Psychological counseling versus psychotherapy

Life always holds challenges that we must deal with and grow from. As the Life Event Scale by Holmes and Rahe shows, both positive and negative life events can have a lasting impact on us and bring us to our stress limits.

Especially when the demands exceed the personal resources and the person does not know how to cope, additional counseling can be useful to strengthen both problem-oriented and emotion-oriented coping strategies.

This does not necessarily mean that psychotherapy is indicated. Psychotherapy is advisable when someone is suffering from clearly defined symptoms with disease value, such as depression or anxiety. Often, sessions over a longer period of time are necessary because the therapist plans and controls the course of therapy based on his expert knowledge after the problem/diagnosis has been established and the goals have been agreed upon.

Psychological counsel

Psychological counsel is usually focused on a specific problem and is therefore shorter. In principle, no diagnoses are made or a therapy plan is created, but solutions to the problem in question are sought selectively or over a short period of time. Psychological counseling is also based on effective concepts as well as a humane, accepting and benevolent attitude on the part of the counselor.

Psychotherapy

Psychotherapy (from the ancient Greek ψυχή psyche for soul, and therapeia for treatment) refers to the “targeted professional treatment of psychological (“mental”) disorders or psychologically induced physical disorders by psychological means.” The procedures, methods and concepts used in this process are influenced by various schools of psychotherapy (psychodynamic therapy, psychoanalysis, cognitive therapy, cognitive behavioral therapy, systemic therapy, conversational psychotherapy, etc.).

However, according to Klaus Grawe – one of my training teachers – one can speak of 5 generally valid effective factors of psychotherapy across all psychotherapy schools.

  • Therapeutic relationship: The quality of the relationship between the psychotherapist and the patient/client contributes significantly to a better or worse therapy outcome.
  • Resource activation: The idiosyncrasies that patients bring with them into therapy are used as a positive resource for the therapeutic procedure. This refers to existing motivational readiness, skills, and interests of the patients.
  • Problem actualization: The problems that are to be changed in therapy are experienced directly. This can be done, for example, by having the therapist and client visit real situations in which the problems occur, or by experientially actualizing the problems through special therapeutic techniques such as intensive storytelling, imagination exercises, role-playing, or the like.
  • Motivational clarification: therapy uses appropriate measures to promote the patient’s gaining a clearer awareness of the determinants (origins, backgrounds, maintaining factors) of their problematic experience and behavior.
  • Problem management: The treatment supports the patient with proven problem-specific measures (directly or indirectly) in gaining positive coping experiences in dealing with his problems.

I also orient myself on these 5 effective factors in my therapeutic work.

Supervision

Supervision (Latin for over-view) is a form of counseling for employees that is intended to encourage reflection on one’s own actions and to ensure and improve the quality of professional work.

Without an external observer (supervisor), who has a neutral view from above on a situation (because he is not involved himself), it is difficult for every therapist to get from the “ground” to the “bird’s eye view” and to keep the overview. To be in direct exchange with the client, to go along and resonate, and at the same time to keep the case conception and the steps and interventions derived from it in the therapy in mind is not always easy. However, it is important and necessary for the success of psychotherapy not to lose the overview and to be clear why you as a therapist do what and when (which intervention when with which goal and for which purpose). The client is the expert for the content of his problem, and the therapist is the expert for managing this process of change. From time to time a neutral view from the outside with an expert discussion is a valuable enrichment and help.

Self-awareness

The term self-awareness refers to getting to know and reflecting on one’s own experience and actions (self), for example in challenging situations.

Self-awareness also refers to the process of training as a psychotherapist, family therapist or coach, in which the prospective therapist or coach experiences the working methods to be applied in the role of the client.

Thus, (individual and group) self-experience is an essential part of the training to become a psychotherapist and supervisor. The training candidate experiences the method and the effect on himself in the role of the person concerned before he applies it to clients. In this way, he experiences associated feelings (hopes, fears) and recognizes obstructive resistances and beneficial mechanisms.

An important aspect of self-awareness is to get to know one’s own sore points and – if necessary – to work through them. Only in this way can the therapist consciously keep them out of the therapy process with the client and remain unrestricted in his role as therapist.

Another important function of self-awareness is the relational experience in the role of the client to the therapist from the client’s point of view: this is later helpful as a therapist for an efficient therapeutic relationship building.

Online versus face-to-face

The pandemic has shown us that psychotherapy and psychological counseling are also effective online and do not necessarily have to take place face-to-face.There are, as for anything, pros and cons to both modalities.

Personally, I prefer a face-to-face conversation to an online session for two reasons: first, I often use my white board as well as other materials I have in my private practice that I don’t always have available digitally. And second, it is easier for me to build a therapeutic relationship with my patient and sense small nuances in interpersonal contact when the person is directly present. Despite all the technological advances, “transmission errors” in both image and voice that are necessarily present when online, are not present in direct contact.