Written By: Lynne Cole – Therapist & Counsellor | Last Updated: July 2023
When you take that courageous step and decide to seek out professional help, it can be hard to choose exactly which pathway is the best one for you. All kinds of therapy have their merits, and some can even be combined to give you the very best service for effective results. Cognitive behavioural therapy, counselling and hypnotherapy are all viable options for treating anxiety and depression, but which is best for you?
Therapy has been utilised to help people deal with a range of mental health conditions, and has a proven track record for delivering great results. Cognitive behavioural therapy (CBT) is a popular treatment option, and can help people dealing with stress and anxiety. Counselling is often chosen to allow people to talk through their problems, as they find it comforting to know that someone is listening. If you’re struggling to decide, read on below.
Counselling; Empathy and Encouragement
Both counselling and CBT are talking therapies and therefore both require communication between the therapist/counsellor and the client. Counselling is mainly based upon listening and offering advice; there’s proof that unloading your worries can make you feel mentally lighter, as ‘bottling up’ is strongly discouraged when trying to achieve a positive mindset. Counsellors help clients reach their own conclusions by allowing them to talk about their problems, providing an empathetic presence.
Counselling is recommended for individuals who are experiencing mild mental and physical symptoms of mental health conditions such as depression and anxiety. It also helps people understand any trauma they may have experienced, and helps them understand why they feel the way they currently do. Some therapists can combine different types of therapy to make them work for the client; if you have symptoms of mental health conditions such as depression or anxiety, therapy is the best choice for you.
Cognitive Behavioural Therapy; Changing and Adapting
A popular option for individuals suffering from long term mental health conditions, CBT is often recommended by GPs for people showing symptoms. There is medication available, but therapy is always recommended as it allows you to develop coping skills that you can adopt for years to come. You and your therapist will work to develop a treatment plan that changes your behaviours and how you approach situations that usually cause distress. You can then implement these skills into everyday life, providing you with a better mindset.
Living with anxiety and depression, as well as other mental health issues, can be stressful, and it’s often tempting to go straight to medication for an easy fix. Therapy can take time, and you may need to keep returning to sessions. It’s a small price to pay for a clearer, healthier mindset, and everyone takes to therapy in different ways. It’s by far the most successful option, and leaves individuals with a tighter grasp on their life. Like all talking therapy, counselling and CBT are all about letting you express your feelings without fear of judgement.
Is cognitive behavioural therapy a form of counselling?
All talk therapies overlap with counselling and are also considered forms of psychotherapy, but different types of therapy vary from the methods of simple counselling in different ways. Psychotherapy covers any form of therapeutic treatment for the mind.
Counselling and CBT are generally considered to be separate, though.
How are CBT and counselling similar?
Both are forms of talk therapy which are used to treat many different mental health issues. Both can be performed over short-term courses of treatment, and involve explaining your issues to a non-judgmental trained professional who can provide an outside perspective and advice about how best to tackle the issues you are facing.
Any information you disclose to either a counsellor or a CBT therapist is confidential unless there is risk of harm to yourself or others, and both types of therapist can work with your GP to provide a medication regimen or refer you on for a different treatment method if necessary.
What is Counselling?
In counselling, you sit with a counsellor and tell them about your problems. They will listen to you and let you direct the conversation. If possible, they will make suggestions for practical solutions, provide a morale boost and encouragement, or just provide a listening ear to let you work out your feelings yourself. It is often very helpful to have your feelings validated by a neutral party in a calm environment.
In my experience allowing yourself time to process emotions can be a way of gaining clarity and understanding.
Advantages of Counselling
Counsellors can provide a confidential and neutral place to talk about problems when you don’t have anyone in your life with whom to discuss them, or are afraid to tell people you know in case they judge you. A counsellor doesn’t know you and can’t tell anyone, and is very likely to have heard similar stories and help you look at them more clearly and accurately.
Counsellors help you to spot patterns in your thinking and discover what causes you to feel a certain way. This is useful for breaking the patterns and forming new habits. For example, a counsellor’s guidance can help you find when and why you’re most likely to snack or smoke, and thus how to stop.
This can all help you track your moods and recognise triggers, and so you will be able to improve and more effectively express your moods. You can also develop better skills in communication, coping, and self-care. Because a counsellor guides you through developing yourself rather than simply telling you what to do, you will develop skills and techniques you can apply on your own when your counselling ends.
