The varieties of counselling

All the branches of psychology stem from one root, so there is considerable overlap between them. Each type can have a specialty, such as children, families, couples, trauma, addictions, gender issues, and so on. They can also favour one type of therapy, such as hypnosis, CBT, EMDR, emotion-focused, etc.

In every case, you can find the good, the bad, and the downright dangerous. Think Silence of the Lambs, for a worst-case scenario involving psychiatry. Some counsellors and coaches will go out on a limb, honestly thinking they can help someone, but then make things worse. Depression is a good example: many counsellors do not realize that having someone simply talk about their depression, makes it worse. Same for trauma. It isn’t just talking that cures. Or these days, an increasing number of people offer psychedelic sessions as the sole therapy; again, simply taking a drug won’t cause a lasting change, no matter how fantastic the drug. Psychedelics, taken after a good preparation, and followed up with integration sessions, can be healing, even transformative. (read more about psychedelic therapy and psycho-spiritual problems here).

Psychiatry: This is the medical branch. Psychiatrists are medical doctors and can prescribe medication. Many seem inclined to simply diagnose, medicate, and follow up later. Some are fabulous clinicians, taking the time to engage in therapy, often of the psychodynamic variety, and in collaboration with other professionals such as social workers, police, other counsellors, family doctors and hospitals. Because their services are free of charge in BC, waitlists are long, and they tend to serve the needs of those with the most serious and troublesome mental illnesses such as psychosis, major depression, and personality disorders.

Psychology: This is a protected title in BC, they are regulated by their association, and psychologists usually have a Doctorate degree. The better-trained ones (it depends on the university they attended) are adept at diagnosis, sometimes administer diagnostic tests, and use a variety of therapeutic tools and styles. They typically have had excellent training and supervision, in addition to theory. They also tend to cost more.

Transpersonal Psychology: This is a branch of psychology that delves as deeply as possible into human nature, to assist people to not only heal, but to transcend normal limitations of human experience, and encounter states of consciousness that result in the transformation of the individual. Holotropic Breathwork, shamanic methods, hypnosis, dreamwork and hallucinogens are some of the tools used. Jungian Analysis has a transpersonal capacity, whereby a person can be guided (over a considerable time) into a more complete individuated state of wholeness whereby you are no longer plagued by disjointed and contradictory aspects of your “self”.

Psychotherapy: This is therapy for the soul (psyche) practised by psychologists, but also by a good counsellor. Usually, it involves some deeper, more serious and complex issues that built up over years, and are intertwined with addiction, relationship problems, childhood trauma, mood problems, etc. It usually takes more time than coaching, but skilled (or, alas, unskilled) “counselling” can also take a similar amount of time, even though it isn’t called “psychotherapy”.

Everything else is a also branch of psychology, but the professionals usually have a Masters’s degree in clinical psychology, counselling, or social work. Or a college certificate, or sometimes nothing from a recognized educational institution. Only psychiatry and psychology are “protected titles”, meaning that anyone else using those titles without permission is breaking the law. In my case, for example, even though I was (and could still be) a member in good standing of the Order of Professional Psychologists of Quebec, I am no longer a member, so I cannot call myself a psychologist. Each Province has their own regulations. Literally, anyone can say they are, say, a “therapeutic coach”, or “counsellor”, or “mental health therapist”, and advertise their services.

One of the great central skills involved in counselling is the ability to listen, empathize, and make people feel comfortable. Those skills come naturally, and education can improve on those skills, but only to a point. So many people are fantastic helpers, just by their ability to listen. If you just want somebody to talk to, then a good friend, or an older person, or even a tree, might be just the ticket.

Counselling: The BC Association of Clinical Counsellors is the organization that tried to keep Registered Clinical Counsellors educated, aware, and properly insured. They advocate with the Province for us to also be a regulated profession, like psychologists. Counsellors can provide a wide range of services, and use a wide range of tools depending on their education, training, and experience. It is all applied psychology. Training refers to the amount of practical (not books), supervised learning they did, to hone their craft.

Coaching: This is a brilliant innovation, that took some of the best tools of psychology, stripped away the jargon and images that encumber psychology, and re-packaged it as “coaching.” Coaches tend to use strength-based, behavioural, and bits of solution-focused psychology. Decades ago, before “coaching” existed, I would often tell clients, “you can think of me as a coach, helping you set your goals, and stick to a plan to get there.” It helped people understand my role, and what to expect, because the role of “coach” is well understood in the sporting realm. Coaching works well for a great variety of issues, especially related to improving work or family life, lifestyle changes, and the last stage of healing addiction. Many qualified counsellors and even psychologists abandoned their “counsellor” or “psychologist” label, in favour of the “coach” label. I recently came across someone touting “therapeutic coaching” as their thing.

Hypnotist: Hypnosis is an excellent and under-appreciated tool for healing and change. Hypnotists can be trained at any level of education, from a medical doctor, to self-taught (in this case, that usually means “having a fool for a teacher”), and everything in between. They tend to treat specific issues such as smoking cessation, weight reduction, and lifestyle change. Look for someone who is a member of a major association, such as the American Society of Clinical Hypnosis. Eriksonian hypnosis is based on the insights of the greatest hypnotist ever, Erik Erikson. He was a medical doctor who pioneered techniques of hypnosis that are unsurpassed to this day. Hypnosis is best used, in my opinion, when naturally woven into the therapeutic or counselling process, as needed. I have written a separate article on hypnosis.

Others: Any other label or service offered to help people with mental, emotional and relationship problems can fit into one of the categories above. For example, “play therapist”, “music therapist”, “behavioural counsellor”, “clinical counsellor”, “clinical therapist”….all will have some overlap with one or more of the above categories. The key thing is the see what education and experience the person has. What they call themselves is not that important. Even more important, is how you “click” with them in the first few seconds and minutes of meeting them. If something is off-putting right from the get-go, then there is an obstacle that may or may not be important, but which will have to be addressed.

Without going into the history of psychology, and all the types of therapy, the above sums it up in a tidy package that can help you make a decision.