My approach to working with individuals
Following an initial assessment period during which we try to figure out the goals and processes of therapy, I offer one of two related services: counselling and/or psychotherapy. Professionals disagree about the precise definition of each of these terms so I will present below my own understanding.
While at times a patient presenting for counselling my end up continuing in psychotherapy, they in general present with more clearly defined symptoms (such as depression and/or anxiety) which can be worked through to a reasonable conclusion in a relatively short period of time. And while they may be experiencing other challenges in their lives their primary concern is to reduce their symptoms to the point where they can resume their familiar routines.
By contrast, patients presenting for psychotherapy may be experiencing more severe symptoms and/or levels of distress combined with difficulties in several areas of their lives. Or they may be struggling with a particular pattern of behaviour, or way of being, which tends to repeat over time, most typically in significant relationships. Another difference is that counselling tends to be more symptoms focused whereas psychotherapy digs deeper into more existential concerns about identity, values, and motivations. Exploring issues in psychotherapy is somewhat akin to the process of tidying a disordered room, where the disarrayed objects are our scattered and conflicting thoughts, beliefs, feelings and behaviours. This being the case, the work of therapy is first to label the contents of our inner world and then to examine how they might come together in a more integrated fashion. However, because the task is frequently frustrated by our resistance to seeing things afresh, even if we understand this is what's required, it takes the combined efforts of both patient and therapist to work through these resistance’s to the point where the patient feels a greater sense of freedom in their life and relationships.