What is psychotherapy, and how does it differ from counselling?

Psychotherapy is a general term used to describe the interaction between a client and a therapist that is intended to alleviate the client’s psychological and emotional difficulties.

Many people use the terms ‘counselling’ and ‘psychotherapy’ interchangeably, however there are some important differences. Counselling is usually shorter in length, and focused on reducing or alleviating a particular issue or problem the client is experiencing. Psychotherapy is more often a longer-term process involving exploration of the client’s history and ultimately a deeper change to the client’s sense of self than merely alleviation of their presenting problem.

How do I know if I need counselling or psychotherapy?

People usually seek out a counsellor or psychotherapist when they are experiencing distress. Often this distress has come from a source - like the loss of a relationship, some sort of traumatic event like being the victim of a crime, or the death of a person or dream important to you.

What kind of psychotherapy do you practice?

Relational psychotherapy

I am trained in a form of psychotherapy known as relational psychotherapy. This is an empathic and relationship-based psychotherapy, which means that growth and transformation for a client comes from the therapist’s ability to empathically understand and engage with the client’s experience so that the client not only comes to know their internal world better but feels known by another human being in a profoundly transformative way.

Some individuals find that their distress is lessened by seeing a counsellor or psychotherapist for a relatively short period of time - the opportunity to express their thoughts and feelings, to be listened to by an empathic and non-judgemental person, and perhaps to get a new perspective on their life, problem and self; these experiences can provide enormous relief.

However, not everyone experiences relief from short-term counselling, and this is perfectly normal and in most cases, expected. Today in Australia short-term counselling has been legitimised as the most effective form of counselling, largely through the Government’s financial support of the Medicare rebate which has historically been for ten sessions of psychological services but was recently increased to twenty sessions (2020 budget). This very much sets up the expectation for clients - as well as practitioners - that an individual’s difficulties can be alleviated in a short period of time. This is often not the case however, and the psychological strategies approved by the Government - mainly cognitive behavioural techniques - have good short-term outcomes, but do not demonstrate longer-term outcomes especially for people with a history of long-term difficulties. That means you might experience some short-term relief from immediate symptoms, but if you are seeking support for an issue you have been dealing with for a long period of time or have a history of trauma, it is unlikely that short term counselling will provide you with lasting relief.

Relational psychotherapy is based on the idea that our sense of self developed from our early experiences of having our emotions recognised by and responded to by others. Individuals do not have to have experienced childhood abuse or neglect for their emotional needs to have not been responded to. There are many circumstances which could lead to a child’s emotions not being seen or responded to, including a caregiver’s own history of not being responded to by their parents, caregiver/s’ mental health difficulties or drug/alcohol abuse, stress in the family including financial stress or the death of a child or grandparent, a lot of children in the home, punitive child-rearing practices, absent caregivers - this is not an exhaustive list.

Children may have been raised in ‘loving’ homes, however if these homes did not allow the child to express their natural self in all their emotional messiness and/or needed the child to be a certain way to maintain the emotional needs of the caregiver/s, then it is likely that child will have cut off or disavowed those parts of themselves that were not responded to in order to maintain much-needed ties to the caregiver/s. This disavowal can cause problems with an individual’s sense of self later in life, experienced usually as emotional distress and then diagnosed by the medical community as mental health disorders.

Relational psychotherapists often work with all mental health diagnoses, from depression and anxiety up to and including psychotic disorders. This is because self-psychologists understand mental health difficulties as arising from the same core problem, and do not need different categories or methods to work with what is essentially expressions of the same core problem.

Psychotherapy with a relational psychotherapist therefore aims at assisting the client with this core problem: the gradual elucidation and integration of emotional experiences that have been previously undeveloped, cut off or denied so that an individual can develop a more full, embodied and whole sense of self that is not reliant on defense mechanisms or coping strategies to survive.

Somatic and trauma-based interventions

In addition to the talking therapy involved in relational psychotherapy, I have additional training in somatic (body-based) techniques that assist clients to become aware of emotions within their body and ways of supporting themselves to experience these emotions. I also have training in Eye Movement and Desensitisation Reprocessing therapy (EMDR, level 2), which can be particularly useful for shifting traumatic memories.

As per the Australian guidelines for Medicare funding under the Better Access to Mental Health Care Scheme, I also utilise a variety of evidence-based modalities with clients, including: exploring cognitions, emotions, behaviours; physiological regulation strategies and techniques; interpersonal communication skill strategies; and, mindfulness.

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