There are all sorts of definitions of counselling and psychotherapy, in my work I define them as,
This is short term therapy focused on a specific, fairly recent problem such as job loss or relationship breakdown. It lasts 6 - 12 weeks, and provides a fuller understanding of the dynamics at play and a more effective range of responses to these. Occasionally, people address a specific problem with counselling and then decide to address an underlying, contributing issue in psychotherapy. It is a fluid transition.
This is medium to long term therapy that explores older, deeper rooted issues that are not resolved and cause persistent upset or problems. These could stem from early life neglect or trauma and lead to destructive or risky behaviour; deep self doubt; dissociation, panic and emotional collapse; unbalanced relationships; cycles of depression; compulsions and obsessions, etc. It is normal for psychotherapy to be difficult at times, that's why it is important to chose a therapist who you feel comfortable and safe with. The treatment is collaborative and open-ended, the work deepens over a year or longer. Sessions are once or twice per week. Therapy ends when the patient decides to leave because he or she is well. This final decision is made by the patient, it is always his or her choice when to go.
DO THEY WORK?
Yes, in a broad study of the effectiveness of talking therapies* researchers (Hubble, Duncan & Miller) found that 75% of clients significantly improved after twenty-six weekly sessions. Shorter work can also be very beneficial but it must be appropriate for the problem being addressed, research indicates that 50% of people significantly improved after five to ten weekly sessions of therapy.
It appears that the positive effects of counselling and psychotherapy generally occur in a chronological order. First, morale is improved, i.e. hope and faith in one's ability to find a way forward is renewed. Second, symptoms improve as the client and therapist become familiar with the problem and generate new perspectives and better options. Third, permanent changes occur in the characteristic manner the client thinks about and responds to the old problem.
When I believe a person will not benefit from talking therapy I explain this early on and suggest a route that is a better suited for her or him.
* The Heart and Soul of Change: What Works in Therapy, by Hubble, Duncan & Miller. Published by the American Psychological Association (1999)
no charge or obligation is involved.