Psychotherapy and counseling are often used interchangeably to describe what transpires between a mental health provider and a client. However, there is usually a distinct difference between the two. Most trained psychotherapists can and do provide counseling services but the opposite is not necessarily the case. Counseling normally involves a process of suggestion and advice giving. A "counselor" may be designated as a professional. Counselor Troi from the Star Trek movies frequently advised Captain Kirk concerning what he might and might not do about various dilemmas that he found himself in and "counselors at law", i.e. attorneys, often advise clients about their legal rights and options. There is no doubt that counseling can provide short term relief from mild anxieties and depressions since a practitioner will listen to the content of the client's conversation and provide support, encouragement and ideas that might impact the current situation. Employee Assistance Programs and Managed Care insurance plans will often have the milieu within which a client can briefly address a current dilemma, get a bit of support and apply some sound advice to his/her difficulty.
Psychotherapy, on the other hand, focuses on the individual in a much deeper way. Most problems that people consult a mental health practitioner for do require a personal psychotherapy. Since we all have characteristic ways of being and behaving that we bring to our work and love lives, we may have a need to understand and alter these experiences of who we are and how we perceive and interact with the world in order to ensure the permanent resolution of symptoms and repetitive destructive patterns and live more happily and productively. Psychotherapy, when successful, tends to expand one's vision and versatility, to enhance coping strategies, to augment creativity so that the individual, in effect, counsels him or herself. Psychotherapy typically emphasizes thought and understanding as opposed to counseling which tends to emphasize action. While counseling might encourage a display of competence, the work of psychotherapy will assist in the enhancement of skill and ability. Counseling does little or nothing in the effort to gain wisdom since the individual need only follow the suggestion of another. The emphasis, as with medication, is on suppression of symptoms. Psychotherapy however, will help the individual create an internal counselor and a self soothing mechanism that can be relied on in times of stress and applied to future difficulty.
In my own work over the years, I have encountered many individuals who have previously engaged in several counseling endeavors. Often they are middle aged and have, perhaps, first been put into counseling by a parent either as a child or a teen. The current crisis seemingly resolved, they went about living their action filled life for some years before recognizing how deeply disappointed they have been or how nervous they are regarding so many of their everyday activities. Perhaps they have never consulted a mental health professional but have been "counseled" by their physician to "slow down" or to take an "anti-depressant" or a tranquilizer with good short term effect but no substantial long lasting impact on the lack of energy, disappointing love life or frequent somatic ailments they have had. In psychotherapy, a bond develops between the practitioner and the client that assists in dispelling the ghosts of the past, the fears of the future and satisfies the striving that all humans have for intimacy, understanding and enlivenment.