Counselling and Psychotherapy

The job of a counsellor, as the name suggests is to offer counsel on his or her specialist area. A counsellor will help clients to recognise their particular problem and ultimately help them to handle it effectively.

A session will usually take place in a private and confidential location and will begin with the counsellor listening attentively to the problems of the client, allowing them to understand the issues from their perspective.

Counselling provides individuals with an opportunity to explore certain feelings in a setting which allows them to talk freely and openly without judgement, in a way which is often not an option with friends and family. A counsellor will not advise clients on the best route to take but will simply help them to reach a stage where they can make that decision on their own.

An essential element of the counsellor client relationship is that of trust and respect, both of which are necessary, as how you connect with one another will determine the success of your treatment.

Are Counselling and Psychotherapy the same?

Though both 'counselling' and 'psychotherapy' involve talking to someone who is trained to listen,and a definite distinction between the two is difficult to pinpoint, there are some notable differences.

Generally speaking, a counsellor will deal with a wide range of problems and specific life issues, whereas a psychotherapist working in a hospital setting for instance is more likely to be involved in the treatment of deeper issues such as severe psychological illness and firmly rooted problems perhaps from the past which are still causing distress.

However, in private practice a psychotherapist is likely to accept clients whose need is less severe, wherein the overlap between the two therapies lies.

The History of Counselling and Psychotherapy

Counselling and psychotherapy can be traced back to around the beginning of the 1880's with the work of Sigmund Freud. Freud, a trained neurologist began his investigations into the human mind by working with patients who were classed as hysterical. In 1886 Freud opened his own private practice and developed a method of working with hysterical patients which he called 'psychoanalysis'.

During his early work Freud would use hypnotherapy for treatment of mind disorders in his patients but soon began to concentrate his efforts on developing his own methods and theories, which even today still form the foundations of counselling and psychotherapy.

During the early 1900's Freud was visited by Ernest Jones and A.A Brill who returned to their own countries the UK and the US respectively to promote Freud's methods to a wider audience. Freud also influenced many others to pursue their own approaches to psychotherapy such as Alfred Adler, Snador Ferenczi, Karl Abraham and Otto Rank all of whom acted as brief apprentices to Freud before each becoming psychoanalysts in their own right.

Carl Jung was a close collaborator of Freud's and was considered by many to be his protege. Eventually Jung went about developing his own school of psychology which drew heavily on what he learnt from Freud, gaining him recognition in the field.

Developments continued throughout the 20th century as many began to open their own schools and develop their own methods. The 1950's saw Carl Rogers publish Client Centred Therapy, a new technique he had established after being inspired by the work of Alfred Alder and Otto Rank. Today we know Rogers work as humanistic therapy, which fits within the three main forms of psychological therapies in use today: behavioural therapies, psychoanalytical and psychodynamic therapies and humanistic therapies.

Models of Counselling

Cognitive Behavioural Therapy (CBT)

Cognitive behavioural therapy (CBT) is a form of psychotherapy which aims to retrain a persons way of thinking in order to help them cope effectively in stressful situations. Those who practice CBT believe that the way a person thinks about a situation has an affect on the way they act and similarly that the way a person acts influences their thoughts and feelings. This means that in order to relieve a problem it is both thoughts and behaviour that need to be changed.

Psychodynamic Therapy

Psychodynamic therapy is centred around the relationship between the clients personality and life experience and the effects they are having on their current thoughts, feelings, relationships and behaviour. Once an individual begins to understand this relationship more clearly they will find themselves able to deal with difficult situations more successfully.

Psychodynamic therapy is particularly useful when used to treat depression, anxiety, post-traumatic stress disorder, long term health issues, eating disorder and addictions.

Humanistic Therapy

Humanistic therapy is a term which describes a holistic approach to an individuals health issue, meaning that mind, emotions, behaviour and spirituality are all incorporated in treatment in order achieve a result which treats the entire person and not just the ailment.

