Which Is Better? The Psychotherapy Vs Counseling Debate

By: Nadia Khan

Updated June 01, 2020

Medically Reviewed By: Whitney White, MS. CMHC, NCC., LPC

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Many people who have not medical training interchange the terms 'counseling' and 'psychotherapy' and, indeed, there are similarities. Generally, therapists and counselors both are able to give advice to clients to help them deal with specific issues such as grief, addictions, anger management, and low self-esteem. The sessions can be over some weeks or months. Psychotherapy deals with people who have serious past issues that may be the underlying reasons for present behavior. This therapy can take place on a weekly basis over a number of years. There is also a lot of overlapping that can occur between the two types of therapies in the reasons people seek help.

Psychotherapy and counseling are two very different solutions that aim for the same outcome. Psychology is not an exact science so it is not surprising to come across different types of therapy for the same diagnosis. The answer to which is better? The psychotherapy vs counseling debate depends on personal preference. Before you can even decide on personal preference, you need to know a bit about both very effective therapies.

Psychotherapy, just like counseling, depends on a strong, trusting relationship between you and your chosen therapist. Both psychotherapy and counseling rely on talking and working through problems but this is where the similarity ends. Psychotherapy relies on delving into your past and working together with your therapist to understand how your past experiences have brought you to the place you are today. Counseling is carried out based on present events and how they affect you in the present.

Which is better? The psychotherapy vs. counseling debate can be solved by you and the right therapist. A good therapist will help you discover which would benefit you most. Therapists are trained to use many different types of therapy, a solid relationship with the right therapist for you will help you and your therapist decide between these types of therapy; some even specialize in both psychotherapy and counseling. If you are seeking help but are unsure which type of therapy is best for you, this online counseling/therapist website can help.


Although a psychotherapist can use counseling and psychotherapy to treat people with problems, a psychotherapist has superior skills because they completed training to become a medical doctor and then a doctor of psychiatry. Psychotherapists focus on determining the causes of chronic physical and emotional issues. They are concerned with the patient's thoughts, how they think, how they draw conclusions and their reasoning for their behavior. Psychotherapists usually treat patients on a long-term basis and work toward the patient making significant and lasting changes to the way he/she sees and reacts or adjusts to the happenings in their world. They may recommend various tests for intelligence, cognitive reasoning, and personality traits. They may also prescribe medications.

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There are different types of psychotherapy in which the psychotherapist is trained, such as cognitive behavioral therapy, dialectical behavior therapy, psychoanalytical psychotherapy, and many more.


A counselor is an advisor who works with a client to find solutions to specific problems or issues. A trained counselor usually has first received training as a nurse or a social worker. A mental health counselor focuses on present behavior with the idea of helping the client find ways to change their behavior. They rely on talk therapy. Counselors usually deal with relationship issues between partners or family members. They give advice and suggestions to deal with grief, the death of a loved one, depression, drug and alcohol addictions, and more. A counselor can direct a client to the appropriate medical doctor or to a treatment facility.

You may decide to see a counselor when:

  • You consider your issues as short-term.
  • You need to learn coping skills for stress and relationship problems.
  • You are finding it difficult to make adjustments to changes in your lifestyle.
  • You have addiction issues.

You may decide to see a psychotherapist when:

  • You are coping with traumas that happened in your past.
  • You have a chronic medical problem that is causing emotional stress.
  • You have been diagnosed as having a mental health condition (bipolar, manic-depressive, schizophrenia, OCD, anxiety disorder)
  • You have seen a counselor and they suggested further more in-depth treatment.

How Does Psychotherapy Work?

Psychotherapy is effective at finding the root cause for depression; this type of therapy assumes that something in the past is responsible for the depression. It can be difficult to know if events in your past are affecting your mental health in the present, and this is where psychotherapy comes in. Many people don't realize just how much traumatic events in the past can affect present decisions, motivations, and behaviors subconsciously.

A psychotherapist is skilled in the use many different therapies, they rely on the therapeutic relationship between themselves and their client to achieve an understanding of which therapy to use. Therapies used include, behavior modification, mindful-based behavioral therapy, and insight-oriented psychotherapies. The choice of therapy depends on the diagnosis and needs of the client; this is why the therapeutic relationship (relationship between therapist and patient) is so important.

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How Does Counseling Work?

Just like the therapeutic relationship relied on for effective psychotherapy, effective counseling relies on this relationship too. The goal of counseling is to use talk therapy to help clients work through the issues that affect them in negative ways. Counselors listen, provide feedback and counsel, they do not provide answers; they facilitate finding answers for yourself.

Counselors will discuss present behaviors and help you to understand how these behaviors elicit un-wanted results. Counselors work to understand you and your life by asking questions that show your thought process. The more they know about you, the more effective their counseling is. If you're looking for counseling services, check our BetterHelp here - https://www.betterhelp.com/online-counseling/

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Ask yourself what kind of therapy might be most effective for you. As you are not an expert in recognizing or fixing problems, talk to your family physician about whether or not he thinks you could benefit from counseling or psychotherapy. Does your doctor think that what he has been doing for you and how his treatment may not be working now warrants further treatment from someone else? Ask him if he thinks you need further testing or a change in medication. Before visiting a counselor or a psychotherapist, be able to verbalize your concerns and symptoms. Be prepared, to be honest about your personal details, your life including any recent changes and the stresses you are experiencing. Be upfront about all the prescription and non-prescription drugs and supplements you are taking. What is really important is to not ignore how you feel and try to cope on your own. You may feel mired in problems and may not be able to see a solution or make a decision without the help and guidance of a counselor or a psychotherapist.


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