Counselling

Counselling is a type of talking therapy or psychological therapy. It involves talking to a counsellor about your problems. Counsellors are trained to listen sympathetically and can help you deal with any negative thoughts and feelings.

People sometimes use the word counselling to refer to talking therapies in general, but counselling is also a specific type of therapy.

Talking therapies

There are several types of talking therapies, including:

Talking therapies can be used to treat numerous health conditions, including:

The aims of counselling

Counselling and talking therapies can help people:

  • discuss their problems honestly and openly
  • deal with issues that are preventing them from achieving their goals and ambitions
  • have a more positive outlook on life

Counselling can be a positive way of addressing any unresolved issues you have and can help you understand your problems better. It can also give you a better understanding of other people's points of view.

There are several types of talking therapies or psychological therapies. Each type aims to help people deal with negative thoughts and feelings and enables them to make positive changes.

Talking therapies include:

  • counselling
  • psychotherapy 
  • cognitive behavioural therapy (CBT)
  • other types of therapies, such as group therapy and relationship therapy

These therapies are discussed in more detail below.

Counselling

The term counselling is sometimes used to refer to all types of talking therapy, but it is also a type of therapy itself.

Counselling involves talking to a trained counsellor in confidence about how you feel about yourself and your situation. The counsellor will listen and help you understand your problem. They will also work with you to find ways to deal with the problem better. Counselling is usually a form of short-term therapy. 

Psychotherapy

Like counselling, psychotherapy is also sometimes used as a general term for psychological therapies. There is no clear definition of the difference between psychotherapy and counselling. However, it is considered that psychotherapy is more in-depth than counselling and able to address a wider range of issues. 

During psychotherapy, a therapist will help you consider how your personality and life experiences influence your current thoughts, feelings, relationships and behaviour. This understanding will enable you to deal with difficult situations more successfully.

Several types of psychotherapy may be used to treat conditions such as:

Psychodynamic psychotherapy

Psychodynamic psychotherapy involves an in-depth analysis of how your unconscious thoughts and past experiences shape your current behaviour. For example, it may involve talking about the relationship you had with your parents when you were a child.

The UK's National Institute for Health and Clinical Excellence (NICE) recommends psychodynamic psychotherapy for some people with depression. A course can last several months or years, although shorter courses are also available.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a type of psychotherapy that aims to retrain the way you think to help you deal with stressful situations.

CBT is used to treat conditions such as:

  • depression
  • anxiety
  • panic disorder 
  • obsessive compulsive disorder (OCD)
  • post-traumatic stress disorder (PTSD)
  • long-term illnesses
  • eating disorders
  • schizophrenia 

CBT is recommended for all these conditions.

CBT is based on the idea that the way you think about a situation affects how you act. In turn, your actions influence the way you think and feel. Therefore, it is necessary to change both thinking (cognition) and behaviour at the same time.

Computerised cognitive behavioural therapy (CCBT)

Computerised CBT is a type of CBT that uses a computer instead of a therapist. It is delivered in a series of weekly sessions and should be supported by a healthcare professional.

Other talking therapies

Humanistic therapy

Humanistic therapies incorporate the body, mind, emotions, behaviour and spirituality to help you develop to your full potential and live life to the full. In addressing a problem, these therapies also involve looking at other people, including family, friends, society and culture.

Group therapy

Group therapy aims to help you find solutions to your problems by discussing them in a group setting. Sessions are led by a facilitator, who directs the flow of conversation.

The UK's NICE recommends group therapy for people with obsessive compulsive disorder (OCD) and for children and young people with mild depression.

Relationship and family therapy

Relationship therapy is where couples who have difficulties with their relationship work with a therapist to resolve their problems. Family therapy is similar, but involves a therapist working with a family that is having problems.

The UK's NICE recommends relationship therapy for people who have tried individual therapy without success. Family therapy is recommended for children with depression or where a family member has a condition such as anorexia nervosa or schizophrenia.