In order to achieve this all aspects of life must be investigated, including family, friends, society and culture. This type of therapy is most commonly used to treat issues such as depression, anxiety, and addiction and the National Institute for Health and Clinical Excellence (NICE) recommends that it be used to treat young people with mild depression and in some cases schizophrenia.

Could Counselling help me?

Counselling is available in a variety of different formats, taking place ether in a face-to-face situation, over the telephone or even via internet or email. It is a versatile and effective treatment that is recommended for the treatment of many conditions, including the following:


Abusive relationships usually develop gradually over extended periods of time and are often identified by behaviour exhibiting a lack of respect and control from one particular individual. Abusive behaviour exists in many forms and whether it be emotional, sexual, physical, child or domestic it is difficult and distressing for the victim to cope alone. There are many specialist agencies offering confidential help and advice and counselling is just one of many options which could help you assess what to do about violence in your relationship.


The term addiction refers to an inability to cease repetitive behaviour regardless of the negative consequences it may cause. Throughout life we will discover there are certain activities that provide us with a high level of satisfaction and it is these activities that release happy hormones dopamine and endorphins into our bodies. When these chemicals are not naturally present this is when individuals become vulnerable to addiction. When unhappy many turn to activities which offer instant gratification, such as shopping, gambling, alcohol, drugs, sex and smoking, all of which produce temporary highs which need to be repeated. As we know what goes up must come down and these highs are followed by periods of depression and hopelessness.

Counsellors and Psychotherapists are trained to help individuals face the realities of their addictions with a view to helping them address the underlying issues which are acting as catalysts.

Anger Management

It is perfectly healthy to feel angry from time to time but we should proceed with caution and ensure that we remain in control of our anger and that it is not in control of us. It is when this emotion is poorly managed that it becomes destructive, subsequently leading to aggression.

There are a number of reasons as to why an individual may become unable to control their anger, from family or culture patterns right through to tiredness or menstrual cycle, understanding what makes us angry is among the first steps towards managing it.

Anger management counselling will help us to identify what has made us angry in the first place. Is there something in particular which repetitively makes us angry? If so these 'hooks' will be examined in a bid to try to understand them before the therapist will work to reduce the feelings and arousal that the anger has created. Others factors of therapy will involve looking into how anger affects our personal relationships as well as learning to take responsibility for our own anger and the consequences it may cause.


Feeling anxious about certain things in life is completely natural, in fact in some cases individuals perform best when they are feeling a little pressure.However, if your anxiety grows to the point where it clouds your everyday life and cripples your ability to perform at all then you need to seek counsel.

A quarter of the population suffer from anxiety, each person affected by something different. No matter what the cause it is paramount that you recognise there is a problem and confront your fears. Counselling can help individuals to understand what triggers their anxiety and stress and can help you to manage these and eventually override them. It can help those suffering with general anxiety, phobias, panic attacks and other various anxiety disorders.


Throughout life most of us will experience the loss of someone close to us and in response will go through a period of grieving. Bereavement is a natural response to death and for many people it will take on the form of a cycle which very often sees anger, denial, loneliness, fear and letting go. It is a distressing process but it allows us to accept the loss on our own terms.

Each person has their own cycle of grief and though some move fairly seamlessly from one stage to the next, others find themselves at a standstill unable to move forward. Bereavement counselling will help those individuals to understand their feelings and why they are unable to move on. The areas which are preventing the cycle from continuing will be explored and eventually this remaining conflict will be resolved so the cycle can continue.


It is estimated that around 50% of the adult population were bullied during childhood, with many now reporting it having tainted their later jobs, relationships and mental health. Bullying is hugely difficult to tackle as not only can it be physical, but verbal, emotional, racial and sexual occurring anywhere from a school environment to that of an office.

