What Is The Difference Between A Counsellor And A Therapist? UK Mental Health Care

Medically reviewed by Melissa Guarnaccia, LCSW
Updated January 29th, 2025 by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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Seeking mental health care can be intimidating for some, in part because the terminology used in this field may not always be easily understandable or clear. Understanding the differences between some of these terms, like counsellor and therapist, may help simplify your search for care. Here, we will explore both of these terms and their meaning and share advice on how you can connect with the right type of professional for your needs in the UK. 

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What is the difference between a counsellor and a therapist? UK and globally 

In addition to there being many different terms to know in the mental health field, some are used interchangeably and others depend on your region. For those seeking care in the UK, understanding which terms are used most often and what their meetings are can help you find support. 

Addressing the question: What is the difference between a counsellor and a therapist (UK)? 

Therapy and counselling can both be used as umbrella terms for a variety of psychotherapeutic practices. From cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) to eye movement desensitization and reprocessing (EMDR) and grief counselling, any research-based practices that support mental health by exploring or addressing specific thoughts, feelings, and behaviors can typically be considered therapy or counselling.

That said, the two can sometimes be differentiated based on their goal and duration. Counselling can be a shorter-term approach with the aim of finding practical solutions to a specific challenge. Therapy, also called talking therapies or psychotherapy, is often a longer-term approach that dives beneath the surface to understand where a person’s emotional challenges may stem from and to address them more holistically. Both approaches can be useful depending on a person’s needs, preferences, and circumstances.

As long as a provider has obtained the necessary qualifications to practice a specific form of therapy or counselling, they can offer their guidance and support to clients. In the UK, the British Psychology Society (BPS) and the Health and Care Professions Council (HCPC) can help you to determine if counsellors and therapists have the right qualifications.

Research on the effectiveness of mental health care from counsellors and psychotherapists

Research indicates that both counselling and psychotherapy interventions can often be effective. For example, in one study, student participants in a short-term counselling program showed decreased symptoms of depression and improved emotional regulation after eight counselling sessions. These findings reflect how even short-term interventions may have a significant impact. 

For those living with more severe or deeply rooted challenges, long-term psychotherapy may be a more effective option—and research generally supports its effectiveness as well. One study, for instance, suggests that when medication alone is not enough for individuals with treatment-resistant depression, adding psychotherapy may be effective for reducing symptoms over time.

Types of counsellors and therapists

Within counselling and therapy, there are many different specializations and approaches a provider may use. Understanding some of these options may help you decide which type of mental health professional to connect with. 

Types of counsellors

If you’re looking to address a specific challenge or get support through a particular period, a counsellor may be a helpful resource. Having received a degree and specific training in counselling or psychotherapy, they are equipped to give you research-based guidance. 

A counsellor may specialize in a variety of areas. Understanding what you need and looking for providers with experience and training in that specialty may be a helpful next step. Some examples of common counsellor specialties for mental health professionals in this field include:

  • Grief counselling
  • Child counselling
  • Couples counselling
  • Rehabilitation counselling

Types of psychotherapists

Psychotherapy is a form of talking therapy that helps you cope with emotional, behavioral, and mental health challenges—especially those that may be more deeply rooted in past experiences or a mental illness. A therapist, also called a psychotherapist, may help you explore the underlying reasons for your thoughts, feelings, and behaviors in order to understand yourself at a deeper level. 

Psychotherapists in the UK need to complete a postgraduate or master’s degree in a relevant psychological field. Psychotherapists may specialize in areas such as:

  • Cognitive behavioural therapy (CBT) 
  • Acceptance and commitment therapy (ACT)
  • Psychodynamic therapy
  • Mindfulness-based cognitive therapy (MBCT)
  • Treatment for depression, anxiety, or trauma
  • Attachment issues
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What to expect in sessions with counsellors and psychotherapists

Sessions with a counsellor and sessions with a psychotherapist will often feel similar in their structure. Both typically involve talking about what's bothering you and being guided through different ways of looking at or approaching the challenge. The differences usually lie in the specific methods used and the longer-term goals of the treatment. 

