The Psychology Service
Counselling or CBT

Given that skilled Cognitive Behaviour Therapists tend to be in short supply, we are sometimes asked whether it would be just as helpful to refer a client to a Counsellor rather than a CBT Therapist. However it is very important that a client is referred for the right sort of therapy for their particular needs.

The main differences between a Counselling and CBT are outlined below.

Counselling

What is the approach?

The approach a Counsellor adopts tends to be “non-directive”, i.e. not offering advice or specific help in overcoming symptoms, but more supporting the client in talking through their problems and coming to their own conclusions how best to deal with them.

What is it used for?

Counselling can be helpful where the client has mild problems such as mildly low mood, and mainly needs support to come to terms with something that has happened to them. It is not effective, however where there is a psychiatric illness or specific symptoms such as panic attacks, significantly depressed mood, phobic anxiety or symptoms of PTSD such as flashbacks or nightmares.

What is the training?

The training of a Counsellor varies between one and two years. For there to be any guarantee of the quality of training and experience, the Counsellor should be accredited with the British Association for Counselling and Psychotherapy (BACP) or the United Kingdom Council for Psychotherapists (UKCP).

CBT

What is the approach?

The basis of CBT is that what people think affects how they feel and also how they behave. CBT practitioners work jointly with the client to help them identify and change unhelpful thinking patterns and behaviour. The approach is very directive and focussed, with agreed goals for therapy. The client usually undertakes “homework” tasks between sessions to address their problems in a practical way.

What is it used for?

CBT has been scientifically evaluated and shown to be effective for a wide range of conditions. It is suitable for clients with more significant problems, and those who have specific symptoms such as Phobias, nightmares, Depression, Eating Disorders etc.

What is the training?

CBT Therapists can come from a range of different backgrounds such as Clinical Psychology, Counselling or Mental Health Nursing. Clinical Psychologists are trained in CBT as part of their post graduate training. Other therapists complete advanced training in CBT following initial training and experience in their own profession. Once sufficiently experienced, they can become accredited as a CBT Therapist through the BABCP.