A counsellor can offer help to both victims and the bullies themselves, advising them on ways to look at the issues which may be causing ether the anger or compliance. Bullying also has a great deal to do with self-esteem and trust and confidence issues and these are aspects which can be addressed within counselling sessions.


Career counsellors are there for those who want to discuss anything from feeling trapped in a job role, to a change in career, to opportunity for promotion. Counsellors are trained and experienced in understanding the difficulties of making career choices and can offer advice and guidance on how to use your skills to your advantage, affective ways of job searching, creating portfolios and generating plans of action.

Child Related Issues

Adolescence is a difficult and confusing time and often young people and their families may require additional support if they are having difficulty adjusting to emotional and behavioural changes. There are many services which offer extra help to young people and their families, from mentors at schools to family liaison officers there are many avenues to explore. If young people do decide they would like to seek further help then they may also opt for it in the form of counselling.

A counsellor can help a young person to recognise their strengths and develop a positive outlook to life. At no point will a counsellor try to impose his or her own personal beliefs or try to influence decisions, they are simply there for advice and guidance.

Debt Management

It is not uncommon for those living in debt to bury the issue in a bid to try and make it disappear. However, this is not the solution and the longer individuals live with the burden of financial difficulties the more stressed, anxious and depressed they are likely to become. Instead, the best thing to do is to face up to the problem and seek help. A financial/debt counsellor can help individuals to manage their debt by prioritising, budgeting, considering ways additional money can be earned and negotiating with creditors with regards to monthly repayment amounts.

They will also be able to offer support on a mental and emotional level, helping you to understand and manage the emotions which come hand in hand with the pressure of living in debt.


Dementia is such a debilitating illness it can completely change the person you once knew. This can bring about a complex surge of emotions. From grieving for the life and relationship you once shared with a spouse, to resentment felt for the new restrictions placed on your life, right through to coming to terms with new aggressive behaviour which is directed at you. If you are really feeling the emotional strain of caring for someone with dementia then it is important that you recognise that you are under a huge amount of stress and you may need emotional support.

A counsellor can help you to get back on your feet, re-establish your own life and move forward effectively with positive memories of the past.


Figures from The Office for National Statistics state that between 8-12% of us will experience depression in any year and 1 in 4 of us will experience at least one diagnosable health problem in any one year. These figures may appear quite high but nevertheless they are not surprising.

Depression is common condition that one in three people are likely to encounter at some point in their life. It is a very complex illness with a series of symptoms and causes and it is important that sufferers seek help from professionals.

Counselling is an effective avenue for the treatment of mild to moderate depression and in many cases is combined with conventional medication such as antidepressants.

A counsellor is there to help individuals understand their depression and its triggers and is there to offer help and guidance on how to control it.

Eating Disorders

With 1% of ten to 20 year olds suffering from anorexia each year and 4% of 16 – 25 year olds suffering from bulimia nervosa on a yearly basis, public awareness about the symptoms and risks of eating disorders is ever growing. However, every year thousands of sufferer's continue to die as their disorder goes unrecognised and untreated for too long.

Eating disorders are characterised by an individuals obsession with their weight. This obsessive behaviour can result in physical issues such as the under nourishment of the body and also causes emotional issues such as extremely low self-esteem and depression.

If you suspect that either yourself or a loved one is suffering from an eating disorder then aside from offering support the best course of action is to seek or encourage help. The first port of call should be your GP as they will be able to provide a diagnosis and screen for any medical issues which may have developed as a result of an eating disorder. Once your GP has established whether or not there are any additional areas which require treatment they will be able to help and advise you on the best course of treatment.

Very often Cognitive behavioural therapy is a suggested approach as its central focus on behavioural changes has proven to be effective in many cases. Other treatment methods include individual and group counselling sessions.

Low Self-Confidence

Having confidence in yourself can bring about hugely positive benefits in all areas of an individual's life, from relationships and social life right through to career. Those who are lacking in confidence usually aspire to be more self-confident and this is a perfectly achievable goal as self-confidence is a skill we can all develop.