Interpersonal therapy (IPT)

Interpersonal therapy (IPT) focuses on your relationships with others and on problems, such as communication difficulties. IPT is concerned with how your mood can influence how you relate to people who are close to you. The UK's NICE recommends this type of counselling for people with eating disorders and depression.

Mindfulness-based therapies

Mindfulness-based therapies combine other talking therapies with a particular focus on the way you think.

By noticing how one negative thought can lead to another, you can learn to recognise the first negative thought and prevent a chain of negative thoughts occurring. This can help you reduce stress and cope with problematic thoughts and feelings. The UK's NICE recommends mindfulness-based therapies to help people avoid repeated bouts of depression.

Eye movement desensitisation and reprocessing (EMDR)

Eye movement desensitisation and reprocessing (EMDR) is a treatment that uses eye movements to stimulate the brain. EMDR has been shown to make distressing memories feel less intense.

EMDR can be used to help you deal with traumatic memories, such as those that come from accidents and injuries or sexual, physical or emotional abuse. The UK's NICE recommends EMDR for post-traumatic stress disorder (PTSD).

Motivational counselling

Motivational counselling involves talking about issues and problems that could stop you achieving your goals and ambitions. The UK's NICE recommends this type of counselling for people who have a problem with alcohol misuse or substance misuse, such as drug misuse.

Telephone counselling

Telephone counselling, such as the service provided by the Samaritans, allows you to talk to a therapist without having to meet them. Telephone counselling may be available through charities or through your employer. Alternatively, you may be able to receive counselling by email or through the internet.

Talking therapies or psychological therapies, such as counselling, can help you deal with a range of issues, from everyday worries to more serious, long-term psychological problems.

Counselling can help you come to terms with distressing or traumatic events, such as the loss of a loved one, divorce or confusion about your identity or sexual orientation. It can also be an effective way of dealing with long-term mental health problems, such as depression and anxiety.

How a counsellor can help

A counsellor is trained to listen sympathetically to your problems and suggest ways to resolve issues and change your behaviour.

By discussing your concerns with you, the counsellor can help you gain a better understanding of your feelings and actions, as well as suggesting ways to find your own solutions to your problems.

The counsellor may encourage you to identify issues and to take personal responsibility for them if appropriate. They can help you recognise the effects of other people and their actions, and explore alternative ways of coping with them.

It can be a great relief to share your worries and fears with someone who acknowledges your feelings and can help you reach a positive solution.

Trusting your counsellor

A good counsellor will focus on you and will listen to your problems without judging or criticising you. They may give you advice about ways you could deal with your problems, but they should not tell you what to do.

For counselling to be effective, you need to build up a trusting relationship with your counsellor.

If you feel that you and your counsellor are not getting on with each other, or if you are not getting the most from your counselling sessions, discuss this with your counsellor. If the situation does not improve, it is perfectly acceptable to look for another counsellor whom you feel more comfortable with.

Types of counsellor

As counselling can involve talking about sensitive issues and revealing your personal thoughts and feelings, your counsellor should be experienced and professionally qualified.

Several different healthcare professionals may be trained in counselling and could be suitably qualified to give talking therapies. These include:

  • psychologists - healthcare professionals who specialise in the assessment and treatment of mental health conditions
  • psychiatrists - qualified medical doctors who have received further training in treating mental health conditions
  • counsellors - people who are trained to give talking therapies that can help you cope better with your life and any issues you have
  • psychotherapists - similar to counsellors, but have usually received more extensive training and are also often qualified psychologists or psychiatrists
  • social workers - someone who can give advice about a variety of practical issues, such as benefits, housing, day care and training
  • community mental health nurses (CMHNs) - registered nurses with specialist training in mental health, also sometimes known as community psychiatric nurses (CPNs)
  • occupational therapists - can provide training, support and advice to help you get the most out of life and regain or improve your independence

Different counselling formats

Many different types of counselling are available in a range of different formats. Counselling can take place:

  • face to face
  • over the phone
  • by email
  • using a computer

You may be offered counselling as a single session, a short-term course of sessions for a few weeks or months, or a long-term arrangement that lasts for many months or years.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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