Melbourne trauma psychotherapy

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

Psychotherapy and psychology are two different disciplines which have as a central focus the alleviation of a person’s psychological and emotional distress. However, their philosophy, approach, and treatment strategies are different.

Psychology is founded on the belief that an individual’s current distress – and mental health symptoms – arise from problems with an individual’s thoughts and behaviours. Strategies that psychologists deploy therefore attempt to change an individual’s thoughts and behaviours. This is the fundamental approach behind cognitive-behavioural therapy, and various other psychological modalities, such as dialectical behaviour therapy, and acceptance and commitment therapy (although these last two incorporate additional approaches, such as mindfulness). In psychology, emotions are thought to be by-products of thoughts, and thus emotions are not the primary focus of a psychologist’s interventions.

Psychotherapy – or sometimes called psychodynamic psychotherapy – is derived from psychoanalysis. It has as its primary principle the idea that the unconscious is central in the cause and perpetuation of our current psychological and emotional difficulties. Psychotherapists therefore focus on understanding early emotional and relational patterns formed in a person’s life (e.g. attachment history and traumatic events), in an attempt to understand how these experiences have shaped an individual’s sense of themselves, their coping mechanisms, and their defense strategies. These insights can then be used to support individuals to process early trauma, bring awareness to their unconscious feelings and patterns, and create change in their lives. Emotions are a central aspect of work in psychotherapy. Psychotherapy therefore offers clients an in-depth approach to self-awareness and change, beyond a model of self as ‘thoughts and behaviours.’

What is the difference between counselling and psychotherapy?

Many people use the terms ‘counselling’ and ‘psychotherapy’ interchangeably, however there are some important differences. Counselling is usually shorter in duration (e.g. six to twelve months), less frequent (e.g. fortnightly), and is focused on reducing or alleviating a particular issue or problem the client is experiencing. Psychotherapy is a more frequent (e.g. weekly), and longer-term process involving exploration of the often unexplored themes from an individual’s past that continue to unconsciously effect them in the present day. Through psychotherapeutic engagement with these themes, a deeper change to the individual’s sense of self is possible.

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 important dream.

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 mental health sessions through the Better Access to Mental Health Care Scheme, which has recently been reduced to ten sessions of psychological support (after the temporary increase to twenty sessions, between 2020 and 2022).

This sets up the expectation for clients – as well as practitioners – that an individual’s difficulties can be alleviated in ten sessions of support. However, this is rarely the case. Not only are contemporary research studies demonstrating individuals with complex or trauma-based histories require over ten sessions of support to achieve improvement, but the frequency and duration of sessions required to demonstrate this improvement are higher than what is currently covered by government rebates (e.g. improvement requires twice weekly sessions, and/or sessions of 90 to 120 minutes duration; see Boterhoven et al., 2020, and McDonagh et al., 2005, for examples). This sets up a contradiction for government-funded, mental health support in Australia: the cognitive-behavioural treatments that the government funds have been established as effective based on research that stipulates more and longer sessions are required that what is actually funded, for measurable or observable improvement to occur. (For a separate discussion of the criticisms of cognitive-behavioural treatment, see Shedler, 2018.)

Therefore, it is often the case that individuals who are experiencing distress will require more than short-term counselling, especially if they have experienced traumatic events. Psychotherapy is an appropriate choice for these individuals.

To find out more about the kind of psychotherapy I practice, my areas of specialty and interventions I utilise, please visit my ‘Specialties and approaches’ page.