Often many of the issues tackled in counselling come hand in hand with low self-confidence, career counselling for instance, perhaps you don't have the confidence to climb onto the next step of the career ladder, or perhaps low self-confidence is holding you back in general, stopping you from achieving certain goals. Counselling uses specialist techniques and strategies which will help to dispel your current pattern of negative thinking and in turn will develop and build confidence levels.

Low Self-Esteem

The word esteem originates from the Latin word aestimare, otherwise known as estimate, meaning to evaluate and to assess ,so self-esteem could be described as how you estimate yourself. Those of us with low self-esteem will not estimate ourselves very highly and this can lead to negative feelings of depression and hopelessness.

The aim of counselling is to change these negative thought patterns so individuals can develop a sense of self and empowerment. A counsellor will be able to offer help and support as well as giving advice on certain activities which may also act as a self-esteem boosters such as dancing, creative writing, support groups, exercising etc, all of which will go towards building up assertiveness and self-esteem.

Mental Health

A mental illness is defined as any illness which impairs an individuals normal cognitive, emotional or behavioural functioning. There are many factors which are thought to contribute to its development such as genetic inheritance but as yet experts have been unable to discover why up to 30% of British people are affected.

Many who are suffering with a mental health disorder are often too embarrassed to seek help or tell anyone. In these cases it is important to remember that mental disorders are very common and there is a huge amount of help for those who are suffering, including counselling.

Obsessive Compulsive Disorder (OCD)

This is a psychiatric disorder which is characterised by obsessive thoughts and compulsive actions. Individuals who suffer from this often become trapped in a pattern of repeating certain actions such as washing hands or checking and re-checking to see if doors are locked.

Contrastingly to addiction, the repetitions do not provide any pleasure or a temporary high, it is simply a matter of an irrational fear from the sufferer about what would happen if they did not repeat the action.

OCD occurs on many different levels, from mild to severe and if left untreated it can disable a persons ability to function on an everyday level at work, school and even in the home.

Treatment exists in many forms and cognitive behavioural therapy in combination with medication has a record of significantly improving the behaviour of many patients who complete it.

Personality Disorders

A personality disorder is characterised by persistent styles of behaviour, attitudes and feelings which differ greatly from everyday social expectations. Individuals suffering with a personality disorder will find it difficult to cope with and respond to demands, stresses and interactions

Those with healthy personalities are able to cope with stresses of everyday life and have no trouble forming relationships. However, those with a personality disorder typically find it extremely difficult to respond to the demands of life and deal with other people, avoiding social activities which eventually leads to distress.

Post Traumatic Stress Disorder (PTSD)/ Trauma Counselling

Regrettably many of us will experience a traumatic event at some point during our lives and when these terrible things happen each and every one of us will respond in a different way.

Many of us are able to deal with the fall out before moving on, others may struggle for a time and some may repeatedly experience the ordeal to the point where it begins to cause anxiety. The latter describes the onset of PTSD, a debilitating anxiety disorder which develops following exposure to a traumatic event. The traumatic event could be anything from witnessing a natural disaster through to serving in the armed forces or being a victim of sexual abuse.

The common denominator is that the symptoms always begin with the ordeal before progressing to a stage where they are repeatedly re-experienced through frightening memories, flashbacks, nightmares, thoughts, colours and smells all of which can result in a difficulty sleeping, feelings of isolation, avoidance of activities or conversations which are a reminder of the ordeal, loosing interest in activities which were once important, feeling constantly on guard, the inability to express emotions and overwhelming feelings of irritability and anger.

There are many ways to treat PTSD, and post trauma counselling is among the most effective. Treatment may be through cognitive behavioural therapy, group therapy or exposure therapy all of which aim to help the individual to process the traumatic events and deal with the by products and accompanying symptoms such as the nightmares and depression respectively.

