What is psychotherapy — and how is it different from counselling?

"Psychotherapy", "counselling", "therapy" — the words get used interchangeably, which can make the whole field feel murkier than it needs to. Here is a clear picture.

What psychotherapy is

Psychotherapy is a structured, confidential relationship in which you work with a trained professional to understand and change patterns of thought, feeling and behaviour that are causing you difficulty. It rests on a simple but powerful idea: that being deeply understood — and understanding yourself — is itself healing, and that much of what troubles us has roots and reasons we can't see on our own.

Counselling vs psychotherapy

The two overlap a great deal, and many practitioners do both. Broadly, counselling tends to be shorter-term and focused on a specific current difficulty — a bereavement, a decision, a period of stress. Psychotherapy tends to go deeper and often longer, working not only with the present problem but with the underlying patterns, often rooted in earlier life, that keep producing it. Think of counselling as addressing the weather and psychotherapy as also looking at the climate.

The main types

You'll encounter several. CBT focuses on the links between thoughts, feelings and behaviour, and is practical and present-focused. Psychoanalytic and psychodynamic therapy explores the unconscious and the past. Humanistic and existential approaches focus on meaning, choice and growth. Integrative therapists, drawing on several, tailor the approach to the person rather than the other way round.

What it is not

It is not advice-giving, and it is not someone telling you what to do. It is not a sign of weakness or a last resort — increasingly people use therapy proactively, to understand themselves and live more deliberately, not only in crisis. And it is not endless: the length depends entirely on what you are working on.

Last reviewed: June 2026 by Natalija Hayter, BABCP-registered psychotherapist.