What is the difference between CBT and counselling?

There is certainly some overlap between counselling and CBT, and many people could benefit from either type of therapy. They are both an opportunity to talk to a non-judgemental and supportive person, to better understand your current problems, and to identify strategies to help you problem solve.

You might choose counselling over CBT when the problem in your life is caused by something that can't be changed (like a job loss or bereavement), or when you're not sure whether or how you want something to change (like a difficult relationship in your life). Counselling is particularly recommended for adjusting to difficult circumstances. It can also be helpful if you are not really sure what the problem is.

You might choose cognitive behaviour therapy over counselling when you are working towards changing repeated patterns in your life, and when you know what it is that you would like to change. It focuses on what you can do differently to change how you feel, or to change the impact your emotions have on your life. CBT is particularly useful as a treatment for anxiety, behaviour change and breaking vicious cycles.

What is the difference between psychotherapy, counselling and CBT?

Psychotherapy is sometimes used as a general term to cover all talking therapies, including counselling and CBT. It is also used to describe psychodynamic psychotherapy, which involves uncovering deeper patterns and internal conflict that might be underlying your problems. It is usually longer term and less structured than counselling or CBT, giving the patient the freedom to explore deeper issues that might not be addressed in other forms of therapy.

CBT might use your past experiences to help make sense of your current patterns, but the focus remains on making changes in the here and now. Psychodynamic psychotherapy is particularly useful when unresolved issues from childhood and adolescence get in the way of making changes in your life.

If you are not noticing any changes from CBT and you find that issues from the past keep coming up, it might be worth exploring psychotherapy as an option. If you are currently in psychotherapy and you feel you have understood and processed your past difficulties, but this is not translating into changes in the present, perhaps CBT could help you to make that shift.

What is the difference between a psychologist and a CBT therapist?

The term "psychologist" refers to a therapist's qualification, while "CBT therapist" refers to the type of therapy he or she practices. A CBT therapist can come from a range of backgrounds, like psychology, social work, nursing, or occupational therapy. CBT therapists can be accredited by the British Association for Behavioural and Cognitive Psychotherapies (BABCP), indicating a high level of training and commitment to this particular type of therapy. Some psychological therapists might use aspects of CBT in their practice, but might not call themselves CBT Therapists if this is not the main type of therapy they use.

Psychologists who are registered with the Health and Care Professions Council (HCPC) have usually trained to a doctorate level or equivalent. There are different types of psychologists who specialise in different areas. Counselling Psychologists usually specialise in counselling and psychodynamic psychotherapy. Clinical Psychologists are trained to assess and treat people with a wide range of difficulties, but then tend to specialise in a particular area at the end of their general training. Specialty areas include common mental health problems, long term mental health problems, children and adolescents, health psychology, older adults, and learning disabilities. They will learn a range of therapies and then continue to develop skills in the therapies that are most useful for their particular specialisation. Both types of psychologists can also be CBT therapists.

Which therapy is right for me?

Ultimately it is up to you which type of therapy you try. The decision might be based on the nature of your problems, your personality and preferences, the individual therapist and, of course, time and money.

What is the difference between NHS and private therapy?

Counselling, psychotherapy and CBT are all available on the NHS, and I usually suggest that people explore these options through their GP first. Therapy in the NHS is provided based on national recommendations for treatment, and you should not be offered a type of treatment unless there is evidence that the therapy is helpful for your particular problem. The NHS also works on a "stepped care" system, which means that you will first be offered the least intrusive type of treatment that your assessing therapist thinks will be helpful for you, based on your current problems, psychological history and prior treatment. If what you are given is not helpful enough, then you may be "stepped up" to a more intensive treatment, or offered an alternative.

Many therapists who work in private practice also work in NHS services, and so one is not necessarily "better" than the other. The decision to have therapy privately could be for any number of reasons. Sometimes it is more practical or convenient to choose your therapist, time slot or location. Some people want more support than is offered under the NHS, are put off by waiting lists, or prefer the style of a particular therapist. If you are unsure, it is probably worth speaking to your GP to find out what is available in your area. If you have limited options, then you may decide to have therapy through private practice. This may give you more flexibility to find the therapy - and therapist - right for you.

Some NHS services don't require a GP referral. If you are looking to access CBT for depression or anxiety through the NHS, find your local IAPT service here.