Relationship Issues

Relationships aren't all plain sailing, they take hard work and will inevitably have their ups and downs. All relationships will go through a stage where everything is not quite as it should be, but the key to solving issues is good communication and knowing when to seek help.

Relationship counselling can vastly improve the way we relate to the people around us, pointing out certain destructive patterns we may have and addressing them whilst improving our communication skills and realising our potential.


Schizophrenia is a brain disorder which affects the sufferers ability to decipher fantasy from reality. This disorder often develops gradually so it may be some time before the individual or their friends and family realise that something is wrong. Dealing with the disorder may be especially difficult for the family as they will remember how the person used to be before the illness.

Schizophrenia can be treated using a combination of various medical treatments such as cognitive behavioural therapy used in conjunction with antipsychotic medicines. Many people respond well to treatment and will never have another acute schizophrenic episode, others are more challenging to treat with symptoms still present and relapses occurring over time.

Sexual Issues

If sex is no longer on the agenda and is suddenly the subject of many a row and sulk then it may be time to address the sexual difficulties in your relationship. All couples will experience stages in their relationships where they don't have the time and energy for regular sex but you need to establish whether or not this is an indication of deeper problems.

If so sex therapy can be helpful for individuals or couples who feel as though their difficulties are beginning to affect their quality of life on an emotional, psychological and physical level.


The term sexuality in its broadest sense actually means capacity for sexual feelings implying it is all about how a person goes about expressing themselves as a sexual being, recent years however, have adopted the term sexuality to describe a persons sexual orientation or preference and it is now a word associated with whether our sexual partners are the same gender as us or different.

Those of us who are unsure of our sexuality, or those of us who have decided but feel our friends and family may not be supportive often find the experience very confusing and at times extremely lonely. There are a number of support groups and counsellors available to help individuals who feel they have no one to confide in and it is with them that you can talk through the complex web of emotions you will be feeling.


Stress is a natural human response to the demands of daily life. Often we can use stress to our advantage, letting it spur us on to complete tasks or push us to the next level, but too much stress and our health can be compromised.

Second only to back issues, stress is a major cause of absence at work and can often lead to the development of more serious mental illness such as anxiety and depression.

There are many causes and symptoms of stress and though it is natural to experience a minor level of stress at certain points if you begin to feel as though it is dominating your life then it is time to seek help.

Visiting your GP will be the first port of call as they will be able to assess the severity of the problem and offer professional advice on what steps you should be taking. Often counselling or talking therapies are recommended and in some cases medication is prescribed.


Deciding to end a pregnancy may be simple for some women but others will struggle with a complex set of emotions heightened only further if they have made the decision not to tell family and friends. In situations of extreme pressure such as this it may be useful to talk the situation through with a counsellor who will be able to help those considering a termination to reach the best and most well-informed choice.

For those who have been through the trauma miscarriage/stillbirth, counselling can be useful to process the grief.

Tourettes Syndrome

Usually appearing during childhood Tourettes Syndrome is a neurological illness characterized by sudden movements which the sufferer cannot control.

Those with minor symptoms will usually not require medication but for those who suffer with more severe tics that inhibit daily functioning, treatment is often needed. Though there is no treatment which can eliminate Tourette's Syndrome there are many options which can help to manage the symptoms. Counselling for instance, may be able to help individuals to cope with any of the additional emotional issues which can be caused by the illness.

Work Related Issues

Though working provides us with a sense of purpose, structure and financial stability it can sometimes cause stress and frustration which subsequently have a knock on effect on our health.

If your job has pushed you to the point where you are loosing sleep and constantly dreading the next day then you should consider seeking help. If there is no one at work you feel you could share your concerns with then another option is to discuss the situation with a counsellor who may be able to help you examine the issue which are preventing you from having a more fulfilling career.

To find a qualified counsellor or psychotherapist visit Counselling Directory.

Therapy Directory is not responsible for the articles published by members. The views expressed are those of the member who wrote the article.

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