Choosing Between Psychotherapy Vs. Counseling For Mental Health

Medically reviewed by April Justice, LICSW
Updated August 12, 2024by 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

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

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. 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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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.
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