In the jungle of offers of help, it is not that easy to find your way around. Perhaps you have already asked yourself: what is the difference between psychological counselling and psychotherapy? And which psychological help is the right one and when? This article deals with content-related and formal similarities and the demarcation of these two areas.

The diagnosis as an essential difference between psychological counselling and psychotherapy

Psychological counselling and psychotherapy are areas that overlap in terms of content and method. So they cannot be clearly separated from one another.

By definition, the treatment of a mental disorder with a so-called ‘disease value’ is psychotherapy. Psychotherapy is therefore a treatment of the sick and may only be carried out by psychological or medical psychotherapists or alternative practitioners for psychotherapy. For this, personal face-to-face contact is required at the beginning. Pure online therapy is not permitted.

‘Disease-related disorder’ means that the symptoms correspond to the ICD-10 international classification system in terms of their type and duration of diagnosis . For example, ‘social withdrawal’ or ‘loss of interest’ are symptoms. If different symptoms come together over a certain period of time, then they may correspond to a diagnosis according to the ICD-10. A psychiatric diagnosis is then, for example, a ‘mild depressive episode’, a ‘generalised anxiety disorder’ or ‘adjustment disorder with depressive reaction’.

The therapist makes the diagnosis by asking for various information. So you don’t have to be able to classify yourself whether your complaints or worries fall into a disease-related area.

The focus is on people

In my opinion, however, it makes sense in psychotherapy to focus on people and their experiences and not on the diagnosis. As a therapist it is important to have psychopathological and diagnostic knowledge, but in contact it should run in the background rather than reducing a person to their symptoms.

Psychological counselling: Life events & stress

There are numerous life situations that can be associated with a great deal of suffering and yet do not (yet) meet the criteria of a disease, for example because the symptoms have not lasted long enough and a time criterion has not been met. You may have already experienced how stressful, for example, lovesickness, a difficult separation, problems at work or a death can be. Such stress could lead to emotional crises.

In return, there are mental disorders that have been with a person for a very long time and sometimes appear to him * her as part of the self. This sometimes happens, for example, with dysthymia, a permanent, continuous depressive experience. Even with personality disorders, the symptoms of which arise per se in youth and are stable over time, symptoms are experienced as belonging to one’s own personality.

Concrete advice on specific conflicts and burdens

Psychological counselling is not aimed at treating a disease, but rather on life issues or on conflicts from different areas of life. That’s why it’s not a cash benefit. These areas of life and topics include relationships, families, upheavals and losses, sexual orientation and work / bullying. There are counselling centers on many topics, most of which offer counselling sessions free of charge or for a donation. Counselling is also often offered in private psychotherapeutic practices. There is also a large online market. ‘Psychological advisor’ is not a protected professional title. So everyone can call themselves and everyone can offer it, as long as one is not directed at people with a disease.

As it is already in the word advice, it contains more structured advice and knowledge transfer about interpersonal and psychological processes – however, psychoeducation (transferring knowledge about mental illnesses) is also part of psychotherapy.

Coaching starts at a point where you already know where you want to go, is aimed at healthy people and generally uses more structured exercises.

Psychotherapy tends to be a longer, even more individual process, as the secure relationship between client and therapist is of particular importance as an effective factor. It offers the framework in which even very difficult inner experiences can be viewed and new experiences can be made at your own pace.  

The difference between psychological counselling and psychotherapy is illustrated

Whether advice or therapy, a concern with or without diagnosis, the internal dynamics are often the same and only the characteristics are different.

You can think of it as an example like a cluttered storage room in your own apartment or a blocked cellar – which is socially considered ‘normal’ and ‘healthy’. A permanently cluttered apartment, in which one can hardly move, would be considered ‘disease-worthy’. The dynamics of the disorder itself and the clean-up process are fundamentally similar.

Since stressful life situations can be the trigger for mental illness, support in the form of psychological counselling is good prevention.