Common therapy practices of a psychotherapist

Psychotherapy practitioners usually need to have a certain level of observation and awareness to pay attention to thoughts, feelings, and cognitive processes that may appear when a client speaks. A therapist may also teach clients some practices to help raise their awareness, such as deep breathing, body awareness, or journaling exercises.

With each type of psychotherapy, you may gain different insights and learn different coping strategies. For example, from interpersonal therapy, you may learn ways to express your relationship needs in a healthy way. In cognitive behavioral therapy, you may learn mindfulness exercises to let thoughts pass without judgement.

Common counsellor practices

There may be some overlap between the strategies that a therapist uses and the strategies that a counsellor uses. That said, a few approaches that may be particularly helpful for the short-term format of counselling include:

  • Structured sequential strategies: Known as the fives As (ask, advise, assess, assist, arrange), this set of counseling techniques can be useful for those who are receptive and responding well to counselling.
  • Motivational interviewing: uses empathy to help the client build internal motivation, which may be effective for those ambivalent about change
  • BATHE: This strategy (background, affect, troubles, handling, and empathy) may be particularly useful for those experiencing symptoms of complex mental health conditions like post-traumatic stress disorder (PTSD).

Exploring treatment with a clinical psychologist

For advanced diagnostic practices and treatment, you may want to consider speaking to a clinical psychologist. A clinical psychologist, sometimes called a counselling psychologist, is required to receive a doctoral degree (PhD) in psychology and therefore undergo intensive training before offering support and guidance to clients for a mental health condition or other challenges. Note that in the UK in general, psychologists aren’t considered medical doctors and can’t usually prescribe medication, though the topic is under review.

Counselling and psychotherapy with a clinical psychologist

Like therapists or counsellors, clinical psychologists often specialize in some form(s) of psychotherapy. After creating a supportive environment for clients to explore their thoughts and feelings, therapists will usually work in depth with them over a significant period of time to explore past experiences and how they may affect thoughts and behavior today.

Choosing between counselling and psychotherapy

Both counsellors and psychotherapists are equipped to help you in many ways, and there can be a lot of overlap in their roles as healthcare providers. So while either can be helpful in most situations, you might consider your key goals for treatment before choosing between these two types of professionals.

If you are looking for short-term support through a specific challenging period, such as adjusting to parenthood, coping with grief, or addressing substance misuse, counselling might be the best choice. If you're looking for more in-depth support to better understand where certain feelings, symptoms, or behaviors may stem from—like how your upbringing may affect your choices as a parent, parsing complicated emotions about a lost loved one, or uncovering underlying reasons for coping through substance use—therapy might be a useful approach. If you’re not sure, meeting with a therapist or counsellor for a consultation may help you decide.

Finding the right mental health care provider for your needs in the UK

Finding a therapist or counsellor who you feel comfortable with and who has the training and expertise you need is usually important for promoting positive treatment outcomes. If you live in the UK, there are many different ways to seek the support of a therapist or counsellor. Those who qualify for services through the NHS may self-refer or get their GP's referral to speak with a therapist for free treatment. Other options include paying out of pocket or using insurance to see a provider with an independent practice or exploring an online therapy platform.

In addition to the convenience of being able to meet with a counsellor or therapist remotely from home, online therapy platforms like BetterHelp can make it easy to find the right provider for you. To get started, you'll fill out a brief questionnaire about your needs and preferences in a therapist or counsellor. Then, many people can be matched with a professional provider in as little as 48 hours. If you decide they're not the right fit for you, BetterHelp allows you to switch providers for any reason, at any time, for no additional cost. 

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Is online therapy effective?

A growing body of research generally supports the effectiveness of online therapy and counselling for addressing a variety of mental health concerns and emotional challenges. Many suggest that online treatment can often be as effective as in-person treatment for addressing many different mental health challenges. 

Takeaway

With the right training and certifications, both counsellors and therapists can provide effective mental health interventions. If you’re looking for short-term care for a specific challenge, a counselling program may suit you. Or, if you’re interested in exploring the root causes of your feelings and behaviors, psychotherapeutic methods may help you dive deeper into your cognitive processes over time. Both methods can be effective in supporting health and well-being. Individuals in the UK who are interested in seeking mental health care may be able to find support from a counsellor or therapist through the NHS, through an independent provider, or via an online therapy platform.
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