So, you have taken the step of starting to look for support for your wellbeing, but how do you know what therapy is best for you?
Two common types of psychotherapy are CBT and Counselling. So, what’s the difference between CBT and Counselling? Both CBT and Counselling provide a supportive place to explore difficulties. While, both CBT and counselling have the same aim of helping to alleviate distress through the use of a talking therapy, they do this in different ways.
What is counselling?
Counselling provides a non-judgemental, safe space to explore emotions, events, thoughts and past experiences. The goal of counselling is to help you to develop awareness of your difficulties. Counselling uses active listening and open- ended questions to provide emotional support and gives you the space to talk through your experiences. It is a less structured type of psychotherapy. Counselling is highly effective to help with relationship difficulties, interpersonal difficulties, grief and life transitions including divorce and retirement.
What is Cognitive Behavioural Therapy (CBT)?
Cognitive Behavioural Therapy (CBT) is a type of psychotherapy that focuses on the here and now. It does touch on how your past experiences have impacted you but the focus is on your current goals and how to break cycles of thoughts, feelings and behaviours that are causing distress in order to reach your goals. CBT is built on the theory that our thoughts are powerful in creating emotion and are not always accurate. CBT involves looking at thoughts, feelings behaviours and emotions linked to distress and experimenting with different coping strategies to change thought patterns and behaviours linked to distress.
An example that demonstrates how CBT may help is imagine I am experiencing low mood and negative thoughts including 'people are going to find out I'm not really good at this job' and 'I am going to make a mistake and be judged negatively for this mistake'. As a result of believing these thoughts I might also be holding back from putting myself forward for jobs and not sharing ideas for fear of people seeing that I am not really good at my job. Short term this gives a me a sense of relief as people do not get to see that I am not good at my job. In the long term not looking at evidence that I can do my job and acting in a way that gives me less opportunities to see I can do my job will lessen my sense of confidence and my belief that I cannot do the job grows stronger. In the example above CBT may involve looking at whether my thoughts of not being good at my job are accurate and problem solving if they are. It would also look at coping strategies aimed at building a sense of self worth and achievement. For a more in-depth discussion on what CBT entails read here.
CBT is very collaborative and structured. It involves practicing different ways of coping in-between sessions to enable you to practice these skills on your own so you no longer need therapy. This also means these skills become habits and ensures these strategies are tailored to your life.
Qualifications
To obtain the CBT qualification you need a core profession or equivalent experience prior to doing the qualification. This usually includes being a social worker, nurse or OT or having a psychology degree and relevant experience. This is all prior to doing the qualification itself. This means CBT Therapists are highly experienced mental health professionals with a degree and post graduate qualifications prior to even commencing the CBT qualification. Psychologists also have a significant level of CBT training in their Doctorate and are required to have an undergraduate degree prior to starting the doctorate.
If you want CBT check the person you see is qualified. There is a huge difference in doing a course of CBT for a few days versus the minimum year long post graduate qualification in CBT that as mentioned before requires a lot of experience prior to being eligible for the course. You can check a CBT therapist is qualified by using the BABCP registration checker. The BABCP is the body that people practising CBT belong to. This body checks their members qualifications and regularly audits CBT practitioners to check they are keeping up to date and taking part in regular professional development. Ensuring that the therapist/ psychologist you choose to se is BABCP accredited means you can be assured they have all relevant qualifications.
To be a trained counsellor it is not necessary to have a undergraduate degree. Instead their are different levels of counselling qualifications that people obtain together with practical experience.
What does the research say?
National Institute for Health and Clinical Excellence are an independent body who state what the recommended treatments are for different difficulties based on research. The research currently says CBT is a more effective treatment for a range of difficulties compared to counselling, this includes for the following difficulties: PTSD, anxiety, depression, social anxiety disorder, generalized anxiety disorder), panic disorder, phobias, obsessive-compulsive disorder (OCD), eating disorders, insomnia and body dysmorphic disorder. These guidelines are regularly updated so please refer to the guidelines for the latest research. What treatment is best depends on your aim of therapy and current difficulties. Counselling as mentioned before has been found to be beneficial for processing major life changes including grief, loss and divorce.
What to do if I cant decide?
If you are unsure it is best to talk to a mental health professional who will be able to book an assessment where you can discuss your difficulties and decide what is best suited to your needs. Each professional ethically can only work with people they are qualified to work with so they would signpost you elsewhere if they didn’t think they were the professional to best support your needs. An assessment gives you a chance to get a feel fir the practitioner you are working with and by the end you should have an idea of how the therapy will work for you.
Where can I look for more information?