Counselor Vs. Therapist – Differences and Similarities

A therapist speaks to a patient with a clipboard in his hand. The male patient lays on a couch with his arms folded, staring at the wall.

The terms counseling and therapy are often used synonymously. There are, however, core differences between psychological counseling and psychotherapy. For one thing counseling is generally a more short-term solution as opposed to therapy which is more long term and focuses on a wider scope of issues.

What do Therapists do?

Therapists focus primarily on long term treatment. The function of a therapist is to help patients highlight and address feelings and issues. These issues vary greatly. Your therapist might discuss dissonance, which is the uneasiness one might feel when actions, feelings and thoughts do not resonate. They might discuss projecting, which is manifesting your concerns and feelings onto another as a defense mechanism. Both of these therapy terms are probably familiar to you and there are a lot more.

What is the Role of Counselors?

Counselors tend to be the front lines of dealing with trauma and suffering. They focus more on advising and encouraging patients and clients. A good metaphor to use is that counselors are the first level of engagement like paramedics. They deal with “patching up” the wounded. In contrast, a psychotherapist is like a doctor at the hospital. They have more refined skills to treat deeper damage. Unlike counselors, therapists often take on the responsibility of a patient’s long-term care.

A graphic table describing key attributes of counselors and therapists. Counselors: 1. Counselors do not require an advanced degree to provide services. 2. Counselors mainly work in the context of institutions like rehabs and clinics. 3. Counseling focuses on particular problems like addiction or stress management. Therapists: 1. "Therapist" is a protected title that requires licensure to operate. 2. Therapists primarily work in private practice, providing long-term treatment. 3. More long-term, psychotherapy focuses on a broader range of issues.

Is Counseling the Same as Therapy?

In the context of mental health, counseling means a relatively brief treatment period focusing primarily on behavioral modifications. For example, drug & alcohol counselors often work in rehab settings, trying to help clients stay sober. Unlike therapists, they tend to work in group settings with multiple clients.

Counselors do not have the tools or the time, however, to resolve the underlying trauma. As Dr. Gabor Maté, a respected addiction doctor, explains, “The question is not why the addiction, but why the pain.” Very rarely do counselors address such deeper issues. In contrast, therapists focus not only the addiction but the childhood suffering behind it. But such therapy takes time and effort.

Key Differences Between a Counselor and a Therapist

Here is a list of some of the differences between a counselor and a therapist:

  1. Counselors do not require an advanced degree to provide services
  2. “Therapist” is a protected title that requires licensure to operate
  3. Counselors mainly work in the context of institutions like rehabs and clinics
  4. Therapists primarily work in private practice, providing long-term treatment
  5. Counseling focuses on particular problems like addiction or stress management
  6. More long-term, psychotherapy focuses on a broader range of issues

While counselors provide relief and support in a crisis like drug interventions and grief management, therapists handle long-term mental health challenges. For example, a counselor is not qualified to singlehandedly treat bipolar disorder or clinical depression. Such chronic mental health issues require the advanced expertise of a therapist. Often, a therapist works in conjunction with a psychiatrist or doctor, who can help with medication management, thus prescribing drug regimens when needed.

Before an appointment, write out the following:

  • Issues and concerns that led to this decision to get help – what was the trigger?
  • Any significant stresses or recent life changes, even if they seem disconnected
  • All medications, vitamins or supplements taken by a teen, including doses
  • Questions to ask at a first session to raise your comfort level

Counselors and therapists often work in conjunction with each other, providing complementary services. Thus, reaching out for help is a smart move. You will obtain the guidance needed to find the support and help you need to move forward.