Understanding the Difference Between Counselling and CBT

You may not know where to begin when you need to talk to a professional about your mental and emotional well-being.  Shall I go to counselling?  Isn’t CBT supposed to be better?  What’s the difference between CBT and counselling?

I’ll describe the key differences in this article to help you decide.

What is Counselling?

Counselling happens when you talk to a trained professional.  They create a safe place for you to explore your thoughts, feelings and behaviours.  It aims to help you better understand your experiences and habits.

A counsellor doesn’t give you advice or tell you their opinion.  They are trained to listen closely, hearing what you say verbally and non-verbally.  For example, they pay attention to what you say, tone of voice, body language, and facial expressions to understand your feelings.

Instead of dictating solutions, they guide you in identifying your own, empowering you to take control of your mental and emotional well-being. 

Counselling is typically more open-ended and flexible than other forms of therapy, although an organisation may be limited by funding or need to keep waiting lists down.  In these circumstances, you may only get six sessions. 

Counselling sessions may cover many topics, including relationships, work-related stress, grief, or self-esteem.  The counsellor often acts as a facilitator, helping you explore your thoughts and emotions deeply, but without directing the conversation or offering specific strategies for change.

Key Features of Counselling:

• Person-Centred: Focuses on you and your experiences, allowing you to set the agenda.
• Exploratory: Encourages deep exploration of emotions, relationships, and past experiences.
• Supportive Environment: Provides a non-judgmental, empathetic space for self-expression.
• Flexible: Can address various issues, from everyday stresses to deep-seated emotional challenges.

What is Cognitive Behavioural Therapy (CBT)?

Cognitive Behavioural Therapy (CBT) is an umbrella term for multiple therapies, including:

• Cognitive Therapy
• Behavioural Activation
• Cognitive Analytic Therapy
• Dialectical Behaviour Therapy
• Meta-Cognitive Therapy
• Mindfulness-based Cognitive Therapy
• Compassion Focused Therapy
• Acceptance and Commitment Therapy

While similar, they also have specific differences.  Cognitive Therapy is often confused with the umbrella term.  While it has dominated CBT provision, studies show it is no more effective than other therapies within the CBT school of psychology.

Cognitive Behaviour Therapies are a structured, goal-oriented form of therapy focusing on the connection between thoughts, feelings, and behaviours. Unlike counselling, CBT is more guided and involves working on specific problems to change unhelpful thought patterns and behaviours.

Cognitive Therapy is based on the principle that our thoughts influence our feelings and behaviours. By identifying and challenging negative or irrational thoughts, CBT helps individuals develop healthier thinking patterns, which can lead to more positive emotions and actions. Cognitive Therapy is commonly used to treat conditions like anxiety, depression, phobias, and obsessive-compulsive disorder (OCD), among others.

Key Features of CBT:

• Structured Approach: Sessions are typically planned with specific goals in mind.
• Problem-Focused: Targets specific issues such as anxiety, depression, or behavioural problems.
• Short-Term: Usually involves a limited number of sessions (typically 6-20).
• Skills-Based: Teaches practical skills for managing symptoms and preventing relapse.

Comparing Counselling and CBT: Which is Right for You?

Both counselling and CBT can be incredibly beneficial, but they serve different purposes and suit various needs.

1. Approach:

   – Counselling is more exploratory and flexible, ideal for individuals who need a supportive environment to talk through various issues without a specific focus on changing behaviours.

   – Conversely, CBT is more structured and goal-oriented, making it a good choice for those who want to tackle specific issues with practical strategies.

2. Duration:

   – Counselling can be open-ended and continue as long as you find it helpful.

   – CBT is typically time-limited, with a clear endpoint that is often defined at the beginning of therapy.

3. Focus:

   – Counselling focuses on understanding and expressing feelings, exploring relationships, and gaining insight into past experiences.

   – CBT focuses on changing negative thought patterns and behaviours, providing tools to manage specific psychological problems.

4. Techniques:

   – Counselling uses active listening, empathy, and reflective questioning techniques.

   – CBT employs techniques like cognitive restructuring, acceptance, exposure therapy, and behavioural change methods such as experiments.

When to Choose Counselling

Counselling may be the right choice if you are dealing with general life stresses or relationship issues or need a safe space to explore your feelings. It’s also suitable if you’re looking for a therapeutic relationship that can evolve without a specific end goal.

When to Choose CBT

CBT is often the preferred approach for those dealing with specific mental health conditions like anxiety, depression, PTSD, or OCD. If you want a therapy that is more structured and focuses on tangible outcomes, CBT may be the better option.

In Summary

Understanding the difference between counselling and CBT is crucial in choosing the right therapy for your needs. While counselling offers a more open-ended exploration of emotions and experiences, CBT provides a structured, goal-oriented approach to overcoming specific challenges. Both are valuable mental health tools, and the right choice depends on your needs and preferences.

If you’re still unsure which therapy is right for you, consider speaking with a mental health professional who can guide you toward the best option based on your unique circumstances. Remember, seeking help is a positive first step towards better mental health.