psychologist, on the other hand, has completed a doctoral degree in psychology and
has received extensive training in psychological assessment, diagnosis, and treatment. They may also
specialize in a specific area of psychology, such as child or forensic psychology.

Clinical psychologists may offer psychotherapy as part of their practice, but they also have the skills to
conduct psychological assessments and diagnose mental health disorders. Their training is typically more extensive and may include research, teaching, or consultation in addition to providing therapy.

What is the definition of psychotherapy?

Psychotherapy, also known as talk therapy or counseling, is the use of psychological methods and
techniques to help individuals improve their mental health, well-being, and overall functioning.
Psychotherapy involves a collaborative relationship between a trained therapist and a client, where the
therapist helps the client explore their thoughts, feelings, and behaviors to gain insight into their
challenges and develop coping strategies.

Psychotherapy can be provided in various settings, such as offices, hospitals, or community mental health centers. Treatment may also involve different approaches and techniques, including cognitive-behavioral therapy (CBT), psychodynamic therapy, humanistic therapy, or family/systemic therapy. The type of psychotherapy used will depend on the individual's needs and the therapist's expertise.

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