Disadvantages of Counselling
One-on-one counselling risks the client becoming too attached to the counsellor and end up relying too heavily on them. This is bad for the professional relationship and raises problems if the client has to change counsellors. On the other hand, not forming a strong enough rapport and trust with the therapist means the client may not listen to them enough or follow their suggestions. Similarly, it might make a socially isolated client more aware of having no one to rely on in their personal life; the counsellor can advise how to make new friends, but this takes time.
While group counselling is better on those points, it can be embarrassing and uncomfortable, as it requires explaining your problems to a group of strangers. This also comes with less confidentiality and less focused attention on each individual.
Who is Counselling suitable for?
Counselling can help with many different types of mental health problem, such as depression, anxiety, and eating disorders. It can be very useful after a major life event, such as a divorce, bereavement, career setback, or stressful relocation. If your social life is limited, counselling can help you expand it and support you in the meantime, and it can increase your self-esteem.
What is CBT?
CBT stands for Cognitive Behavioural Therapy, and involves working with a therapist to challenge negative thought patterns and build positive ones. Sessions are structured and led by the therapist, and focus less on what is happening or has happened than how you think about it.
The theory behind it is that negative thoughts cause negative mental and physical feelings and can make you feel even worse after a negative experience, so you are given techniques to reframe your thoughts in a more hopeful way.
For example, if you suffer from anxiety you might feel absolutely sure your big work presentation is going to go terribly. A CBT therapist can help you to remind yourself of times you’ve done presentations which went perfectly, how well you know the material, and how your coworkers like you and won’t be angry if you do make any mistakes.
Giving you techniques to utilise and challenge your thoughts. When you feel yourself thinking that you are going to fail, you can remember all the evidence that you won’t and replace your destructive thoughts with constructive ones. This can work for any kind of negative thought or experience.
The advantages of CBT:
CBT is good for treating anxiety, phobias, and other conditions based on irrational negative thoughts such as OCD. It has been shown to be as effective as medication in some cases, and makes a good addition to a medication regime.
Courses are often short, and can show significant improvement after only five. Many clients in my experience find the structured system very reassuring and easy to fit into their existing timetables, and a shorter treatment course will also cost less than an ongoing one.
CBT is primarily about building coping strategies. Counselling can do this too, but does not focus so strongly on it. This means that after sessions of CBT you will have methods in place to deal with new problems if they occur in the future.
The disadvantages of CBT:
CBT focuses on changing thought patterns, not behaviours or how you interact with the world around you. If there really is an external problem, such as a bad relationship, replacing true negative thoughts about it won’t solve it.
Similarly, it often doesn’t help with neurodivergence-related issues; for example, autistic people are often nervous in crowded public places, but this is because it physically overstimulates their senses, not because of irrational phobias.
CBT is very structured and short-term, so it works best for simple forms of anxiety and depression, and doesn’t address the underlying causes in as much detail as counselling does. For some people it can be helpful to address past trauma via CBT.
CBT also requires a lot of work and mental focus on the subject’s part, including outside the therapy room. Therapists will usually suggest the client do tasks at home about their thought patterns, which can take time and effort.
Who is CBT suitable for?
CBT is best for those whose conditions are based on irrational fears. Anxiety and phobias fit this well; through CBT, you can remind yourself that the thing you fear can’t actually harm you. Addressing negative thought patterns such as self-hatred can also have drastic results in stopping eating disorders and addictions, and CBT has been useful in managing extreme emotions in many Borderline Personality Disorder sufferers, thus decreasing their self-destructive behaviours.
The key differences between CBT and counselling
While CBT is best for solving internal problems with your thought patterns, such as phobias, counselling can help you through external problems where there may be no simple solution, such as bereavement, instead focusing on how to improve the situation as much as possible even if it can’t be fixed.
Counselling focuses on how you are feeling overall emotionally, while CBT focuses on your precise thought patterns. Counselling is client-led and unstructured, depending on what you feel like talking about, and so it can last a long time, while CBT is very structured and short-term, producing rapid results.
CBT focuses on the present, while counselling can examine the client’s past.
Both help you to prepare for and improve your future.
Which is Right for You: CBT or Psychotherapy?
Only you and your treatment providers can be sure which one will work best for you. Try following our suggestions above, and if the first type of therapy you choose doesn’t work well for you, there is no shame or stigma in trying another to see if you’ll like it better. Your doctor or your current therapist should be able to refer you on to a practitioner of a different type.